Barbell Shrugged - Performance Brain Health Part 2 with Dr. Tommy Wood, Doug Larson, Travis Mash & Dr. Mike Lane #839

Episode Date: March 11, 2026

In this episode, Dr. Tommy Wood returns to Barbell Shrugged for part two of a deep conversation on brain health, cognitive decline, and the daily habits that shape long-term mental performance. Joined by Doug Larson, Travis Mash, and Dr. Mike Lane, Tommy unpacks why oral health matters far more than most people realize, explaining how gum disease, oral bacteria, and chronic inflammation may contribute not only to cardiovascular disease but also to dementia risk. The crew also digs into the importance of sensory input, from hearing and vision to social interaction, and how losing those inputs over time can quietly accelerate cognitive decline. The conversation then shifts into sleep, where Tommy breaks down what actually matters most for protecting the brain. Rather than obsessing over perfect sleep scores or chasing an arbitrary eight-hour target, he argues that the biggest levers are sleep opportunity, regularity, and avoiding behaviors that wreck sleep architecture. The group explores the different roles of REM and deep sleep, how sleep supports emotional processing, learning, and metabolic cleanup in the brain, and why wearables can be useful for trends without being trusted too literally. They also cover naps, alcohol, caffeine, common sleep aids, magnesium, chamomile, and why worrying too much about sleep can itself become part of the problem. Finally, the episode broadens into brain risk and brain resilience in the modern world. Tommy highlights major risk factors for cognitive decline including hearing loss, high blood pressure, diabetes, smoking, obesity, alcohol, air pollution, and toxic exposures like lead and other environmental contaminants. He also gives a nuanced take on technology, arguing that video games, digital tools, and even AI can be either brain-supportive or brain-eroding depending on how they are used. When technology expands your capabilities, it can sharpen cognition. When it replaces thinking entirely, it can weaken the very skills you are trying to preserve. This episode is a practical roadmap for anyone who wants to think more clearly, age better, and protect their brain with smarter everyday decisions. Links: Doug Larson on InstagramCoach Travis Mash on Instagram

Drug family, Doug Larson here, and today on Barbell Strugged, we got Dr. Tommy Wood back on the show for part two of high-performance brain health. You probably heard me say this. Every time we interview Tommy, I tell him he's one of my favorite guests because he is. A super interesting guy, and I always learned a ton when I talk to him. I have a very strong interest personally in brain health and performance, and I don't want to be a person that gets Alzheimer's or dementia ever, but it's certainly not early in life like I have seen.

It's a painful thing to watch, and it would certainly be a painful thing to go through, and I want no part of it. So Tommy's back on the show. we talk about a bunch of interesting things. We talk about oral health and dementia. We talk about why hearing loss and social isolation can contribute to cognitive decline. We talk about sleep and what it really does for memory, recovery, and emotional regulation. And we also dig into a very important question around to what degree technology and AI are impacting our brain,

which seems to be a big concern right now from people in the world. So if you are interested in cognitive performance, clear thinking, you want to minimize cognitive decline and be healthy mentally as you age. This episode is for you. Enjoy the show. Welcome to Barwell Shrug. I'm Doug Larson here with Coach Travis Mash and Dr. Michael Lane and Dr. Tommy Wood. Back for Part 2, brother.

We were on her about a month ago and we covered many things related to brain health, but we got to the end of the show and we were like, man, we have so much left to talk about. We also met over the weekend in Vegas, finally, after many years. Yeah, it was great to finally hang out and I'm excited to be back. Yeah, hell yeah, brother. We covered many things nutrition. and many things training. Early on to dig in.

We got sleep, we got stress. We have a handful of other topics. What other topics do we not cover on the first show that you want to touch on here? Yeah, I think there's a few other things that are worth thinking about. So obviously, I've got this new book coming out. A lot of the kind of the ideas that how we use our brains determines how they function. So we can say to talk more about what actually stimulates the brain, how we interact with technology, but also think about, yeah, sleep, stress, other risk factors for cognitive function, cognitive decline, like air pollution, like microplastics are having a moment, dental and oral health, super important. I would like to know more about that.

the gentle, like, that's, you know, fascinating that your teeth are so, I mean, obviously, they're important, but. That's like an inflammation issue with people that don't floss and that type of thing. Yeah, yeah. So that's essentially what it looks like. There have been a couple of things that the poor all health have been tied to. So dementia risk, but also cardiovascular disease risk, and maybe those two things are linked because we know that heart health and vascular health directly affects the brain.

So probably more than two decades ago, they found gut back. bacteria from the mouth, so particularly porphromerunus gingervalis or pea gingervalis, and then there are other bacteria. So when you get a dysbiosis in the mouth, you have dental disease, things like strep mutants. You can find them in atherosclerotic plaques in the heart. So they're like getting into the, getting into the blood from like an inflamed, um, uh, inflamed gums. And then they might be triggering, uh, like the processes of injure.

and atherosclerosis in the blood vessels. There were also some studies where they found these bacteria in the brain in like amyloid plaques in individuals with Alzheimer's disease. So there's a few things that are thought to happen. First of all, you get this dysbiosis in the mouth. So what we call then gingivitis, right? That's an initial kind of inflammation of the gums. If it continues to progress from there, it becomes periodontitis.

It can start to affect the bone underneath. underneath. And then because of sort of like the inflammation and damage that's happening in the tissue there, those bacteria have direct access to the blood supply. And so there's the direct inflammatory response. We know anything that's causing significant systemic or local inflammation can affect the brain. We know that any time we get an injury or an illness, right, we feel kind of a bit foggy and not great. And right, that's just the effects of inflammation on the brain. So this can have like a long-term chronic effect. And then, the bacteria can also invade the body and have more direct effects.

There was one study that found that individuals that had higher antibody responses to some of these bacteria, like P. Gingervalis, had a higher risk of dementia that was from the Enhanes cohort in the US. And there are some studies that suggest that if you have your parodontitis or your gum disease treated, that then decreases your risk of dementia. So we kind of see the evidence from multiple angles, all just to say that, you know, you should, brush your teeth, you should floss your teeth, you should get any dental disease treated. And then one sort of interesting part of this could be using things like xylitol gums or xylotol mouthwashers. Zylitol can help to like rebalance the microbiome of the mouth without negatively impacting it.

So when you compare this to other types of mouthwash like alcohol-based or claw-hexstein mouthwashes, these can actually have a negative impact on cardiovascular health because what they do is they kill nitrate reducing bacteria that sit in the back of the throat that produce nitrates from nitrate in the diet that then causes our, you know, it contributes to nitroxide, which you know is really important for like blood vessel dilation and blood pressure. So you can actually increase people's blood pressure by giving them these other types of mouthwash because it kills these bacteria that are really important for regulating blood pressure. So that was just like a whole bunch of like a fire hose information about the mouth. So like where do you have any questions or any

followers? Sure. So say you say you're flossing and like your your gums are bleeding. Is that like it's just like a sure fire sign like the most tangible way to see that like there's there's now an obvious path for bacteria to get into your bloodstream? Yeah. Essentially that's that's a good indication that you have some kind of some kind of gum disease. That stuff can reverse fairly quickly. Most people, if you floss regularly, initially if your gums are bleeding, that will start to settle down. So like this is, hopefully you're going to your dentist every six months or so, and this is the kind of thing that they'll track and they'll track like pocket depth around the teeth, like gum recession, that's part of kind of this periodontysis process. You can get,

You can do like a really deep clean, so SRPs scaling and root planing that will kind of like get rid of all the plot, kind of clean beneath the gum line. And for most people that will get you get most of the job done. But then it's just like staying on top of that regularly using interdental toothbrushes or water picks or something like that, just like really make sure that you're kind of cleaning stuff out from between the teeth. And then just, you know, anything else that you might need just to kind of prevent or reverse any disease that's going on. Yeah, dude, I'm all about a water pick these days. Like, I've had it having for many years. And when I don't have it, I'm like, I miss it, so to speak. Like, I love you.

Like, I hate flossing my teeth, but I love using a water pick. I do them both. Like, I water pick in the morning and floss at night. And that's like my typical routine here. But for those of you out there that haven't heard of a water pick, I highly recommend. It's like, it's like water pressure that squirts, you know, at high pressure right between your teeth. So it's kind of like water flossing. It's like water flosser.

Yeah. I like the interdental toothbrushes. like there's those little like kind of mini circular toothbrushes that you can kind of like get in but all the teeth and sort of like scrub them that way but like all of these things will will will help do the job so a pipe cleaner type situation it looks exactly like a little pipe fleeting yeah i mean i'm from missouri so there's a lot of easy jokes to make about dental hygiene and why it's called the toothbrush not the teethbrush um what is your thoughts on the frequency of flossing like i really like to do that for these effects yeah i mean i'm i mean i'm british so i

understand that like I'm telling you about dental health and I'm a Brit. So like I get it. I'm not talking about orthodonture. It's a different thing. Like at least at least once a day. Like particularly, right? If you haven't, it makes less sense to do the flossing in the morning because you haven't like accumulated as much as much stuff.

I think though like most would say you floss two or three times a day, but at least one a day, I think is and then brushing, brushing twice a day if you can. There's some evidence that two minutes, twice a day is sort of like better than, certainly better than less frequent than that. Yeah, at the beginning to show you, you mentioned risk factors. I'm not sure we touched on that in a fully comprehensive way on part one here. What are the most significant risk factors for the potential for cognitive decline? Yeah, so probably the best way to, or least the most evidence-based way to,

to think about this is based on a framework that was published by the Lancet Commission on Demention Prevention, which is run by Professor Jill Livingston. And they basically, they're the ones who estimated that 45% of dementias may be preventable, if we like completely eliminated the risk factors that they mention. I think that because they actually don't mention sleep, they don't mention nutrient status, they don't mention late life cognitive activity, which I think we have some good evidence for, which is why I think that 45% may be a bit conservative. But the things that they mention in their framework,

some of the two biggest are early life education. So the higher educational attainment, the lower your risk of dementia, or if you're diagnosed with dementia, you're diagnosed with it later. And then hearing loss, I think those are two, those are the two biggest ones.

And then that, I think that fits into the bigger picture of sense, sensory loss. We know that if you lose your eyesight, you'll lose your hearing, that not only changes inputs to the brain that can affect cognitive function, but also changes how we interact with the world, right? We feel less comfortable, less able to go out and meet people and spend time like out in the world the way we did previously. So we're removing multiple sort of social and other cognitive inputs. So there's some pretty good evidence that hearing aids for hearing loss decreases the risk of dementia, particularly in those who are high risk. Cateract surgery

for people who cataracts decreases is associated with a lower risk of dementia. Then other things, these are sort of like all kind of a similar level, sort of like one to four percent of dementias potentially tied to brain trauma, smoking, alcohol, obesity. We're trying to think of, I think those are the biggest ones compared to the other two that I mentioned, anything else that I didn't say. Oh yeah, high high out, so high cholesterol, so high cardiovascular disease risk. That's another big one.

High blood pressure. Yeah. And then types diabetes. So I think that that covers most of them. Yeah. Well, that's really interesting. I never really thought, I've never really thought too much about having, being blind rather and or being death.

Or just like losing any one of your major senses as being something that would, that would increase the likelihood for cognitive decline simply as a consequence of you're just interacting not just for the fact that you're not using that part of your brain anymore so to speak but the fact that you're just out interacting in the world less and less and less and less and so like the amount of stimulus and the input it just affects everything down the line and then as a result you're using your brain less in many ways which contributes to the downfall so to speak. Less data input.

I mean. Yeah. And then I kind of wonder when it's a traumatic loss of vision, you know, you know, because that obviously happens. Is that a different outcome, obviously, than a gradual? Because it's a slow cessation of signal. Or like people that obviously are born without hearing, without sight, if they probably don't have the same risk factor because they spent their entire

life honing it on the other senses. Yeah. So that's a great and very important distinctions. Dr. Andy Galpin here. As a listener of the show, you've probably heard us talking about the RTA program, which we're all incredibly proud of. It's a culmination of everything Dan Garland and I have learned over more than two decades of working with some of the world's most elite performers,

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physically and mentally, when the stakes are the highest. To learn more, visit artaelab.com. That's A-R-E-T-E-Lab.com. Now, back to the show. So people who are congenitally blind, right? So they're born without sight. They do not automatically have an increased risk of dementia. And I don't have the perfect kind of trials to say why,

but I think it's because they learn how to interact and spend time with the world. in other ways, right? So they, right? So it's much more about losing inputs that you adapted to, be they sensory or social or whatever, rather than needing those inputs to begin with. So then similarly, right, if early in life

you have a traumatic or some kind of injury that results in a loss of sight, if you then adapt around it such that you find new ways to interact with the world and you're still getting social inputs all these other things, then I think that's much less of a risk factor than in the processes of aging, you lose your sight. And as you do that, you slowly become more and more socially isolated, like less and less physically active because you don't feel confident, like interacting with the world in the same way. I think those are two very different scenarios. And it's the latter one where we

really have better evidence that finding some way to reverse that sensory loss then reverses all these helps to mitigate some of that dementia risk. Do you know if there's any correlations or even causation for people that are highly extroverted and just like the number of conversations that they are in throughout their life is 100x, someone who's like exceptionally introverted or shy or timid or what have you? Yeah. So there was this massive meta-analysis that was published a year or two ago that looked at the big five ocean of personality traits and their relations to dementia risk.

And every, so like when you think about openness and some of these other sort of, and conscientiousness, some of these more sort of like slightly more extroverted type personality traits, they were associated with a lower risk of dementia, whereas neuroticism was associated with an increased risk of dementia. However, when we think about how people interact with the world and what it takes for them to feel socially connected, and not lonely, it's very different from person to person. So I think the most important thing is that if you have the social connections

that allow you to feel safe, secure, somebody's available to help you if you need it, you know, you can talk to people about things that are important to you. Then I think you've probably ticked all your boxes and for different, whether you're on this sort of introversion, extroversion kind of scale,

as long as you feel like you're getting all the social contacts that you need or benefit from, I think that's probably enough. When you're thinking about some of these personality traits, I think some of them are maybe indicators of like, are you going out into the world and like interacting with people and getting kind of stimuli and that kind of stuff. But equally, they change over the lifetime

and they change based on our health status. So in this kind of big, in this big metanalyst, they were careful to say it's not like if you're more neurotic, you're going to get more dementia automatically. It's that sometimes if you have, some kind of chronic health condition, some kind of inflammatory state. We know that affects our mental health. We know that can affect personality.

That might increase neuroticism. And then it's like it's the underlying condition that's changing personality and is changing dementia risk, right? It's a correlation rather than a causation. So I think some of this might be just a signal of other health-related factors that can affect how we interact to the world that are then also affecting dementia risk. So introverts aren't automatically at a greater risk, right? as long as they feel like they have the level of social contact that sort of makes them feel fulfilled.

So it's all about if we're reaching our expectations or like our kind of automatic set points, if you're super extroverted, like you require 20 conversations a day or whatever it is. And if you're super introverted, you only require three conversations today. And if you can get to those numbers, like as an individual with those preferences, then it's more or less the same thing as long as you're hitting capacity. Yeah, yeah, exactly. And so you kind of see that from when, from the studies that look at, social contacts and like loneliness and risk of dementia, it's, you know, do you feel well supported?

Do you have, you know, do you have any kind of frequent social contact? Do you live with a partner or do you live with somebody else? Actually, doesn't need to be a human. There's data on pets, particularly dogs, decreasing the risk of dementia. And so it's just like, are you having contact with other beings in a way that allows you to kind of feel like you're, yeah, you're feeling your bucket in the way. that you you make you feel good yeah when I was younger I used to think stuff like that was kind of silly like the like the interacting with the dog thing but as I've gotten older like I feel like there's I don't know I don't know how to explain this but I feel like there's something to it so to speak

that I didn't recognize when I was younger yeah yeah me too I never had dogs growing up but now I could like never never live without them and there's like super interesting data on like there's HIV coherence between dogs and dogs and their owners like when they spend time so you can like see their HIV move together based on who's stressed and who feels good. There's like microbiome stuff. It increases like pro-social behavior, which for humans is a really important contributors to health and well-being. So there's a bunch of cool stuff.

Actually, so in my book in the second to last chapter where I kind of talk about how like all these different factors that affect brain health kind of come together, I have this picture. It's like an engineering systems picture of how a dog can affect your health. to kind of help people understand how just like getting one thing changes a whole bunch of things. I use a dog as an example because I think that's a really, the thing, that's a really good one. So what you're saying is my entire, we'll say, tin foil had idea that dogs are like their owners. Every time I meet somebody who owns a chihuahua or another type of high anxiety animal,

it's like, oh, I mean, they've got a low archer, HRB dog. Obviously, that's why they're always stressed out. I mean, dogs are like their owners and vice versa. So there is some, there is some truth of that. Plus, they do share microbiomes. So if there's a kind of like a gut brain connection, which we know there is, and we know that what's happening and your gut can affect your brain to some extent. Like, that could be one of the mechanisms.

I don't think we would say, like, definitely. But people have talked about that and they're looking into that as a potential way that sort of dogs and humans can influence each other. I'm definitely curious about sleep. You know, Doug mentioned it early. So like, especially we're a few of sorts of. doing some new research, you know, I don't know if I'm even supposed to talk about it, but, you know, we're looking at some more data on sleeping.

I'm curious, how does that affect cognitive? Of course, it affects it, but in what ways? Yeah. So, like at the big picture level, you definitely see that consistently not sleeping enough is associated with a higher risk of cognitive decline dementia. And that threshold is probably lower than you'd expect. it's like usually around six, it's usually around six hours a day.

If you're consistently sleeping less than six hours, that's where you see a significant increase in the risk of dementia. And like the kind of window for enough sleep across the whole population is quite wide. It's probably like six to 10 hours. So I definitely have a problem with people going around and saying like you have to sleep eight hours.

Like everybody has to sleep at least eight hours. Because I don't think the data really support that. Plus there's what you can do when you create these kinds of expectations. And it's the same when somebody's going around saying, or you need to do at least four hours of Zone 2 exercise a week or else it doesn't make any difference. It doesn't matter.

We know that's not true. If you're doing nothing and you do 30 minutes of walking, right, that's great. We know that has an effect. But if you're somebody who's sleeping six hours a night, and I tell you have to sleep eight hours or else it's going to negatively impact your brain, and you're like, well, where am I going to find two hours?

I just physically can't do it. There's a good amount of data to suggest that the time you spend worrying about the fact that you're not doing enough will actually negatively impact your health more than right the the fact that you're not sleeping enough so oh yeah yeah to a certain to a certain extent but like sleep is obviously critical like what happens when you sleep is that like so particularly REM sleep and and deep sleep they synergize um to cement the the synapses that we've made during the day based on the things that we've learned and the things we've exposed ourselves to. REM steep and particularly is really important for like emotional processing.

And so like that kind of resets and kind of optimises the connections in the brain so that we can go out the next day and kind of learn again and interact with people again. We know that during this period of time where you activate the glymphatic system, you start to clear out metabolites that have accumulated during the day. So with hard cognitive work, we accumulate lactate and glutamate and acetate and these other things. Adenosine that can impair our ability to do hard cognitive work. So we need to sleep to kind of reset that system. The glymphatic system helps to wash out proteins that accumulate during the day due to neuronal activity like amyloid.

And your sleep deficit over your life kind of predicts partly how much amyloid accumulates in your brain, which we know is a risk factor for dementia as well. And then other really important stuff like, if you don't sleep properly, then the next day you're less empathetic, you're more likely to interpret other people's actions as negative. This can then compound over time because it affects your relationships,

it affects your colleagues at work, right? Which we know are gonna be really important, sort of for long term, you know, both just like getting the work done, but then also in terms of our social contact. So like sleep is really critical, across all these different functions. And if we think about the fact that stimulus is maybe the primary driver of brain function,

just like with physical function, stimulus drives adaptation, but that adaptation happens when you're resting and recovering. And the brain is really the same. It's just that we've almost gotten to a point where we're sort of so overcome with data about sleep and wearables and things that these are starting to negatively impact our sleep and make us stress

again. So the only thing that I try and remind people is that you're not always going to sleep perfectly. If you're doing a good job of like hitting the bases most of the time, you will perform just fine if you didn't sleep well. Like there's good data to support that. So just like, yes, a regular sleep habit is critical, but if we get in our heads about our sleep, it can almost like cause more more harm than benefit. So so for some people like the the pendulum is swung a little bit too far in the other direction. What about deep though? Like we mentioned rim but like what's happening when you get deep sleep and like I'm and like I don't want to like you now you've got me freaking out about over analyzing but just curious. Like how much rim and how much deep sleep should

well let's analyze this as thoroughly as we can. Okay. Not that I'm going to worry about it. So during deep sleep, some things that we know, and like some of this has to come from animal studies, but we know that whereas in REM sleep, sort of disparate ideas are kind of brought together. And that's where you do like emotional processing in deep sleep, particularly when you've done some kind of learning. So like the studies they've done in animal studies has been like motor skill learning. During deep sleep, the areas of the brain that were activated during motor skill learning, get reactivated. And in that reactivation,

you're kind of strengthening those synapses. And then the synapses that get reactivated during deep sleep are kind of optimized during REM sleep. So deep sleep and REM sleep kind of synergize in that way. Then deep sleep is where there's maybe more activation of the glymphatic system, though the glymphatic system does kind of expand in general during sleep. And some of this also has a circadian timing. So the body and brain kind of get ready for sleep on a circadian rhythm.

And this is why sleep regularity is maybe one of the best predictors of like cognitive and health outcomes. Because early in the night, you tend to get more deep sleep. And later in the night, you tend to get more REM sleep. And it's almost like the brain expects deep sleep to happen at a certain time of the night. Right. sort of, for me, it's going to be like 10 p.m. to 1 or 2 a.m. Right, that's where most of my deep sleep is going to happen. And my body is kind of expecting that and then it expects more REM sleep later at night. And there are some studies like with nap studies. Like if you nap during the day,

the deep sleep has less of a deep sleep like benefit because it's not happening at that time when it's kind of like times your circadian rhythm. So that doesn't like, you should still nap if you need to nap. We know that can improve athletic before. and cognitive function if you're sleep deprived. But all of those things kind of come together based on, you know, the different mechanisms that are happening when they're happening and when the body sort of expects them to happen. You're on the on the topic of napping for you know if for societies where they

have like a siesta so to speak like where you know they sleep six or seven hours a night and then then after lunch they kind of systematically go down for a nap for 30 to 120 minutes for 30 minutes to two hours. hours. Do those societies have any differences in the rate or population level, Alzheimer's, diagnoses, etc? I don't think so. At least I haven't seen that. I think in general, just because of how difficult it is to get high quality data, in general, you just like, if you just add up how much total sleep they're getting and you compare that to other societies where you just tend to get it all at night, it's probably roughly, it's probably roughly equivalent. We may get to a point

where you can really break that down in terms of like sleep stages and different contributions and timing, all that kind of stuff. I don't think there's any study that has high enough quality data to look at that. In particular, so it's interesting to talk about deep sleep, in particular, wearables are terrible at knowing when you're in deep sleep. There are published data out there, so I'm not like ragging on these wearables, but like it's not much better than a coin toss. It's like they're like right 60% of the time.

Yeah, and so the plus or minus, if you look at, I mean, if you're doing any statistics on this, you would do something called a bland ormone plot. If you're comparing like you're wearable to a polysomograph, like a formal sleep. sleep study. Most wearables tend to like us underestimate deep sleep at one end and overestimate it. The other. So like when you have a lot of deep sleep, they underestimate it. When you have a small amount of deep sleep, they overestimate it. And the plus or minus is like an hour in terms of error.

So if you're told that your deep sleep is two hours, it could have been one hour or three hours. And then that's within what we call the limits of agreement. So this then, like when you wake up in the morning and your wearable is like, hey, you didn't get much deep sleep last night. And then you're like, oh man, I didn't get any deep sleep. Like, I'm just not going to feel good today. Maybe I did. Maybe I got an hour extra. Maybe you got an hour extra. And then, but the fact that you think that you slept poorly, there are now several

studies that show that if you think you slept poorly, regardless of how you actually slept, if the psychologist, like, manipulate how you think about your sleep, you'll perform worse during the day because you think you didn't sleep well rather than based on how you actually slept. And I stopped looking at that long time. I'm sorry. Even the nocebo effect? You can't cast out me into it.

I do, but I think that's a good point to bring up, which is one, you go to your average. So if on average your wearable is telling you like, dude, your sleep sucks, then probably is an issue. But if, you know, everyone has a bad night. Yeah. I get a laugh with the wearable. Like if you have pets and those pets jump in the bed and it bounces off your wearable, it's going to think that you moved. And you're like, nope, you could have been dead to the world and you just have a cat that's a jerk.

Yeah. Well, I just try to go to bed at the same time and get up at the same time. like try to get eight hours and that's it. You know, it's like, yeah, yeah. I do all the right things. That's it. The biggest lever is for most people is sleep opportunity, right? So that's exactly what you're saying.

Like are you getting enough time in bed? Like that you see that again and again and again. Everybody's like worried about the routines and the wearables and like the environment. Of course that that matters a ton, right? Is it dark? Is it cool? Is it like all that kind of stuff? But are you just spending enough time in bed is is probably the the biggest lever?

And then just like a fine. final point on the wearable just to like come back to what you're saying, Mike. Even if the numbers aren't accurate, the error is probably fairly consistent within an individual, right? So even if it says that your deep sleep is terrible and it says that consistently, it might not be getting the absolute amount of your deep sleep right. And this is particularly because they often use things like resting heart rate as part of deep sleep. So people who are very fit, the wearables tend to have more trouble. with figuring out when they're in deep sleep or not because they have such a low resting heart rate.

But the error is probably consistent. So trends over time are probably fairly accurate, even if the absolute numbers aren't. Kind of the same thing with tracking body count and the natural error built in there. Yeah, exactly. Nice. With, and I know this is the point of nuance in avoiding black and white thinking. And I already made your comment about the quantity is probably the first thing to prioritize. and then the quality.

Yeah. What's kind of like, I know you talked about like that six hour threshold of making sure like, you know, let's just get over that in the first place. In what context would you prioritize the quality of sleep

over the quantity of it? Yeah. If you can't, if you can't get more quantity, then I think you would think about quality. The way that quality is measured though in most studies is as a, is a proxy because you're not doing polysovenographs in all these people,

sort of in like big population studies, which you can then tie to dementia risk. So often when they're asking about quality, they're usually asking questions like, like how often you wake, do you feel you're waking up, like waking up at the night? Are you waking up and not being able to go back to sleep? Or it's are you taking something to help you sleep?

So do you take alcohol? Do you take sedating antihistamines? Do you take Ambien? And we know that those things can also mess with the quality of our sleep. So things like alcohol cause a REM sleep deficit in particular, whereas Ambien seems to mess with some of the neuroplastic processes that happen during sleep. And we know that if you chronically use sedating sort of first-generation antihistamines, things like diphton hydramine, that's associated with an increase,

risk of dementia long term because they have like an anti-colonergic effect. So then first of all is like are you doing whatever you can to improve the sleep environment, right? Not having caffeine late in the day, not relying on some of these things to help you sleep. Then you might think about other factors that are a player also like exercise improves in terms to improve sleep quality, cognitive stimulation. tends to improve sleep quality. This is probably more relevant in older individuals, right? A lot of people who are in their 40s, listen to this podcast are probably exercising enough to kind of

improve sleep quality. But that's where I'd focus. If you can't get enough time in bed, then doing whatever you can to kind of support the quality of your sleep, which, and then I think regularity is going to help with that, which is kind of like the next stage. Because if you're consistently sleeping at the same time, like I said, your body will expect sleep at that time of day and you're more likely to get the most out of it. Let me ask you for free. What if you know of a person who uses too much of like, say the Benadryl stuff? What did it?

The die, whatever. Diefenhydrine. Yeah. I like to see the Hatman on occasion. Don't tell me to stop my Benis. So what if you knew a person who used that every day? Like how would, how would you tell them to stop? Would you just say stop or?

Don't your drugs, kids. It totally wants. So this is a good question. I think that people are going to become dependent on them for a few different. One is psychological, right? I'm only going to be able to relax. I'm only going to be able to sleep if I take this thing. So you could titrate down the dose to begin with.

Then you would think about replacing it with other things. So can you replace it with some like more relaxing compounds? would you think about taking magnesium in the evening, thionine. There's a really nice product made by a company called Ainsley and Ainsley that have like a night powder that has some tart cherry in it, which has like can have some melatonin type effects plus some of these other things. We know that magnesium can help an individual with insomnia.

Plus like generating a routine, that kind of stuff to kind of know that you're winding down. Some people might need some psychological input. So cognitive behavioral therapy for insomnia. insomnia, CBTI. You can get this from a professional therapist, but also there are some apps that guide you through some of the steps of CBTI. The important thing to remember is that most people who have insomnia, they're sort of like all the structure and architecture required for sleep are still intact. You just need to get them to the point where they can actually truly

relax, switch off and like be able to feel comfortable and able to sleep. There's newer compounds, like newer classes of drugs that may be better from a sleep standpoint without having a negative effect. Traditionally, people would use tracidone. That was one of the sedatives that impacted sleep architecture the least. Now we have the Dora's, the dualorexin receptor antagonists that seem to be potentially even better from a sleep architecture standpoint. There were several randomized controlled trials in like individuals with insomnia, with obstructive sleep apnea, et cetera. So there are some other drugs that are available if needed, but I think you can achieve a lot of it by just getting a routine in place, maybe thinking about some other supplements,

at least to kind of help you transition. And, you know, most people should be able to set up, you know, a kind of a routine that will get them to sleep. I'd be remiss to not bring up which type of magnesium are you the biggest proponent of for sleep. And then secondarily, Isn't this an individual of British descent, you should bring up camomile tea? Yeah. So, absolutely. So camomil tea, I am a big fan of. One of the compounds in camomile that seems to be supportive sleep is apigenin. You can take apigenin as a supplement, but I feel like that removes some of the some of kind of like the process and the wine down.

Right, the ritual, exactly. And there might be some other things in camomile that are having an effect as well. So yes, that kind of hot beverage as part of a wind down process can be great. I think caramel is a nice option. It may have some compounds in it that can help to support sleep. And then on the magnesium front, we've basically gotten to a point where we think that different forms of magnesium do different things in the body and most of that is complete nonsense. When you take a bioavailable form of magnesium, and this could be an amino acid chylate, this could be yeah, things like glycinate, this could be malate, citrate. Citrate is slightly less bioavailable, but probably still

pretty bioavailable. All of those things dissociate in the gut. So the magnesium becomes a free magnesium ion, which is the primarily of the thing that it gets absorbed as, and then it's going to be distributed to the body as needed. There is one not great study in rats that seemed to suggest that magnesium 3 and 8 was the version of the magnesium that was most likely to get into the brain.

There have been other people who have suggested that certain amino acid keylates can do the same thing. But I think nobody has actually demonstrated a reason why the magnesium would stay attached to the 3-8 molecule, get absorbed across the gut, be circulated around the body as magnesium 3-8, and then get absorbed into the brain. I have not been able to understand that biochemical mechanism, because magnesium should just associate and be absorbed as a magnesium ion. And that's what makes magnesium bi-available.

All of this to say, it probably doesn't really matter. The only version that we know isn't particularly bi-available is magnesium oxide. It has more of a laxative effect because it doesn't get absorbed. There is evidence, if you look at human trials, there's good evidence for both magnesium bisglycinate and magnesium 3-8 to support sleep in particular. But I think that all of the, you know, when we think about all the mechanisms, then other forms of bioavailable magnesium should. So, and I think that's what the evidence supports,

that in reality, as long as it's a bi-available form of magnesium, and it's not causing GI side effects because of the bi-availability, and you're getting enough, it should help to support sleep. But if you're looking at randomized control trials, then bisglycinate and three in eight have the best evidence for them. And I know some people report when they take magnesium, that they have a lot more dreams. Is that like very indicative of increased,

REM sleep because of the magnesium for some reason? It could be. I honestly don't know because you can have dreams and not remember them. So they're obviously remembering their dreams. But your REM sleep is when we do tend to dream. So if it's and if they're getting right, you can imagine a knock on effect where they're getting to sleep earlier. They're getting their deep sleep early in the night. They're therefore able to get more REM sleep later in the night.

right and then they can start to remember those dreams. It certainly makes sense. I don't think the magnesium has specifically an effect on REM sleep, more so than other forms of sleep. But you can certainly imagine that kind of like knock on effect. Yeah, a similar-ish question. And I thought of this right after you, he said something similar earlier where you said that you tend to have your deep sleep

between certain hours of the night, like your body knows it's between 10 and 2 or whatever the hours were. I feel very similar with REM sleep for me. like again this is this is mostly related to my comment on dreaming which again may not be all the way accurate maybe to your point you only you remember your dreams best like right before if you have right before you wake up as opposed to earlier in the night but it it seems to be that when I sleep a little bit later I'm having intense dreams right before I wake up like I normally get up at 615 like on weekdays and then on the weekends might sleep till 7 maybe 7 30 at the latest and on the weekends I tend to have way way more memorable intense dreaming or dreams right before I wake up. Is that because I'm sleeping later for some reason? It's probably because you're sleeping later. So you end up having more REM sleep because it's happening like later in the

night or early in the morning and then that happens right before you wake up. The final part of that could be if you if it's the weekend and you had a beverage the night before then. Possible time that right. It happens. Then that causes a relative deficiency of REM sleep early in the the night and you then catch up later in the night, which tends to then people experience crazier dreams.

That's what they're sort of like. So it could be either because you're sleeping later, but it could also be because you drank some alcohol and your body is like trying to catch up on its REM sleep and then it causes all these crazy dreams later in the night. Yeah, I can see that because also, you know, typically you're very spot on. Like I don't drink during the week at all ever. And then occasionally I will go out with a friend or whatever. We're going to have drinks, but then I'm also going to get home two hours later than normal.

I'm like, so I go to bed at like 11, which is kind of more normal for me. I might go to bed at like 1230. Yeah. And then therefore I'm going to sleep an hour later. And so those things are kind of playing together. Yeah, that's what I think. Yeah. So to kind of go down this rabbit hole of Doug's drug use on the weekends, what other substances,

because I mean, right now, depending on where you live, there's the legality of THC. Obviously, CBD seems to be the thing that cures everything. And there's other people that use, you know, they like to go hang out with, you know, Doug's friend Molly on the weekends. And, you know, no. But as far as, you know, obviously other, we will say, substances that people utilize, how does that affect sleep architecture? And like, as far as obviously you understand, you know, if you're going to go hard at the Electric Daisy Festival,

your sleep is going to be very perturbed for a number of reasons. Yeah. But is it one of those things that like, yeah, this is really bad for your sleep. It's pretty caustic. You should probably seldom do this. Or if this is one of those things of we just don't know, just. Yeah. So things that we know impact sleep architecture,

alcohol is obviously one of them, some of the other ones we've mentioned. Caffeine is another, right, we know that caffeine in particular impairs deep sleep, as well as just overall sleep quality. Then some of the other stuff, there is some evidence, particularly in neurogenitive conditions

or in the setting of chronic pain, where a combination of CBD and THC can, can improve sleep. That's like some of the original FDA-approved sort of cannabis-based therapies. However, other studies in healthy people, I haven't looked at this literature for maybe a year or two, so maybe there's been some better stuff recently,

but higher doses of CBD can actually be slightly alerting or arousing in some people. So, like, CBD on its own in high doses may actually impair sleep. But that seems to be very personal, like, from person to person. And there are some studies that use very high doses of CBD in certain conditions. So, like, I have a friend of mine. He's a pediatric neurologist.

He uses, like, hundreds of milligrams of CBD to treat pediatric epilepsy. So, like, it can do some super interesting stuff. But I think the best evidence for sleep is this, like, a smaller doses of sort of THC and CBD in the milligram dosages. but I don't know what that does to sleep architecture. Like people may, I think it's going to help people if they have, you know, insomnia due to pain or something like that, but it's sort of like it's a work,

it's like a roundabout effect because it's improving the pain and therefore they can sleep rather than, you know, the average healthy person taking CBD because it's going to help them relax and recover. I know that CBD is being sold to athletes in that effect. And there's really no evidence to support that. Plus the fact that, you know, at higher doses, it may actually be arousing and it may impair sleep on its own.

And then, you know, other things like MDMA, X-C, you know, like you mentioned, I think that's at the point where I was... I heard that was really good is what I heard. I would say that we don't know. It's certainly interesting from a therapy standpoint. Just leave it at that. Yeah, we don't know. If it's very occasional and it involves dancing and so...

social connection and all that kind of stuff, there may well be a net benefit, like, because, you know, and you can see some of some people say some of the same things about alcohol. If you're occasionally drinking it in a social context, right, maybe there's, there's a net benefit there. So I'm not going to say it's, it's definitely beneficial. But in terms of how it affects sleep, I don't think we know. Really. Sleep it at that. Uh, similar to that you mentioned MDMA, but like what about, uh, I've heard like with, with mushrooms as an example,

I hear people make neurogenesis. comments about it. With I've again, I've heard other, it cleans your brain type, like very, very, very generic comments about it. Like it. Like it leads your brain, like whatever that means. Are there are there research studies? Again, not related to sleep specifically, it would be just brain health in general for how it could potentially benefit you, independent of the social connection and longstanding anti-anxiety or whatever else it helps produce psychologically. Yes. So I think the best evidence we have so far, is really in this sort of therapeutic setting for other mental health or behavioral health conditions, depression. So Ibergain has been tested particularly in PTSD. And this is where MDMA, ketamine, cytosybin, you know, they're all being investigated in that kind of way. And I think there's a ton of promise there. And this, you know, I think partly what's happening is it's kind of resetting some aspects of like, perseverative or, you know, like ruminative kind of thoughts.

So like this idea being that you have these like well-worn tracks of thought processes in the brain that could be detrimental because they're, you know, self-damaging or, you know, repetitive in some way. And this kind of helps to kind of reset some of those. But you also need it in the right set and setting with a therapist and all the kind of stuff to kind of process what you experience. So there's plenty. of evidence of like people who are just like doing this stuff at home and thinking they're,

you know, achieving the same effect and obviously they're not. Cleaning their brain. Yeah. In the preclinical literature, so when we look at animal studies, looking at some of these psychedelics, they do seem to have an effect on neuroplasticity. The effect seems to be better with macro dosing rather than microdosing, at least from the studies that I've read. So I think that in that kind of setting,

where this sort of thing could be beneficial, you know, and actually psychedelic dose with the right kind of therapeutic approach may be helping, and that includes through opening the process of neuroplasticity. I'm sure there's much more to come on that front. But neuroplasticity does seem to be one of the mechanisms by which is having this effect, at least from what we can see in, you know, in like animal studies. Can we, I know it's getting late, but can we hit on two things. You mentioned earlier, like toxins,

having a moment and like technology. So like if we get just at least touch on those two or out of time, then Mike has to be somewhere too. Yeah. So the simple answer is that we know that so on the toxin front, we know that there are things in the water and in the air that can increase the risk of dementia. So air pollution is increasingly seen as a risk factor for dementia. Air quality both inside and outside.

living close to a road, PM 2.5. So there's a two and a half micron particles that are released by industrial activity or cars. We know they're associated with increases to dementia. The simplest thing to do if you can, right, not everybody can move, not everybody can move house, but it just have some air filters in rooms that you spend a lot of time. So there was one study recently where they had people who sort of lived near or you had a reason amount of local air pollution. They installed air filters in the house and their blood pressure reduced.

And we know that blood pressure is one of the most important risk factors for dementia. So getting a high-quality air filter or any kind of air filter, if you think that you might be, you know, there's lots of wildfires. So like in Seattle we have tons of wildfires in the summer wearing N95 masks outside when it's really smoky, having an air filter, that kind of stuff. water the same. There was just a paper that just came out looking at lead exposure and dementia risk. And that basically affects you throughout the entire lifespan.

And there's still plenty of plumbing around the world, including in the US and UK and Europe, that has a significant amount of lead in it. PFA's like polyfluoral alcohol substances like forever chemicals, they may have an effect. So again, any simple water filter will just help reduce the burden of those things. not everything's perfect, but it could be a filter in the fridge. You know, if you want to get reverse osmosis or something that like fits into your tap, you can. But just whatever sort of helps the decrease burden over time, I think is a simple, quick intervention. The final part of the toxins is, or there's several things, but like so microplastics have come up a ton recently.

There have been papers that have found microplastics in like atherosclerotic, you know, plaques in heart. So in heart disease that have found microplastics in the brain. One study said that those who had dementia had higher amounts of microplastics in their brain. I'm sure it's true that we're exposed to a lot of microplastics. The problem is that the methods they're using to measure those microplastics in the body aren't actually valid at all. And there's been this big pushback against these studies. The reason is when you take this tissue and you're trying to measure how much plastic is in it, you do something called pyrolysis, which is basically just like you set fire to it, or you heat it up a lot, and then the product of that, you run

through a mass spectrometer to kind of measure the compounds that are in it. The thing that you measure when you're looking at plastics is polyethylene. So, you know, if you look at like your plastic containers, it's got that little recycling thing, and it's got PE in the middle, that's polyethylene. The problem is that polyethylene is just a string of carbons and hydrogens. And do you know what else is a string of carbons and hydrogens, saturated fat. So saturated fat, which your body is full of, looks like polyethylene when you expose it to this procedure. So in reality, we don't actually know that we're measuring what we think we're measuring

when we're doing these kinds of studies. Now, that doesn't mean microplastics don't matter. Plastics are in everything. We know that plasticizers like BPA and thylates, these forever chemicals, we know they can have effects on heart disease risk, cognitive function, cognitive decline. So the easiest thing is just that as much as you can, avoid things stored in plastic, don't heat things up in plastic. When you're cooking, use wooden utensils, use stainless steel pots, that kind of stuff. Throwaway pots that are non-stick that have, where the coating is damaged because we know

they tend to release a bunch more of these things. So just like being sensible about your exposure as much you can is probably going to be the best thing. But like control what you control and then just like don't get too worked to fight the rest of it. What about technology? Yeah, technology. So the first thing that's worth mentioning is that there are several studies that suggest that engaging with new technologies,

particularly like cognitively stimulating or complex technologies, can actually improve cognitive function, right? Older adults who spend more time using technology tend to have a lower risk of dementia, playing things like video games, particularly complex, multi-sensory world, video games can improve cognitive function. There are randomized control trials that show that. So what it really comes down to is what am I using, how am I using this technology, and then what am I doing the rest of the time?

So the issue is not that you're spending time on social media or that you're playing video games. It's are you spending so much time doing that that you're not. out in real life, spending real time with real people, being physically active, sleeping properly, eating and nutrition diet, all that kind of stuff. So that's kind of the main thing. But particularly when it comes to social media, we know that it can be a social stress. And that can trigger stress responses, inflammatory responses. So if you're spending all your time looking at people who are like more jacked, more successful, richer than you are, we know that triggers a low-level

stress response. So it's worth kind of curating your feed, certainly. And then the last thing, which I think is potentially the most important is then how we, how we interact with tools that are like related to AI and, you know, generative AI and LLMs. And everything we know right now, and what I say right now is probably going to be out of date in six months time, because these things are going to advance so quickly. But the way I think about it, and I've stolen this framework from a friend of mine, Ken Ford, who's been an expert in AI for decades, you know, worked, you know, around the NSF was a presidential science advisor. He basically, you can classify these things as you, whether you're using them as

orthotics or prosthetics. So an orthotic is something that you use to enhance your current capabilities, right? So I think about orthotics like people with cerebral palsy who maybe because of like muscle structure and coordination can't walk, but you give them, you give them an orthotic and they can walk, right? You give them an orthotic shoe or something like that. So then that orthotic is enhancing their capabilities. But you use a prosthetic instead of something that you don't have, right? You use a prosthetic leg because you don't have some or all of your leg. So if we use these tools to expand our capabilities, right, we're making a presentation or we're writing an email,

or you're writing a blog post or you're writing an essay or something like that. And you actually write it yourself first and then you say to your AI, hey, what could I do better? What should I be thinking about? What did I miss? And it gives you information that you then incorporate. You get a better result. You've engaged your brain in the same way.

You're still like you're enhancing your capabilities. If you instead say, hey, chat, ChbT, I've got to write this essay. Write it for me. Then you're using it as a prosthetic, like instead of your brain as if you didn't have a brain. And the result is you will lose those skills or you'll never develop them in the first place. So I found luckily for us that like using AI, it's wrong a lot. Like, yeah. I've asked it to, you know, do that just to see.

And it's wrong. It's like, luckily for people like us, I mean, call us what you want, experts. But like, thank God, it's not quite caught up just yet. Yeah. So, like, I'm glad. As an academician and go figure I've had students try to do that, it's equivalent of like a calculator if you put in the right inputs will allow us to solve math problems faster than we ever can independently. Exactly. Yeah.

But I get it. Sorry, one bad anecdote, I had a student where in my exercise phys class, I asked him like, hey, what are the different ways the body produces energy and, you know, what's the limit to each of these systems? And they fed that in AI. And then it goes, coal power is currently the way that we're power and blah, blah, blah. I'm like, oh, God, you didn't even like check it. You just copy, pasted it. And, like, to be fair, I do agree that nuclear is probably, you know, too much fear mongering and should be used more. But that was not what I was asking.

But you see, like, I see this from other faculty, right? So, like, they're having grant proposals. They're having them write their papers, design their experiments, analyze their data. And then you can read this and be like, you didn't even check it. Like, that's what worries me. Like, yeah. It's so scary. Like, they didn't even engage their brain in that at all.

And so if that's where we're going, like that's that's just like the fast track to cognitive decline and like deskilling and all that kind of stuff. But you can use it in a really cool way, but it just requires you to engage your brain. Mainly I like, you know, the only way I use it is I will write something. And then I'll say take my information and turn it into a thread for Twitter. And it takes and then I still check it to make sure it mess up the stuff that I've already written. to be so but like no way that i would use it to just write something because it can totally ruin someone like you know like you put it out there and it's wrong and like yeah quickly people just destroy you yeah yeah like a poor you know mike uh isrott you know they're not trying to be like

that get wrecked by you know people are just waiting to crush people and and but also like you want to maintain these skills right you want to maintain skills in writing i want to improve them Yeah, I want to continue to get better. Yeah. Yeah. There's a time and a place for both. There's a time and a place for just getting something done as quickly as possible just to get it off your plate and out of your face. And then there's a time for actually like sitting down and doing the work because getting it right matters.

Yeah. But yo, we got to shout down. Mike Lane's got to be somewhere. Dr. Tommy Wood, my friend, appreciate you coming on the show again. Stoke to meet you in person over the weekend. You got a book coming out and an audio book version of it, which I believe you read, right? Yes. Yeah, I did.

The stimulated mind comes out. March 24th. I read the audio book version. I finished recording that a couple of weeks ago. So you can hear my dulcet tones reading my book to you. If that's how you prefer your information, the stimulatedmind.com or my Instagram at Dr. Tommy Wood has all the information. Fantastic. Coach Travis Mash. Mashlead.com. I've so enjoyed reading your information ever since the first time. I've been reading all your stuff. Thanks. It's awesome. So the book at home run, I think. Oh yeah, Dr. Mike Lane.

Yeah, Mike Lane, Ph.E at Instagram and Dr. Wood. I mean, we didn't get to talk about brain injuries. So I hope we can have you back for a third round and we can. Maybe something. Yeah, not blocking things with your face. Yeah, yeah, no, definitely. That's super important, too. All right.

You bet. I'm Doug Larson on Instagram at Douglas E. Larson. We are barbell strug to barbell underscore shrug. If you want to come work with the whole team at Rapid Health Optimization, including Dr. Andy Galpin, Tommy Woods, even helping us out these days as well. Dr. Mike Lane, Travis Mash, on the whole team. You can see us at our Arteelab.com, A-R-E-T-E-L-A-B.com. Friends, we'll see you guys next week.