Finding Mastery with Dr. Michael Gervais - Dr. Matthew Walker, Professor and Sleep Expert
Episode Date: July 10, 2019This week’s conversation is with Matthew Walker, a Professor of Neuroscience and Psychology at the University of California, Berkeley, and Director of the Center for Human Sleep Science.He ...is also the lead sleep scientist at Google.Matthew has received numerous funding awards from the National Science Foundation and the National Institutes of Health, and is a Kavli Fellow of the National Academy of Sciences.His research examines the impact of sleep on human health and disease.Matthew is also the author of the International Bestseller, Why We Sleep, which has sold over 1½ million copies worldwide, having been translated into 34 different languages.In this conversation, we focus specifically on Matthew’s deep body of knowledge when it comes to sleep.I wanted to dig deep and better understand the nuances of sleep… how does it impact our overall health, how can we sleep better, and what can you do if you feel like your suffering from a sleep related disease.As I’ve mentioned previously, gone are the days in professional sport and business where it’s cool to brag about how little sleep you’re functioning off of and I hope this further brings to light how critical sleep is for just about every facet of life._________________Subscribe to our Youtube Channel for more powerful conversations at the intersection of high performance, leadership, and meaning: https://www.youtube.com/c/FindingMasteryGet exclusive discounts and support our amazing sponsors! Go to: https://findingmastery.com/sponsors/Subscribe to the Finding Mastery newsletter for weekly high performance insights: https://www.findingmastery.com/newsletter Download Dr. Mike's Morning Mindset Routine! https://www.findingmastery.com/morningmindsetFollow us on Instagram, LinkedIn, and X.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
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and psychology at the University of California, Berkeley, and he's the director of the Center
for Human Sleep Science.
He's also the lead sleep scientist at Google.
His research examines the impact of sleep on human health and disease.
And I love this conversation because we get into wellness, we get into performance, we
get into optimization.
And he's also the author of the international bestseller, Why We Sleep.
And when I say international bestseller, that's not lost on me.
He sold over 1.5 million copies worldwide, and it's been translated into 34 different languages.
Why is that? Because he's really concrete and he bases his statements on evidence. It's really
crisp. This conversation is great. It's very applied. There's also some really wonderful
philosophical conversations about sleep. So in this conversation, we focus specifically on
his deep body of knowledge when it comes to sleep and the research and the application of it.
And I wanted to dig deep and better understand those nuances of how does it impact the overall
health? How can we sleep better? And as I mentioned previously, gone are the days in professional
sport and business when it's cool to brag about the little sleep that you're getting.
That's done.
So I hope this conversation helps you sharpen your sword on how critical sleep is for just
about every facet of life, as well as the tactics to get better sleep.
And with that, let's jump right into this week's conversation with Matthew Walker.
Matt, how are you?
I am very good, Mike, and it is a pleasure to be speaking with you.
And thank you for having me on the show.
Oh, good.
Well, you know what?
Ditto.
I'm super stoked to talk to you because you have spent your whole life working to understand
something that I have recognized as well is at the center of vibrance and flourishing and health and wellness and high performance.
And so, you know, sleep is no joke.
And we're a mess as a community right now.
And so, look, I love what you've studied and spent your life working through.
And I'm super excited to dive into it with you.
I mean, I think your point is an excellent one just right from the off, which is, you know, sleep in some ways is the neglected stepsister in the health conversation of today.
We've spoken a lot about diet and movement and physical activity, and those things are absolutely essential.
But, you know, we used to even think of
sleep perhaps as the third pillar of good health. And I don't believe that's true. I actually think
sleep is the foundation on which those two other things sit. And there's great ways that you can
sort of slice and dice that question to give my claim validity. And I won't go sort of too far
into that unless you would like me to, but I think
it really is just something that we neglect despite it being the tide that rises all health
and performance boats. Oh, for sure. And, you know, it used to be a badge like, ah, you know,
sleep later and I have no time for sleep or, you know, I'm a grinder. And what we know from
research, and I can't wait for you to
share some of the newer research, but what we know from research for sure is that, you know,
memory's compromised, vigilance is compromised, you know, hormonal kind of juicy, powerful
testosterone stuff is compromised. Like there's some real compromises to that effect. And before
you get into those details, I've got five pillars. You have three. I'd love to hear your three and I'll share my other two.
Well, yeah, I would actually extend it a little bit.
So certainly diet, of course, nutrition.
Secondly, movement, physical activity.
Third, I think, is sleep.
Although I would put that, as I said, the bedrock on those two other things.
The other, I would say, is essentially mental health or for want of a better word sort of emotional health and I think we're probably
sleep and mental health may be equally deficient in society I think we're doing much better
on nutrition and physical movement despite needing to do. So I would love to know what the,
right, if those four overlap with yours, and what the fifth one is that you have all the other ones.
Okay, cool. So we've got like this model that we've built, and it's based on, you know,
best practices and research and philosophical pining, as well as what we found works in the field with, you know,
true high performing organizations and individuals. We've got five main pillars.
And one of those pillars is about recovery. So the other ones are squarely about like the,
the psychology of humans. And so let me just do all five and then we'll get to,
we'll drill in on recovery. So we've got self-discovery as a practice to get to know yourself. You've got psychological framework, which is how you
understand yourself and how you make sense of the world around you and events. We've got mental
skills, calm, confidence, focus, right? Then we've got mindfulness, which is a central thread that
runs through everything, being aware, developing wisdom about oneself and the world. And then the fifth pillar is about recovery. And inside of recovery, we've got four basic
tenets. Okay. And I, I know there's five, but I only cram in four. Okay. And they go in this order.
It is, um, sleep well, eat and hydrate well, move well, think well.
So I think based on what you just said, I just said the same thing.
And then the fifth one is like laugh well, right?
The social component.
But I just, I put a pause in that one because I don't know how to help people really train
for that.
It meaning be social.
It's not like straight down the strike zone.
But you and I, I think, are absolutely lockstep with sleep is the number one.
Then it's move or eat, you know, the nutrition piece.
And then it's movement.
And then if you get all three of those right,
and you wake up in the morning and you're angry or anxious,
we end up draining our resources
in a ridiculous way as well. So that's how we think about it in our business, which is the
compete to create business. But listen, enough of me. That's not what I want to talk about here.
I think it's beautifully elegant because so many of those things are things that we tend
not to be verbally explicit about.
We tend not to speak about them.
We tend not to actually construct them as actual things to work towards.
And I think social interaction is one of the other big missing pieces.
You're absolutely right.
We actually did a study recently looking at a lack of sleep and loneliness and social
isolation. We know that
when you're socially isolated and lonely, that your sleep becomes more fragmented. But what we
didn't know is whether the same was true in the opposite direction. In other words, if you're not
sleeping well, do you become more socially isolated? And the answer seems to be yes, that you don't
want to interact with other people. Worse still, when other people meet you in person and interact with you, they wish to interact with you less.
You are socially repellent when you are sleep deprived.
And what was even more striking is that it was contagious that after someone who is well slept has interacted with someone who is underslept, the person who was well-slept actually
felt lonelier themselves. So the loneliness jumped like a contagion, like a virus from the sleep
deprived individual to the non-sleep deprived individual, which was striking. But I think
loneliness in general, we know is a killer. It may be as much of a mortality risk as smoking, if you believe
some of the numbers, which just blows my mind. Oh, this is a terrible finding. I mean, it's
powerful and good for that reason, but it's really troubling because when I think about
the number of people I know that are sleep restricted or even deprived or just struggling with sleep.
And if the case is, and I want to make a supposition that I'd like to hear what you think is,
or what you think about it, is that if they're, they wake up and they're not vibrant, they know
it. And then that becomes contagious or a repellent and it forces greater isolation. I'm wondering if when
they wake up, they know they don't feel great is if the default mode network, right? That network
in our brain, which is self-referencing, am I okay? If that thing becomes a little louder and
then they go out into the world and they're self-referencing, self-checking, and that is just
so self-consuming
that other people are like, dude, you ain't, you ain't even in this conversation. Like this isn't,
this doesn't feel good. I wonder if it has something to do with that.
Would you, would you like to come and do a sabbatical at my sleep center? Because
that is remarkably prophetic. So we actually did brain imaging in this study too,
to actually see what was going on in the sleep deprived brain.
And inside of the scanner, we had people walking towards the person in the scanner with a video.
So it's like someone approaching you. Social approaches is the term.
And what we found is that as people are walking towards you, when you've had lots of sleep, there is a network called the theory of mind network,
which allows you to sort of essentially take other people's perspectives. It's very pro-social. It helps you bond. That network was actually shut down. And instead, the network that's much more about self-referential processing, in other words, just going inside of you, thinking about you, thinking about what you haven't done, what you need to do, That network was actually lighting up and shutting down the pro-social part of our brain.
So you're exactly right.
That's precisely what we found.
Oh, how about it?
That's great.
So you knocked that out of the park.
That was great.
And that's why you definitely need to come and do a sabbatical at the Sleep Center.
I think you've jived very well.
Yeah.
Well, you know what?
What you guys are doing is fantastic. And that, but that finding
is really powerful because, well, both of those findings, because let's just think about our small
community, our family first. If we're not getting proper sleep, those around us are going to feel
more isolated because we don't feel right. And our brain is not working right to connect.
And so we get on this, you know, we talk in sport about like at the beginning of the year,
and this is business too, like there's, okay, here's our mission. This here's the vision. This
is, this is what we're going to go set out to do this year. Or as an entrepreneur, like this is our,
you know, our primary objectives and everyone's like, yeah, like, man, that sounds big, but like,
yeah, okay, good. And then we lock arms and we're like, yeah, like, man, that sounds big, but like, yeah, okay, good.
And then we lock arms and we're like, okay, here we go. And then as we start to wear down
and we start to get feedback about how hard it is, that what we've noticed is that people that are,
haven't conditioned their mind. And I'm going to add now and, or are fatigued, they're just worn down from sleep, nutrition, whatever, overtraining, that they tend to try to unlock their arm because they need to go save their own ass, right?
Because they're struggling.
And when as soon as you get that chain to unlink and people unlock their arms, no can't, no one does the extraordinary alone.
And so we need each other and that's where missions fray, you know, because the, the true
spirit of the human connection isn't found and your evidence, I can't, will you send some research
that I can read if you've got it? Like, I'd love to read. I'd be delighted to send you those.
Yeah. I love that. Okay. condition in which sleep is normal. And I think that tells us everything that we need to know
about the intimate relationship between a good night of sleep and emotional first aid.
I think sleep is probably the best bridge between despair and hope. And if you are shortchanging
your brain on your sleep, you are neglecting your mental health. And we see this now. It's not just associational.
We can do these causal experiments. And so psychiatry used to think that psychiatric
disorders caused sleep problems. But I actually think now the evidence is swinging back the other
way. I'm not suggesting that it's unidirectional and that every psychiatric disorder
is simply caused by a lack of sleep. That's not true. But that it is a two-way street is much
more clear to me. And is the traffic flowing more dominantly one of those directions than the other?
I think it may be. And I think it's the direction of insufficient sleep predisposing you to a risk
of mental health or mental ill health, I should say.
So, okay. I love that nuance because that is a tide shifter, right? Is that we used to first
think that, okay, depressed people, one of the symptoms is they don't sleep well,
and that creates a little bit more depression. But what you're saying is that, wait, they could
have a sleep disorder and that's causing depression or influencing depression.
Now, can I ask you about sleep in this respect? Do you think that this is a psychological behavioral thing that people can change or
is it organic?
Are some people born with the true struggles in sleep?
Because I don't think that's me.
I think mine's a bit more environmental and behavioral.
But sometimes in spurts of my life, I'm waking up at three in the morning and going, okay,
let me fall back asleep.
And then I'm like, oh, shit, there it is again.
I'm thinking about whatever, whatever, whatever.
And that's why I've got a little dump pad next to my bed,
where I just write some stuff down to get it off my mind. But there's a long way of saying,
is it organic? Is it environmental? Is it more behavioral, psychological? Can you help paint
that for us? Yeah. And there are a number of lines of evidence that help us think through
that question. The first is heritability of insomnia. So let's just
say that the principal thing we're talking about here is insomnia in terms of sleep difficulty.
Now, that's not the only sleep disorder. There's sleep apnea, heavy snoring, which we can get onto,
or restless leg syndrome, all of those. In fact, there's probably over 50 sleep disorders. But
one that probably many people listening are concerned about is insomnia. So is it innate or is it sort of essentially environmentally co-opted?
About 30% of insomnia seems to be heritable.
In other words, we do know some of the genes that are associated with insomnia.
And so if your parents suffer from insomnia, there is somewhat of a higher risk of you
than being someone who will suffer from insomnia, there is somewhat of a higher risk of you than being someone who
will suffer from insomnia. But that also means that 70% of insomnia does not seem to be anchored
to genes or heritability that we can find, which opens up the possibility that the vast majority
of insomnia is actually perhaps, you know, sort of nurture environment rather than nature, which is
your genes. Another way that you can address that question, though, and we've done some of this work
where you go out and you study hunter-gatherer tribes whose way of life hasn't changed for
thousands of years, because if 70% of our sleep problems with insomnia are caused by perhaps
either what we are doing to
ourselves or what our environment or society is inflicting on us, and it's all of those things,
by the way, then studying these types of cultures should give us some information.
And what's fascinating is that when you ask them about sleep problems, firstly, they struggle to
understand the question, sort of, what do you mean by problems with sleep? And then if you really knuckle down,
it seems to be about one to 2% of those hunter-gatherer tribes actually would qualify
for suffering from insomnia, whilst somewhere between 12 to 15% of the population in Western
developed worlds actually suffer from insomnia. So there's something about the modernity that has dislocated us from the ability to sleep well.
And we've now started to unpack many of what those things are. So does that sort of help
answer some of that question? I love the British modernity. Instead of just saying the modern era,
the modernity. Yeah, that's good. Yeah, good. And when I hear modernity, I'm thinking like the modern conditions of light and blue light and the stimulations that we have post work, rather than the winding down of the traditional workday. watching some sort of TV or doing something that is unfortunately stimulating likely the
wrong brain centers, right?
Which is either beta or probably theta if you're watching TV.
But yeah, I think those are definitely culprits.
We could almost start off at a higher 30,000 foot sort of perspective.
And we could say, I think firstly, sleep actually has an image problem in society, which is what you mentioned before, which is, you know, we have this braggadocio sleep machismo attitude, which is not all people, but some people, which is that they're proud to boast about how little sleep that they're getting.
And so I think some people are ashamed about getting sufficient sleep, that it's associated with being slothful, which is a terrible thing.
Yeah, that's actually changing in sport. So like what we're seeing in sport, like as you've seen
as well, is that even as little as five years ago, people would say I'm a grinder and they
still like to say that because it means I work hard and I'm tough, but they are no longer saying,
dude, I'm so on it. I'm on four hours of sleep. Let's go keep up. Like I'm getting
extra reading in, I'm getting extra plays in whatever. They're not saying that anymore.
The conversation has shifted as you would recognize is, is like, Hey man, how's your sleep?
Yeah, it's good. About seven and a half. I think I need about nine, you know, this is athletes,
athletes tend to need a little bit more sleep, I than other folks but i'm not sure that that holds up completely because brains are brains but um
and i'd like to hear your response to that i think you're right and i've been fortunate to um
i'm part of the nike high performance sports council and have been um working with some
some great athletes and you definitely see that embracing of sleep more.
And in fact, some of the athletes have been great because they've become very vocal advocates of sleep.
LeBron James has been wonderful about that.
Serena Williams, Roger Federer, you know, will speak about needing somewhere between 11 to 12 hours.
Usain Bolt, somewhere between 9 to 10, and he frequently naps.
And we can speak about naps a little bit later. So I think there is a shift in the mentality and some people are even showing why it's important. he released some fantastic numbers when he was sleeping less than eight hours versus when he
was sleeping more than eight hours. Because I think it's one thing to say, look, this is me,
this is how much sleep I get. It's another thing to say, this is me and this is my performance
when I'm shifted from getting sufficient sleep and not. And what he published, and I'm just
trying to bring these numbers to memory, when he was getting eight hours of sleep or more relative to less than eight hours of sleep, when he was getting more than eight hours of sleep, he had a 29% increase in points per minute, a 12% increase in minutes played, a 9% increase in three-throw percentage. He had a 45% decrease in fouls committed, which will come on to decision
making and emotional irrationality that we can speak about. And then he had a 37% decrease in
turnovers. And if you were to think about those numbers, those numbers would change him from being
an all-star MVP to probably a fifth or sixth round pick in the draft. And it's the same player,
but just with or without sufficient sleep, which blows my mind.
It's a great slice of evidence. And in elite sport, we're looking for one to 2% margins
because it's so tightly wound around excellence that somebody that can find a one or two or even
3% marginal gain ends up becoming, you know, starter versus bench for sure. And so those
numbers are extraordinary. And then you match the genetic talent that he has, but the tide has
changed. Even Satya Nadella, CEO of Microsoft. And I've been fortunate enough to have a long
relationship with that firm that he raised his hand and said, no, no, no, no. We've got an important thing to do. And I'm going to make the
commitment to get eight hours of sleep as best as I can, eight hours on a regular basis. And that
sets a tone for everybody. Like, okay, well, if he's getting it, I should get it. And it really
does. And I think, you know, you're seeing that with people like Jeff Bezos, who is actually quite vocal about how much sleep he needs and how much sleep he gets. And it's very counter to some of the classic heads of state that we've had in the past. People like Margaret Thatcher, Ronald Reagan, current head of state of America, Donald Trump, all of them have this sort of chess beating mentality of sleep is useless and sleep is for the weak.
And I would note, by the way, that's something else that we do a lot of work on is the relationship
between sleep loss and Alzheimer's disease and your risk. And that evidence is causal now, too.
And whilst it's just two people, I don't think you can make anything of it. And I would speak
about the science. But I would just note that those two heads of state, Margaret Thatcher and Ronald Reagan, both claimed to be living on about four to five hours
of sleep, and tragically went on to develop and die from the disorder of Alzheimer's.
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When I think about your message, I go, okay, yeah, yeah, yeah. I don't know if I need any
more research to know any more doom and gloom and alarm. Like, oh my God, sleep is the center.
Let's get it right. And I, my family, we organize our life around making sure that we've got proper time to fall asleep as best we can, especially my son.
And I still don't get enough.
Like just the other day, I had to take a red eye.
And I haven't taken a red eye in 15 years because of the value of sleep.
And I had to take a red eye.
I was thrashed the following day.
And so I, listen, I think that we are not fragile humans. We are finely tuned, but when we,
when we abuse ourself from natural resources, we slowly run into a new normal, which is suboptimal.
I want to ask you, like, what is your sleep like, Matt? Like, how are you doing?
Well, you know, I give myself at least an eight hour to eight and a half hour non-negotiable
sleep opportunity every night. And I do that not to be sort of, you know, some poster child for
sleep or suggesting I practice what I preach. It's actually purely selfish because if you knew of the
deleterious sickness and disease that you invite into your brain and body by way of getting
anything less than seven hours of sleep a night, you know, you would do nothing other than give
yourself this eight to eight and a half hour opportunity. For example, my family has a history of cardiovascular disease,
and we know that sleep is probably one of the best forms of natural blood pressure medication
that you could ever wish for. So I don't want to die any sooner, and I don't want to die soon with
sickness and ill health. So the best way I know that you can elongate both your lifespan, but more importantly,
your health span is by investing in this thing called a full night of sleep, you know, and it's,
it's largely free. It's mostly democratic. Um, it's quite available and, you know, it's mostly
painless too, in terms of a doctor's prescription. So I think it's one you can embrace
easily. Unless you've got anxiety to fall asleep, which is something that is really,
it is quite alarming how the, if you struggle with sleep and want sleep, but can't easily fall
asleep, it's an easy trap to find yourself in to have some anxiousness as soon as your head hits the pillow.
So I'd love if we could do some good house cleaning on some, some pre-sleep stuff,
some actual proper sleep conditions. And the stuff that I talk about a lot, I hope you can course correct me on this. If it's off is like, you want it dark, you want it around 68, you know,
ish degrees somewhere in there, plus or minus. And, um, you'd like it as quiet as
possible, but it doesn't have to be completely quiet. And then, you know, good old stuff like
blue light and TV and all that stuff is not healthy. And, but I'd love for you to walk
through some pre-sleep strategies. And then as well as like, if you wake up in the night
and then if you find yourself waking up too early, what, what are some strategies there?
Great questions. So, um, let me see if I can give sort of five tips that people can adopt sort of tonight
to start getting better sleep.
And then I would love to circle back around to the, the concept of anxiety or not being
able to fall asleep or waking up and not being able to fall back asleep.
Cause that's a real issue for many people.
More generally, the tips you've got many of them, right? waking up and not being able to fall back asleep, because that's a real issue for many people.
More generally, the tips, you've got many of them, right? The first thing is, however,
regularity. Go to bed at the same time and wake up at the same time, no matter whether it's the weekday or the weekend, or even if you've had a bad night of sleep, in fact, still wake up at the
same time, because our bodies are designed around regularity. We have a timing
system called the circadian system, and we have lots of sub-timing systems. So our bodies respond
to regularity. And if that regularity will anchor your sleep and improve the quantity and the
quality of that sleep. So I think the first rule is regularity. The second, you're right, is darkness, because we are a dark deprived society in this modern era. And I'm not just talking about darkness when you go to bed, which is good, you know, blackout curtains, if you needed a face mask, but darkness before bed, because it's darkness in the evening that releases a hormone called melatonin. And melatonin helps time the healthy onset of your sleep.
And if you're not getting a darkness signal at night, your brain still thinks it's daytime.
And so shutting down computers and laptops, probably at least in the hour before bed,
if you can, that would be great. But it's not just those devices, however. It's the environment
in which we live. When you come back to your apartment or your house, dim down half the lights in the last hour before bed, and you would be surprised at how sleepy just that will make you feel.
The next thing you noted was temperature. That's another critical thing. Probably closer to around 65 to 67 degrees is optimal for the sleep of most people.
The reason, and by the way, I always try to provide people with reasons, not just rules,
because I don't think people respond to rules. They respond to explanatory reasons. And that's
why, if you don't mind, I can sort of try and unpack them. So temperature, we actually need
to drop our core body temperature by about two to three degrees Fahrenheit or about one degree Celsius to initiate sleep and then to stay asleep.
And it's the reason you will always find it easier to fall asleep in a room that's too cold than too hot, because too cold is taking you in the right temperature direction for good sleep.
So keeping it cool is a great one. The other one that makes me usually
very unpopular surrounds alcohol and caffeine. And I'm going to bust some, probably some myths,
but firstly, everyone knows, of course, caffeine is a stimulant. It keeps you awake. It's probably
the only psychoactive stimulant that we readily give to our children without too much concern, I should note. But caffeine has a problem because obviously it's not only going to keep you awake,
but it has a long duration of action that lots of people don't realize. Caffeine has a half-life
of about six hours. It has a quarter-life of 12 hours. And what that means is that if you have a
cup of coffee at noon, at midnight, a quarter of that caffeine is
still swilling around in your brain, which is frightening because it would essentially be the
equivalent of getting into bed at midnight. And before you turn the light out, you swig a quarter
of a cup of Starbucks and you hope for a good night of sleep. And it's probably not going to
happen. So caffeine has a real danger to it as well. The other thing I would just briefly note
about caffeine, a lot of people say, like, I'm one of those who can have espresso with dinner,
and I fall asleep, and I stay asleep. So no problem. It's actually not true. We've done
studies where we've given people a standard dose of coffee, sort of about 160 milligrams of caffeine. And even in those people who fall
asleep, they end up having about 20% less deep non-rapid eye movement sleep or deep non-REM sleep.
And to put that in context, for me to remove 20% of your deep sleep, I would have to age you by
about 20 to 25 years, or you could just do it every night with a cup of coffee with dinner.
So I think that's, you know, something to be mindful. Do you want me to go on to alcohol,
or is this just too depressing already? No, it's perfect. Yeah. I mean,
my understanding of alcohol is that like, it is a CNS depressant, but when you put poison on board,
so people will feel relaxed or whatever. But if you got poison on board so people will feel relaxed or whatever but if you got poison on board your
body actually has to work to get it out and that working underneath the surface is now a stimulant
and so and you know and the research obviously supports that that non-REM sleep is compromised
as well so i mean are we close on that with alcohol or is there some other stuff yeah
no no it's pretty close.
I think alcohol, you're right, is a class of drugs that we call the sedatives.
And the problem that people have when they take a nightcap in the evening, they think
they sleep better.
But what they're mistaking, they're mistaking sedation for sleep.
And those two things are very different.
Sedation is not sleep.
But what you're doing is just knocking out your cortex with alcohol. The two other problems with alcohol. Firstly, it will fragment your sleep throughout the night. So you'll wake up many more times throughout the night. And the next morning you will rise and you'll feel unrestored or unrefreshed by that sleep because it's fragmented. You typically don't remember waking up that many more times, but it still is present. We can measure it. It's very reliable,
and it leads you to feeling very underslept the next day. The final problem with alcohol is that
it's one of the most powerful suppressors of REM sleep or dream sleep in the last half of the night.
So I think both of those substances should be,
you should be mindful of. I'm not, I don't want to be puritanical here. You know,
life is to be lived and I don't want to suggest that I should tell anyone how they should live,
but all I want to do is empower you with the knowledge of sleep science that we have. And
then you can make informed choices for yourself as to what you would like to do.
I'm right there with you. It's like, know what you're doing, you know, like in that,
and to make an informed choice. And you and I are not saying don't take a glass of alcohol or two
or wine or whatever, but just know that there's going to be a compromise for you. And then how
about this? Let's say it takes about an hour to process alcohol per glass. And so what if you
had two glasses at seven o'clock and then you tried to fall asleep around 10? Do you think that
it's already cleansed through the system? Like the liver has done its job?
Sadly, yeah, not. The aldehydes and the ketones, which it's actually not alcohol that disrupts
your sleep. It's the metabolic byproduct of alcohol, the aldehydes and the ketones. And those things are going to stick around for, you know, somewhere
up to eight to nine hours in terms of the sleep disrupting impact. And we've done studies where
you have just a single glass of wine at seven o'clock in the evening, and we still see significant
sleep disruption as a consequence. Yeah, that's, it is such a bummer, isn't it? Like, yeah, it's such a bummer.
Well, you could take that mentality, or you could take advice that I would never give
on a podcast, particularly with someone, a healthcare professional like you, which would
be to say that you should go to the pub in the morning.
And that way the alcohol is out your system by the evening and there's no harm, no foul.
But I would never suggest that publicly.
Spoken like a good Brit.
There you go.
Good job. Yeah. Okay, cool. But, um, and I think the last piece of advice, last of the five tips,
so we've gone from regularity, darkness, temperature, um, alcohol and caffeine.
The final thing I would say is walk it out. And this comes back to anxiety. What I mean by that
is don't stay in bed awake for too long. And the reason is that our brains are incredibly associative devices. And if you lie there in bed awake very quickly, your brain night after night, week after week starts to learn the association between your bed being the place that you are awake, not asleep. And I hear this from patients a lot. They all sort of say, look, I'm falling asleep watching television on the couch. And then I get into bed and I'm wide awake and I don't know
why. And it's because the bedroom has become a trigger for wakefulness, for being alert.
And so what you need to do is break that association. So if you haven't fallen asleep
after 20 minutes or you've woken up and you haven't fallen back asleep for 20 minutes, one piece of advice, and it's not the only solution, but one piece of advice is get up, go to a different room and in dim light, just read a book or a magazine.
Don't check email. Don't eat because it trains your body to wake up for that repetitive stimulus.
And then only return to bed when you are sleepy. And there's no time limit for that. And that way you will relearn the association that your bed is the place of quick and sound sleep rather than the place of wakefulness.
So I think the analogy there would be, you know, you would you would never sit at the dinner table waiting to get hungry. So why would you lie in bed waiting to get sleepy?
And the answer is that you shouldn't because it creates a bad associative behavior.
I love that. One of the things, the strategies that I use with people is I have this like a 10 to 15 minute window. So the 10 is maybe a little more ambitious than what you're suggesting.
And so if I can't fall back asleep, let's use that one first in like 10, 15 minutes,
then I definitely get up. But what I've been, what I, what I found to be useful is, let's use that one first in like 10, 15 minutes, then I definitely get up. But what
I've been, what I, what I found to be useful is that let's use the associative impairing mechanism
for behavioral modification change is that I can't tell you how many times I've brushed my teeth at
night, crawled into bed and fallen asleep just fine. So what I do is I get up, go grab my
toothbrush. I don't turn the lights on.
Grab my toothbrush, brush my teeth without toothpaste.
I don't need it anymore.
But then just that sensation and the sound, it's like this trigger and pairing.
Like, oh, it's time for sleep.
And you've got hundreds of thousands of repetitions at this.
I know what I'm supposed to do.
And so I found actually that to be a good technique.
The other is to get up the book.
It depends on the book, right?
Don't open up your phone.
Bad decision, right?
But go grab a little book, whatever.
The more boring, the better.
And then as well as a third is just go jot some stuff down.
The stuff that's swirling, you know, a little dump pad, get it out.
So those are the three strategies I've found to be, you know, most useful. I really like the toothbrush. You know,
we are all, you know, Pavlovian dogs in that regard. We're all creatures of, you know,
stimulus response habit. But I think your point is very good one. The last one about journaling
or just getting your concerns out. One of the things that I'll often recommend to people who are struggling with sleep, especially if they are sleep anxious and
anxiety, we now understand is the principal underlying cause we think of, um, of many
circumstances of insomnia, um, because of a, an overdrive of the fight or flight branch of the
nervous system together with, um, a sort of a cortisol reaction, which is a
hormonal reaction. So one way that you can try to ameliorate that anxiety, you know, just to speak
in plain terms when people will say to me, like I wake up and all of a sudden, as soon as I wake up,
the Rolodex of anxiety and concern just starts whirring in my brain. And at that point, I'm dead in the water for the next hour. The first question you need to do is to say, don't turn to sleeping pills. And we can speak
about why you shouldn't do that. But you should actually, that's just putting a bandaid on the
problem. Ask yourself, why are you anxious and how can you resolve that anxiety? And one way that
you can do that is an hour before bed, just grab a pad of paper and a pencil and do what you suggested,
which is a worry journal. Just vomit out all of the anxiety and the stress and the concerns that
you have on a piece of paper. And the studies demonstrate that you end up having done that,
falling asleep within about half the time that it would normally take you otherwise.
So it sounds very woo-woo and sort of hokey, but the science is pretty sound.
The other thing I would say is if you don't like the idea of getting out of bed,
going to a different room, which I understand, meditation has been demonstrated to be wonderfully
efficacious. Now, sometimes if you're doing guided meditation with apps, then obviously that poses a
problem because you need to use your phone or you need to disrupt your bed partner.
But if you can just walk yourself through having trained on meditation practices during the day and you could do it yourself, that's wonderful.
If you don't feel comfortable doing that type of guided meditation, simply doing belly breathing.
And what I mean by that is not breathing up into your chest and sort
of, you know, making your shoulders a little bit higher. That's sort of, you know, that's actually
the worst type of breathing because it will cause hyperventilation and it will stress your nervous
system. Instead, belly breathe where your belly becomes big and sort of fat and you push it out
and you sort of breathe that way. That actually activates what we call the parasympathetic
nervous system, which is this sort of quieting branch of the nervous system. And it deactivates
the fight or flight branch of the nervous system, which is called the sympathetic nervous system,
which I always think is poorly named because it's anything but sympathetic. It's very
activating and aggravating and stressful. It can be very good, you know, in certain circumstances, but it shouldn't be switched on for sleep. And in fact, it's impossible, no matter how tired or
sleep deprived you are, it's near impossible to fall asleep if your fight or flight branch of the
nervous system is switched on. And this is a syndrome that I'm now starting to see a lot more
of, which I ascribe to the exhaustion economy, which is tired and wired.
That people will say, I am desperately tired.
I am so sleepy.
But I get into bed and I'm just so wired that I can't fall asleep.
And I think many players that I've worked with in professional sports have this after
a game that they know they're tired and it's 2 o'clock in the morning.
And normally, they'd be fast asleep.
But they're just too wired after the game that they can't fall asleep. So doing these types of practices can be immensely helpful
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You know, that deregulation is so critically important.
And one of the strategies, like I just learned this from an athlete this year that I thought was incredible,
is it's not totally related to sleep, but it's part of
the decompression is, so he's in a combat sport. He says, listen, after my games, I don't have
family in the car. I work on just making sense of what happened on my drive home. I just process
what I experienced and did. And by the time I go into my house, I'm like, he calls it five steps down at a scale of
one to 10, he's five steps down. And so it's like, now I've got an easier chance to go kind of
almost be normal, you know? And then by the time, and it's an accelerant to falling asleep faster.
And so that's a cool little process. And the other piece is like, as you talked about the
abdominal breathing, the belly breathing is that I think I was 12 or 16. I think it's 12, 12 abdominal breaths is the beginnings
of where the parasympathetic begins to really take hold. Isn't that a cool piece of information?
Like, so if you can get to 12, you're at the beginning stages of parasympathetic activation.
And I think, you know, so much of this is not just about quieting our
nervous system within the body, but there's also a challenge, which is quieting our mind,
because in this modern era, we are constantly on reception and very rarely are we on reflection.
And the only time nowadays when we do reflection is when our head hits the pillow, when we get into
bed, and that's the last time you want to be doing reflection that's that anxiety rolodex so i think people
sort of starting to address exactly what's going on in their mental life just as you were describing
with that athlete that you know the need to process and work through those things um so
getting one's mind um off itself almost uh when you're trying to fall asleep is critical.
And there's a lot, you know, there's ways that you can do that.
Firstly, a myth that I should bust is counting sheep.
It's a complete fallacy.
In fact, if anything, the studies demonstrate that when you count sheep, it takes you longer
to fall asleep.
So don't count sheep.
But what they have found is that if you just take yourself, for example, for a mental walk, if you can think about a walk that you know well, you know, on the beach or in the woods or
just around your neighborhood, try to just take that mental walk like virtual reality in your mind.
And what you're doing is tricking your mind to shift away from this interceptive focus on
concerns and become a little bit more extraceptively focused
on sort of, you know, the outside world or the virtual outside world that you're projecting.
That's been shown to be helpful. And then also just take away triggers. You know, phones in
bedrooms can be real triggers and we can speak about the three or four ways as to why they are
problematic, but also simple things. Clock faces are a great example,
and there's good science. If you are sleep anxious or you're suffering with sleep problems,
remove all clock faces from your view in the bedroom. They will do you a terrible disservice,
and they will just create more sleep anxiety. So a couple of little hacks that you can do.
Yeah. On that note, I love seeing this or noticing this is that over the last, let's call it maybe three years,
when I traveled to hotels, I'm not, I know I'm not the only one that would go to a hotel and
unplug the clock. And I think that people were so bothered by it because of the resource to
plug the thing back in or, um, and to reprogram it is problematic. So they're like
flat screens now. Have you seen that? And so all you have to do is just put it on the nightstand
and like put it down on the nightstand and it covers the, uh, the entire like light as well
as the actual display. Yeah. Part of the things, one of the, the ideas I've had for one of those sort of coffee table fun, you know, in which ways are you trying to like hotwire that
alarm clock so that it, you know, it definitely won't go off or cover the television with X number
of blankets and pillows. And, you know, I would love to do that. I'm sure there's no end of
wonderful stories. Yeah. Socks over the, the, uh, the air conditioning blue light that is like,
it's crazy. Okay. Yeah. All right, good. So let's do a couple
quick hits on like some real stats. And I know that you have cited that 40% memory deficit while
sleep restricted. Do you have some other stuff that is like just quick hits that people can go?
Ah, yeah. Okay. Got it. Yeah. So I'll start with just, um, you know,
men, firstly, we, what we know is that, um, men who are sleeping four to five hours a night will
have a level of testosterone, which is that of someone 10 years, they're senior. So a lack of
sleep will age a man by a decade in terms of that critical aspect, wellness and virility. We also see similar
impairments in female reproductive health. We see about a 30% increase in abnormality of menstrual
cycles with insufficient sleep. Men who are sleeping less also have significantly smaller
testicles. And there's evidence in animals that that's actually a causal.
It's not just simply associational.
So that's reproductive health.
We could take a step down and we could speak about the cardiovascular system.
And I'll give you one statistic.
There is a global experiment that is performed on 1.6 billion people across 70 countries twice a year.
And it's called Daylight Savings Time.
And one of the things that we've discovered is that in the spring, when we lose one hour of sleep,
we see a subsequent 24% increase in heart attacks the following day.
But yet in the fall, in the autumn, when we gain an hour of sleep, we see a delightful 21% reduction in heart attacks, which just stunned us when you're
seeing that type of data. We see exactly the same profile for things like suicide rates.
We see the same profile for road traffic accidents. You even see the same profile
in the harshness of federal judges and the sentencing that they provide on those days. So you definitely
don't want to be sentenced on that day after the spring time shift. You get a much harsher sentence
because of insufficient sleep. I'll take a step down then into the immune system.
And there is a critical set of anti-cancer fighting immune cells called natural killer cells.
And you can think of them almost like the sort of the James Bond secret service agents of your immune system.
They're very good at identifying especially cancerous bodies and destroying them.
So what you want is a virile set of those anti-cancer fighting immune cells. And what we've found is that if you limit someone to four hours of sleep for one
single night, we see a 70% drop in natural killer cell activity, which is an alarming state of
immune deficiency. And that happens after just one single night of sleep.
Why is that? Like, what is the reason that we think that resource would, because natural killer cells are a long-term play.
Let's clean up the house now so we don't have problems later.
And so is that because we kick into some more survival mechanisms because our vigilance is compromised?
We're not thinking clearly.
We don't remember as well.
So we put brain resources somewhere else.
It actually seems to be more down to the bodily consequences of insufficient sleep and particularly two axes, one nervous system, one hormonal.
The first is that when you are underslept, that fight or flight branch, that sympathetic nervous system kicks into high gear.
So it's almost as though your car engine is in neutral, but you've got the foot to
the floor in terms of the gas pedal, and you're just revving the nervous system. Now, sometimes
you need to rev the nervous system, you know, if you're being attacked by a saber-toothed tiger,
and that's important. But to leave it on chronically, day after day, after, you know,
night after night of insufficient sleep, leads to a state of essentially chronic nervous system agitation from
the sympathetic branch of the nervous system. And when you have that, what you end up seeing is that
your immune system becomes compromised. As a consequence, you end up having long-term chronic
inflammation because the immune system isn't operating properly because that fight or flight
branch of the nervous system is constantly switched on. So that's one reason. The second is because of what we call the HPA
axis within the brain, which is a hormonal axis, which goes from the hypothalamus in the brain
down to the pituitary in the brain and then out to the adrenal glands. So you essentially become
hyper sort of adrenaline based. And when you have
high levels of adrenaline, you also typically have high levels of cortisol. Cortisol is a
stress related chemical. It's good for short term use, bad for long term use. And when you have high
levels of cortisol, you also block the immune system. So it's probably for both of those
pathways that we see this remarkable demolition of every aspect of your immune system. So it's probably for both of those pathways that we see this remarkable
demolition of every aspect of your immune system. And in fact, I can give you two other examples in
the immune system. We know that if you're sleeping five hours of sleep versus eight hours of sleep,
you're about 10 times more likely to catch a cold. The other one is a striking finding if you were to get your flu shot um during flu season
and you've only been getting let's say five or six hours of sleep you will create less than 50
percent of the normal antibody response rendering that flu vaccination largely useless so you can
go and get your flu shot but if you haven't slept well the week before it there's no reason for you to come get that flu shot because it's a moot point.
It won't trigger the right antibody response.
You're not going to be immunized.
So I think at every level, we can see that immune system compromised.
The other one that's probably interesting for athletes and that may not be discussed enough, is the regulation of blood sugar. You need to pack in
blood sugar into the muscles to have enough energy in those muscle fibers. But what we found is that
if you take people who are perfectly healthy, no signs of diabetes, but then you limit them to
four or five hours of sleep for one week, at the end of that one week, their blood sugar regulation
is so poor that they would
be classified as being pre-diabetic by their doctor. Wow. Jeez. I mean, the costs are outrageous.
Now that everyone that's listening, myself included, is like, okay, let me sharpen up my
game. I know that you're going to have a point of view that sleep aids or I should say like prescription sleep aids are not sensitive
enough of an instrument. And, but I'd like to hear your take on it. I'd like to hear your take on CBD
and I'd like to hear your take on melatonin. So we're going to check the box on mindfulness.
We're going to check the box on behavioral strategies, pre-sleep, and even during interrupted
sleep. We've checked those two boxes.
Now, what about some of these other aids? And there's also some products that people are using,
but let's just start with the medication slash consumables.
So unfortunately, there's not good news for sleeping pills. This was probably the only chapter of my book where the publisher got
their legal team in because they feared litigation from the pharma companies. But the evidence is
just robust and very strong. Firstly, we know that when you're taking sleeping pills, I won't
name any particular brand, but these are prescription sleeping pills that people take.
Firstly, they do not produce naturalistic sleep. So again, there are a
class of drugs that are sedatives. They're called the hypnotic sedatives. And if I were to show you
the electrical signature of your sleeping brainwaves when you're taking these medications
versus when you're having natural sleep, they are very different. They're not the same. So you're
not getting natural sleep. That perhaps wouldn't be bad enough. But unfortunately, what we found is that sleeping pills are associated with a significantly higher risk of death as well as cancer.
Now, right now, that evidence, I should note, is simply associational, but it's very strong in terms of its association. And the reason that we'll probably never know if it's causal in humans is because
the relationship between increased risk of death and cancer with sleeping pills is so strong,
you probably wouldn't get the ethical approval to do the study to look at the causal relationship.
That's how powerful it is, frighteningly. So the other two things about sleeping pills,
firstly, they tend not to perform above and beyond placebo, not very
much more at least. And it was for this reason that in 2016, I believe, the American College
of Physicians made a landmark recommendation after they reviewed well over 40 placebo-controlled
studies. They suggested that sleeping pills, because of their minimal benefit over placebo
and because of these health concerns we've just discussed should not be the first line treatment for insomnia anymore it has
to be something different called cognitive behavioral therapy for insomnia or cbti go figure
yeah you know and use your own internal volition use your own internal like resources to actually
work with a sustainable solution go go
figure right well you're talking you're talking to a psychologist so like i love finding of course
yes okay yeah i think you're absolutely right which is you know cbti actually addresses the
underlying problem whereas i think sleeping pills are simply a band-aid um they're not really going
to address the wound in that sense. So
CBTI, if people are struggling with sleep, I would strongly recommend them doing some research. You
can go onto the National Sleep Foundation website and you can find yourself a provider of CBTI,
cognitive behavioral therapy for insomnia. So that's sleeping pills, um, that unfortunately I would not advocate for.
What are the alternatives?
Well, you spoke about melatonin, which is actually quite interesting.
The early studies actually suggested that, um, melatonin is not necessarily efficacious,
uh, for people who are regular in a time zone.
So when you're going through jet lag and suffering
from jet lag, melatonin can actually be quite helpful. But once you're stable in a new time
zone, it doesn't necessarily seem to cause an improvement. That said, I'd probably add two
caveats. The first is the placebo effect is probably the most reliable effect in all of
pharmacology. And so if you think it's working for you, then I would say, you know, no harm, no foul there again. Maybe that's just fine to take.
So the one thing I would note about melatonin, however, is that it's not FDA regulated. So it's
a supplement, it's over the counter. And in one study, they looked at about 20 different vendors
of melatonin that you could buy online or in a health food store.
And they looked at what it said was the concentration on the bottle versus what was actually in the pills that you were taking.
And frighteningly, the dose accuracy ranged from anywhere between 80 percent less than what it said on the bottle to about 160% more than what it said on the bottle.
And if that wasn't bad enough, what they found was that even within any one batch, sorry, even
within any one vendor, with any one sort of maker, from one batch to the next, there was a lot of
variability too. So it's a little bit of a wild west when it comes to melatonin. But I would say that if you do feel it's beneficial
for you, take it. It does seem to be more beneficial for people as they get older. That's
where we start to see the real sort of efficacy, the real effectiveness of melatonin. Something
else that's got me interested, though, is that a lot of the studies with melatonin showing that
it doesn't really have a true sleep benefit were done back in the early 2000s and after that people
thought well that's been done let's leave it alone i think there may actually be a benefit of
melatonin in this more modern era because we're bathed in so much more artificial light especially
from devices that were not around in as much you know know, in the early 2000s. So I think
we're looking into this to do some studies now to see if melatonin can actually help combat some of
that electrical light pollution that we suffer. I love it. Would you, okay, and I want to hit CBD,
but before I ask you that, so let's say that we're going to do a trip, a West Coast team's
going East Coast, which is harder than to go the other direction,
right? If you're going to perform. And I want to ask you why traveling that direction is harder.
But that being said, I'm clear. You would say no sleep aids or no prescription medicine.
And if we're going to do a European trip and we're going to travel 11 hours, you would also say no prescription aids.
But it sounds like you would say, hey, let's do some behavioral stuff.
Let's start adjusting our clock six days before to try to get ahead of time zone stuff.
And let's use some melatonin.
Does that sound right?
It does, yeah.
So let me backtrack.
The first question, why is um easier when you're traveling
west and harder when you're traveling east well it's really just a very simple fact when you're
traveling west you end up having to stay up later you have to stay awake later which is easier for
you to do when you're traveling east you have to force yourself to sleep earlier, and that's harder.
Now, there are some subtleties around the way that the circadian rhythm and particularly the circadian clock in the brain called the suprachiasmatic nucleus deals with east to west travel.
But by far and away, the bigger factor is just that when you're traveling west, what you need to do is just stay awake a little longer and consciously and volitionally that's just easier to do it's very difficult to travel east and you know it's 10
o'clock and fall asleep right yeah yeah which is essentially you know seven o'clock you know west
coast time and say okay i'm just going to get into bed at seven o'clock and force myself to go to
sleep you just can't do that in a willful way. Whereas it's much easier to willfully stay awake
than it is to willfully go to sleep. Got it. Okay. So let's punch over to CBD really quickly.
CBD is interesting. I should firstly note that THC, which is the sort of the psychoactive
component of cannabis. It's the thing that sort of, you know, gives you the high tetrahydrocannabinol.
THC is not good for sleep.
It does help people help.
I should, in inverted commas, it does help you fall asleep faster.
But THC is actually very good at disrupting your REM sleep.
So it's a little bit like alcohol in that way, although it does it through a different
mechanism.
So I would advise against the use of THC. CBD, we don't yet have enough evidence for me to sort of, you know, really go out on a limb
and say, I think CBD is a great compound for sleep, but I actually think it has some really
impressive promise right now. If you look at some of the evidence, the preliminary evidence,
you speed up the time it takes you to fall asleep. There is a possible increase in some deep sleep.
You don't suffer the blockade of REM sleep, rapid eye movement sleep, which is dream sleep,
that you do with THC. It may reduce the number of times that you wake up throughout the night.
There doesn't seem to be strong signs
of tolerance or rebound insomnia, which is when you stop using it, you get hit with nasty insomnia,
which does seem to be the case with THC. So I think there is some emerging hope for CBD. In
fact, there was a study that just came out about three days ago in a population of about 100 people looking at long-term CBD use.
And they showed, again, some positive benefits. The magnitude of that benefit was almost about
80% of that, which you typically see for common sleep prescription medication in terms of overall
sleep quality. You do need to be very careful with the dose, though. And I think we've yet to understand the dose. At some doses, perhaps slightly lower doses, CBD may actually cause insomnia. It may keep you awake. Whereas at sort of higher doses, it may be more soporific and help you with sleep. But that's still yet to be worked out. I would be very cautious as to buying brands off the internet where you can't really understand
the dose.
And even right now, scientists like myself, we don't really have the data to tell you
exactly what that dose is.
So I think it's CBD, very promising, THC to be avoided.
But for CBD, I think give it another year or two of scientific study and we'll understand
the correct dosing.
I'm right there with you. The melatonin piece around not knowing exactly what's in the pill
holds true for CBD as well because it's not regulated. That being said, is that some of
the more reliable companies that are saying, hey, listen, we got 0.3 THC and you can't strip all of
it out of CBD. There's one company that's promoting that they have stripped all the THC out. But listen, I'm not going to
trust that until we actually see some lab results from it.
So there's a trace. 0.3 is a trace amount of
THC. As far as I can tell, none of the CBD
stuff, when they're stripping out the THC as best as possible,
there's no high,
there's nothing like that that's going to happen. What is happening is a, it's a mechanism that is
helping promote sleepiness. And, you know, the other research is really promising too,
around some of the other benefits of CBD, and it's early, it's really early.
It's very early. And I think, yeah, there's a lot of, I think, hype. And we'll look back and, you know, maybe sort of like cryptocurrency, you know, Bitcoin,
that there was a big hype and all of a sudden it imploded on itself.
But I think the evidence is favoring CBD for pain.
I think it's favoring it for anxiety.
I think it's emerging, but not as strong for helping the immune system.
And I think it's trending towards
some potential benefit for sleep. But right now, I think all we have for CBD, especially for sleep,
is mostly headlines. And I would never follow headlines. I would follow trend lines rather
than headlines. Yeah, I've been trying to, so I found a company that I really think are very
thoughtful and they've got the right approach to it.
It's not a mass consumer product and it's something that is more bespoke and boutique
and high fidelity.
And I've been trying to see the effects myself.
And the one I noticed above all else is benefits of sleep.
And so again, placebo, non-placebo, you know, no one wants to believe
that they're those victims of placebo. But anyways, so that's been my personal experience.
Well, I think, you know, the data, some of the data, and there's not many studies
that have conducted these trials with sleep and CBD in rats. And there you could argue,
you know, there probably isn't much of a placebo effect.
You know, you can't really get a rat excited about the fact that it's going to receive some CBD and get it to understand exactly the difference between that and THC.
So I think, you know, those animal studies, you know, which are tricky for people.
I think, you know, some people obviously have difficulties with animal studies in general, and we should be thoughtful about that too.
But that's one way you can get around the placebo issue and concern you know there's there was just not that long ago a piece of research that came out that says it could be very dangerous at high dosage and then when you really look at the
research around it it was um well the dose that they're talking about was a prescription-based
dose which is like 200x what anyone ever would buy, you know, off the shelf. And so I saw that
and I was like, okay, but it was a little misleading. It was a little bit salacious,
like trying to go counterculture to some of the early promises. Anyways, let's talk about
knowing your optimal amount of sleep. Like some people are outliers and they're listening to this and they go, oh gosh, am I an outlier or, or like, am I really kind of blowing it with sleep?
So how can you help somebody figure out if their right amount of sleep is 6.25 hours or 9.1?
Like how do you help people with that? So firstly, I would say from the scientific evidence that we
have that the number of people who can survive on seven hours of sleep or less without showing
any impairment rounded to a whole number and expressed as a percent of the population is zero.
Oh, come on. Okay. So, so this is not, there's not a normal distribution? There is not. Oh, my God.
But let me sort of come back.
That's just, I think, a slightly blunt answer to the question.
Let's make it more nuanced because it is more nuanced.
Firstly, we do know that there is a genetic mutation that allows people to sleep as little as about six and a quarter hours.
And we know what gene that is. It's called the DEC2 gene, D-E-C2 gene. It seems to have something to do with the regulation of the circadian system,
we think, but it's not quite clear. But yet, if you look at the, it's a small fraction of 1%
of the population, if you look at the numbers. in other words, a lot of people will be saying, Oh, well, maybe I'm one of those people. I,
cause I seem to think I do fine on just six hours of sleep a night.
The chances of you being one of those people are so small. In fact, it's much more likely that you
would be struck by lightning in your lifetime statistically than you would be to have that gene, to put it in context.
Would you want that gene?
I don't think I would right now because, firstly, we don't know if those people with that short-sleeping phenotype, that short-sleeping gene, actually have a shorter lifespan. We haven't
studied those people. But if you look at the data, what's really interesting is that
they may actually have a little bit more deep sleep. And when you deprive them of sleep,
and then you give them recovery sleep, which is often the way that we measure some of your sleep
need, they typically, they chow down on a lot more deep non-REM sleep during the recovery night than
other people who don't have that gene take on board, which is a good thing. That would suggest
maybe that's why they can get by on, and a quarter of hours of sleep, because they have
kind of a supercharged, turbocharged-like version of deep sleep. However, if you look at that data,
it comes at the cost of rapid eye movement sleep, of REM sleep. And we know that, firstly,
rats will die as quickly from a lack of sleep as they will from a lack of food.
So sleep is just as essential for life as food.
But what's interesting is that if you selectively deprive a rat of either rapid eye movement sleep or non-rapid eye movement sleep, the rat will die more quickly of dream sleep deprivation than it will of deep sleep deprivation. In other words, these short sleepers are having less rapid eye
movement sleep. And it seems to be in terms of your mortality, that rapid eye movement sleep
or a lack of it would probably seal your fate quicker. So right now, I think we just don't know.
And on the basis of that, if you were rolling the dice for me, I would prefer not to have that short
sleeping gene. More generally coming back to your question,
though, how do you understand your sleep need? This is a real problem because one of the other
issues with a lack of sleep is that your subjective sense of how well you're doing
when you are underslept is a miserable predictor of objectively how well you're doing with a lack
of sleep. In other words, it's a little bit like
a drunk driver at a bar who's had, you know, seven or eight shots and a couple of beers and they
pick up their car keys and they say, look, I think I'm fine to drive home. And your response is no,
subjectively, I know you think you're fine to drive, but trust me, objectively, you are not
fine to drive. It's exactly, yeah, it's exactly the same way with a lack of sleep. So people should not trust their own perception of their performance when they are underslept.
There's a couple of things that you can do to test this.
Firstly, if you're using an alarm, and I do advocate for alarms to keep regularity, but one question you can ask yourself is, if your alarm didn't go off, would you sleep past your alarm?
And if the answer is yes,
then you're not getting sufficient sleep. Your brain is not done with sleep.
I need more sleep.
Yeah. It's the most simple and obvious question that I would ask everyone.
And if you look at what we see at the weekends, which is where we see something called social
jet lag, which is where people sleep late in at the weekends.
What they're trying to do is sleep off a debt that they've lumbered themselves with during the week.
And unfortunately, sleep doesn't work like that. Sleep is not like the bank. You can't accumulate a debt and then hope to pay it off at some later point in time. So that would be my simple question
for people as to how much sleep that you need. That's great. I love that. Okay. And then what
technologies are you bullish on that, you know, there's lots of noise that, you know, Apple
watches got into it. There's lots of technologies that are in the sleep game, sleep monitoring game.
Some are noisy, some create anxiety, some provide marginal feedback, you know that is applicable and i i can't tell you how often i've been asked
like hey i've only got like 40 no 4.7 minutes of non-rem sleep or of rem sleep is that normal like
like i you know so can you just speak on some technology feedback loops and essentially this
is going to lead to you know what, what can people do their struggle with
sleep, you know? So let's speak about maybe sleep trackers. And I think we can talk about that at
three different levels. The first is what does it mean for the first time really in society for the
general public to be able to track and monitor their sleep. And overall, I think it's a great
thing. Because in medicine, what we often say is what gets measured gets managed. And it's a crass statement, but I think it's often
true that it brings awareness to something, especially something like sleep where you are
unaware of it. Unlike, you know, you can probably feel yourself if you're gaining a little bit of
weight, your pants don't fit, you get a lot of feedback for that, but you tend not to get any
knowledgeable understanding of, you know, whether your sleep is good quality, bad quality and how it's varying from, you know, if I were to say, how well did you sleep last night, Mike, you could probably tell me.
But if I were to say, how well did you sleep last Tuesday, Mike, it's probably unlikely that you can tell me.
So I think these sleep trackers give a hysteresis that is useful.
But that said, I think it can come with some
downsides. There's a new sleep disorder that's teetering on the brink of being official,
which is called orthosomnia. Ortho from probably what people think about, which is orthopedics,
which is about strengthening bones. Well, orthosomnia is about getting your sleep straight,
getting your sleep right. And it seems to be that
some people when they're tracking their sleep, get so obsessed and anxious about it that they,
they suffer actually from insomnia because they are worried about what this tracker is telling
them. So overall, I think it's a good trend at the societal level that we're measuring sleep
with some exceptions, take a step down and we can ask the next level is are they accurate and for the most part most
wearables right now are not bad at quantifying the total amount of sleep that you've had
you know probably in the region of about 70 accurate 75 accurate but when it comes down to
then separating out all of the different stages of non-rapid eye movement sleep and rapid eye
movement sleep that i can do at my sleep center with electrodes and all of this sort of spaghetti
monster nonsense on your head. That's where the trackers are failing. That's where they're
struggling with somewhere between 50 to 60% accuracy. And that's why I would be cautious
right now in believing what your deep sleep numbers are or your REM sleep numbers.
I would say that once you establish a baseline, those devices are probably consistently inaccurate.
So you would be much better off not worrying about the absolute numbers, but worrying about
the change in those numbers from one night to the next. Once you've got a baseline established,
that's where I would probably put my money if that
makes any sense yeah that's so like once you get the baseline established and then you see
big swings that's right now that you're probably not doing well but if you if we make the assumption
that it's 70 accurate and you are 95 consistent then you're probably it's probably okay it's like
you got that first tenant of good sleep
which is the repeatability you know aspect like being stand having a standardized waking up and
falling asleep okay that's right okay yeah so i think yeah that's where i stand on sort of the
sleep trackers and i think a lot of people ask me you know what's the best sleep tracker i would say
probably the best sleep tracker out there is the sleep tracker that you use most consistently. Um, and that probably brings me
on to my, the third way that I think about sleep tracking, which is the form factor. Um, you know,
we typically go to bed and we take things off. We don't put things on to go to bed. So I am actually much
more enamored with the idea of unwearables than I am of wearables in this space now.
So I think the form factor is critical. I'm not necessarily a big fan of sort of headband
technology for consistently tracking your sleep throughout the night. I think the adoption rate there or the drop-off rate is probably going to be quite high.
Wrist watches, I think people, they're not bad, but I think people probably,
if you look at some of the numbers internally, and I won't mention names, but there is a pretty
precipitous drop-off of the utilization for sleep tracking after about the first 30 days. Again,
because I don't think people like the sensation of that on throughout the night, not all people,
but some people. I do like the ring format. There are a number of ring companies out there.
I think that that's less intrusive and I think that that has the potential,
but I think probably the greatest potential right now that we have is this thing called the mattress. I think it is a very good form factor for measuring sleep. I think it's got the chance
to measure a lot of signals. And what's striking to me, if you think about the car that you have
that you drove yesterday or the past couple of days, and you think about a car that you had,
you know, 50 or 60 years ago, in this day and age, that car is so technologically different
than it was 50 years ago. It's packed full of sensors and intelligent hardware. But if you
look at your mattress 50 years ago and where it is now, they're much more similar than they are
different. And I think, you know, mattresses are going to be a place where we'll see a lot of
evolved technology when it comes to sleep tracking. And I think that right now is probably
one of the best form factors for tracking sleep that I, that I can see out there right now.
I love your response. Super comprehensive and really thoughtful ranging from, you know, head
to chest, to wrist, to finger, to actually not a wearable, but the bed, we have a smart bed in our
home and I'm really interested in it. And it's, really interested in it and it's it's i think it's
great i think your analogy of the car and technology is fantastic how about those beds
that have cooling mechanisms like it's a water cooling system what are your thoughts on that
um i think body temperature is a real issue for many people and i think it's probably an
unrecognized it is for sure it is for me for males i think it through any sort of part of their life
it's a problem um and then i think for females once they get to a certain age as they're going
through menopause um hot flashes at night are a real cause of sleep disruption. So I do think that cooling
systems within beds are something that we can embrace. I think it's one of the ways that you
can leverage better sleep. I think that's the other reason that I like the mattresses. It's not
just an apparatus for measuring sleep. It could also be a tool for actually augmenting sleep.
And that's why I'm much more excited about it.
I love it. Okay. So listen, I want to honor our time. I feel like you and I have lots to talk
about when it comes to like, you know, helping athletes and helping humans at scale to be able to
like flourish and be better. So I want to, I want to say thank you. Thank you for your position.
Thank you for your knowledge and you know, the 20 plus years that have gone into being able to speak eloquently.
And I've really enjoyed listening and learning and celebrating what is the most important functions for human flourishing, which is getting this recovery system right of sleep.
So I just want to say thank you.
And where can people get your book?
Where can they find you?
Where can they follow along, whether it's the technology that you're building or whatever projects you have um so people can
find the book at any bookstore or online at amazon if that's your choice the book is called
why we sleep um and uh i will let some of the uh the reviewers speak for it you can filter
if you want to see the the bad stuff. It's pretty binary.
But so the book is called Why We Sleep and it's hopefully it provides a more comprehensive
view. Although this has been a delightful conversation. People can find me on the web
at sleepdiplomat.com. And they can find me on Twitter at the same handle at sleep diplomat. And finally, just thank you, Michael, for two
things, actually. Firstly, the work that you do, especially with this podcast, but out in the world,
I think the way that you approach what you do is utterly unique. I love the embodied approach that you take to what has normally been a singularly body uh i think um
profession and the embodied view is so critical and it's so forward thinking and i think you've
been you know one of if not the leading voices in that so i think that that's something to be
um you know truly honored and i i think you're brilliant at it and then the second part is
keep going keep going that was wonderful no that means a lot coming from you so thank you thank And I think you're brilliant at it. And then the second part is just to say. Keep going. Keep going.
That was wonderful.
No, that means a lot coming from you.
So thank you.
Thank you.
Thank you.
Thank you.
But I would add to that, too.
I think there's also a graciousness about which you conduct your business and yourself
and the interactions that you have with people.
You know, I've listened to lots of your podcasts and I enjoy them very much. And, and that degree of a grace, gracious nature
with which you gift people sort of the ability to, to bring to, to a huge audience, you know,
what their story is and how they can learn from them. And there's something, you know,
very skilled in that graciousness. And I would, not many people have it and you do, and I think it's innate and I
think it's a delightful quality that we can all learn from. So that's the other thing. And the
final thing I would mention is just also thank you for giving me this opportunity to speak on
the podcast. You know, I think I have a mission. I am desperately trying to reunite humanity with
the sleep that is so clearly bereft of. And I can only
do that by way of partnering with, you know, wonderful folks like you who give me the chance
to speak to an audience. So thank you for being a wonderful sleep ambassador by way of this
opportunity. I so greatly appreciate it. That's awesome. And you know what, the graciousness
has returned. So thank you, recognized. And you know what? The graciousness has returned. So thank you. Recognized. And I made a conscious decision, maybe in error, but hopefully not, that there's two ways
these conversations go on finding mastery. One is about mastery of self. And the other is really
about mastery of craft and the knowledge and insight to help people be better. And I made
the decision because I know how important sleep is to talk more
about your craft than about you. So if you're open to it, I'd love to do a part two and note,
it's obvious how well you understand. So I'd like to deconstruct your early life and how it led to
some of the phases in your life to really go deep, to become world leading in a very important human function.
So if you're open to it, when the timing is eloquent, I'd love to do a part two,
which is really about you. And I think it's going to be a harder conversation.
I would love to. For me, I think it certainly is. And I would love to do that. That sounds
lightful and frightening.
My biggest worry is that I am the most bland, vanilla character that you will ever encounter. Everybody says that.
Yeah, everyone says that.
Then we get into the good stuff.
It's like, oh, you're just like me.
You know, you struggle there too.
Yeah, okay, good.
But I would be delighted to come back at any point, should there be the appetite and interest from yourself or the audience or both.
I'm about it. Yeah, very cool. Matt, thank you. Thank you. Thank you. Thank you.
And I'm stoked to know you. So wishing you the best and we're going to get a part two soon.
Likewise. And I look forward to the latter. All right. Take care, Matt.
Thanks very much. Take care. Bye. Bye.
Bye.
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