Huberman Lab - Guest Series | Dr. Matthew Walker: Protocols to Improve Your Sleep
Episode Date: April 10, 2024This is episode 2 of a 6-part special series on sleep with Dr. Matthew Walker, Ph.D., a professor of neuroscience and psychology and founder of the Center for Human Sleep Science at the University of ...California, Berkeley. We discuss basic and advanced tools for improving sleep and explain how sleep quality is affected by temperature, light and dark, caffeine, alcohol, cannabis, nutrition, meal timing, and different medications. Dr. Walker also provides strategies for coping with a poor night of sleep, wind-down routines, technology in the bedroom, insomnia, visualizations, and building sleep “confidence.” We also discuss the current status of sleep research for developing advanced techniques to optimize sleep. This episode provides numerous zero-cost behavioral protocols for improving sleep quality and restorative power, which can benefit daytime mood, energy, performance, and overall health. The next episode in this special series explores napping, caffeine, and additional protocols to improve sleep. For show notes, including referenced articles and additional resources, please visit hubermanlab.com. Thank you to our sponsors AG1: https://drinkag1.com/huberman Helix Sleep: https://helixsleep.com/huberman WHOOP: https://join.whoop.com/huberman Waking Up: https://wakingup.com/huberman InsideTracker: https://insidetracker.com/huberman Momentous: https://livemomentous.com/huberman Timestamps (00:00:00) Improving Sleep (00:01:16) Sponsors: Helix Sleep, WHOOP & Waking Up (00:05:30) Basics of Sleep Hygiene, Regularity, Dark & Light (00:12:05) Light, Day & Night; Cortisol, Insomnia (00:18:45) Temperature; “Walk It Out”; Alcohol & Caffeine (00:26:05) Sleep Association, Bed vs. Sofa (00:29:43) Tool: Falling Asleep; Meditation, Breathing (00:35:23) Sponsor: AG1 (00:36:37) Alcohol & Sleep Disruption (00:40:01) Food & Sleep, Carbs, Melatonin (00:49:25) Caffeine; Afternoon Coffee, Nighttime Waking (00:55:52) Caffeine Metabolism & Sleep, Individual Variation (01:01:19) Sponsor: InsideTracker (01:02:04) Cannabis: THC vs. CBD, REM Sleep, Withdrawal (01:12:03) Sleep Hygiene Basics (01:16:08) Tool: Poor Sleep Compensation, “Do Nothing” (01:20:23) Tool: Sleep Deprivation & Exercise (01:24:11) Insomnia Intervention & Bedtime Rescheduling, Sleep Confidence (01:32:58) Wind-Down Routine; Mental Walk; Clocks & Phones (01:41:29) Advanced Sleep Optimization, Electric Manipulation (01:50:07) Temperature Manipulation, Elderly, Insomnia (01:58:57) Tool: Warm Bath Effect & Sleep, Sauna (02:04:36) Acoustic Stimulation, White Noise, Pink Noise (02:13:30) Rocking & Sleep, Body Position (02:24:17) Enhance REM Sleep & Temperature; Sleep Medications (02:28:35) Pharmacology, DORAs & REM Sleep; Narcolepsy & Insomnia (02:34:12) Acetylcholine, Serotonin, Peptides; Balance (02:40:45) Zero-Cost Support, Spotify & Apple Reviews, Sponsors, YouTube Feedback, Momentous, Social Media, Neural Network Newsletter Disclaimer
Transcript
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Welcome to the Huberman Lab guest series,
where I and an expert guest discuss science
and science-based tools for everyday life.
I'm Andrew Huberman, and I'm a professor of neurobiology
and ophthalmology at Stanford School of Medicine.
Today marks the second episode
in our six episode series, All About Sleep,
with our expert guest, Dr. Matthew Walker.
During today's episode,
we discuss the do's and the do nots of sleep.
Focusing, for instance, on how to use light
and absence of light, as well as temperature,
both of your sleep environment,
specifically the room you're in, your body temperature,
and much more in order to regulate the timing
and quality of your sleep.
And we discuss how things like alcohol, caffeine,
and cannabis impact sleep and the various stages of sleep.
And we discuss the various tools that exist now and that are rapidly becoming available
to improve your sleep.
This episode is essential for anyone trying to optimize their sleep.
And when I say optimize your sleep, I mean trying to optimize the formula that was addressed
in the first episode of the series, which is the QQRT formula, the quality, quantity,
regularity, and timing of your sleep,
four variables that combine to determine
whether or not your sleep is optimized for you
and thereby providing the most restoration and improvement
to your mental health, physical health, and performance.
Before we begin, I'd like to emphasize that this podcast
is separate from my teaching and research roles at Stanford.
It is, however, part of my desire and effort
to bring zero cost to consumer information about science
and science related tools to the general public.
In keeping with that theme,
I'd like to thank the sponsors of today's podcast.
Our first sponsor is Helix Sleep.
Helix Sleep makes mattresses and pillows
that are customized to your unique sleep needs.
It's abundantly clear that sleep is the foundation
of mental health, physical health and performance.
When we're getting enough quality sleep, everything in life goes so, and performance. When we're getting enough quality sleep,
everything in life goes so much better.
And when we are not getting enough quality sleep,
everything in life is that much more challenging.
And one of the key things to getting a great night's sleep
is to have the appropriate mattress.
Everyone, however, has slightly different needs
in terms of what would be the optimal mattress for them.
Helix understands that people have unique sleep needs,
and they've designed a brief two-minute quiz that asks you questions like, do you sleep on
your back, your side, or your stomach? Do you tend to run hot or cold during the
night? Or maybe you don't know the answers to those questions. If you go to
the Helix site and take that brief quiz, they'll match you to a mattress that's
optimal for you. For me, it turned out to be the Dusk D-U-S-K mattress. It's not too
hard, not too soft, and I sleep so much better on my Helix mattress than on any
other type of mattress I've used before.
So if you're interested in upgrading your mattress, go to helixsleep.com slash Huberman,
take their brief two-minute sleep quiz, and they'll match you to a customized mattress for you,
and you'll get up to $350 off any mattress order and two free pillows.
Again, that's helixsleep.com slash Huberman to save up to $350 off and two free pillows.
Today's episode is also brought to us by Whoop.
Whoop is a fitness wearable device
that tracks your daily activity and sleep,
but also goes beyond that by providing real-time feedback
on how to adjust your training and sleep schedule
to perform better.
I've been working with Whoop
on their scientific advisory council
to try and help advance Whoop's mission
of unlocking human performance. As a Whoop user, scientific advisory council to try and help advance Whoop's mission of unlocking human performance.
As a Whoop user, I've experienced the health benefits of their technology firsthand for
sleep tracking, for monitoring other features of my physiology, and for giving me a lot
of feedback about metrics within my brain and body that tell me how hard I should train
or not train, and basically point to the things that I'm doing correctly and incorrectly
in my daily life that I can adjust using protocols,
some of which are actually within the Whoop app. Given that many of us have goals such as improving our sleep, building better habits,
or just focusing more on our overall health, Whoop is one of the tools that can really help you get personalized data,
recommendations, and coaching toward your overall health. If you're interested in trying Whoop, you can go to join.whoop.com
health. If you're interested in trying whoop, you can go to join.whoop.com slash Huberman today to get your first month free. Again, that's join.whoop.com slash Huberman. Today's episode is also brought to us
by waking up. Waking up is a meditation app that has hundreds of different meditations, as well as
scripts for yoga, nidra and non-sleep deep rest or NSDR protocols. By now there's an abundance of data showing
that even short daily meditations
can greatly improve our mood, reduce anxiety,
improve our ability to focus and can improve our memory.
And while there are many different forms of meditation,
most people find it difficult to find
and stick to a meditation practice
in a way that is most beneficial for them.
The Waking Up app makes it extremely easy
to learn how to meditate
and to carry out your daily meditation practice
in a way that's going to be most effective
and efficient for you.
It includes a variety of different types of meditations
of different duration,
as well as things like yoga nidra,
which place the brain and body into a sort of pseudo sleep
that allows you to emerge feeling
incredibly mentally refreshed.
In fact, the science around yoga nidra is really impressive
showing that after a yoga nidra session,
levels of dopamine in certain areas of the brain
are enhanced by up to 60%,
which places the brain and body
into a state of enhanced readiness
for mental work and for physical work.
Another thing I really like about the Waking Up app
is that it provides a 30-day introduction course.
So for those of you that have not meditated before or getting back to a meditation practice,
that's fantastic.
Or if you're somebody who's already a skilled and regular meditator, Waking Up has more
advanced meditations and yoga nader sessions for you as well.
If you'd like to try the Waking Up app, you can go to wakingup.com slash Huberman and
access a free 30 day trial. Again, that's wakingup.com slash Huberman and access a free 30 day trial. Again, that's wakingup.com slash Huberman.
And now for my conversation with Dr. Matthew Walker.
Professor Matt Walker, welcome back.
We're all so happy to have you here.
And in episode one, you beautifully described
the biology of sleep, why sleep is important,
what happens when we don't get enough sleep,
and you incentivized
getting adequate amounts of great sleep.
You defined what great sleep is and you provided some excellent practical protocols and tools
for getting great sleep.
However, today you're going to tell us, I believe, about the protocols for really optimizing one's sleep, both conventional
tools and protocols and some, let's say, unconventional, not heretical, but unconventional tools for
optimizing one's sleep.
So let's start with the basics.
What are the basics of what I think I've heard you refer to previously as sleep hygiene.
Yeah, I think we, many of us can resonate with the idea of dental hygiene, but turns
out there's something called sleep hygiene.
And there are probably, I would say, five edicts of sleep hygiene. I offer them as tools and not necessarily rules because I don't think
people respond to rules. People respond to reasons and not rules. So if it's okay, I'll
probably just unpack each one of them rather than just sort of bark them at you and hope
people assume that it's the right answer.
I'll explain the answer so people understand why it's important.
So as I said, there are probably five things that you can start doing tonight to try to
improve your sleep.
The first we've spoken a little bit about in that first episode, it's part of the four
macros of good sleep.
First piece of advice, regularity.
Go to bed at the same time and wake up at the same time, no matter whether it's the
weekday or the weekend.
Regularity is king.
And the reason is because when you feed your brain the signals of timed regularity for
your sleep, it will anchor your sleep and improve the quantity and the quality of that sleep.
Because part of that signal of regularity going into your brain in terms of that repeated
behavior night after night, sleep, in other words, helps train that central 24-hour circadian
clock that we also spoke about in the first
episode.
So that's the first piece of advice.
Try to keep it as regular as you possibly can.
The second piece of advice is darkness.
In my view, we are a dark, deprived society in this modern era. And we need darkness at night, as well you've spoken about,
to release a hormone called melatonin.
And melatonin will help time the regular onset of your sleep.
So that sounds great, but what boots on the ground, Matt,
what does that mean?
I would suggest the following.
In the last hour before bed, try to dim down 50%,
if not more, of your lights in your home.
And you will be quite surprised
at how sleepy and soporific that will make you feel.
I will do this in a regimented way.
I have a little reminder that pops up and tells me now is the time to dim the lights
based on your bedtime.
And I'll go around and I'll shut lights down.
In my bedroom, I will actually have a small light bulb and it is way down to probably
as little as maybe five lux.
And lux is just a metric of the light.
It's way down there and it's also very deep orange sort of red,
and we can come on to why that's the case.
So that's the first thing, even before you're thinking about sleep,
start to decrease the light.
For example, if you were there at, let's say, for a standard sleep schedule at 10 p.m.
and normally you are getting into bed at 10.30 p.m., but you feel pretty wide awake, if there
was an electrical blackout and you lost your phone, magnetic too, phone goes down, lights
go down, total blackout, my suspicion is that fairly soon you'd say,
gosh, I actually feel quite sleepy. Whereas if the lights were blazing, you've got your
phone, televisions on, lots of stimulation, you're probably going to think 10.30, no,
I could probably push through for at least another hour. So try to dissipate that light.
And then if you need to, wear an eye mask, blackout
curtains, always good as well. But we need that darkness at night because when you give
the brain the signal of darkness, it releases effectively a brake pedal. That brake pedal
has normally been applied by way of light on the release of that spigot of melatonin.
And when you take the brake pedal off, it starts pumping out into the brain.
You can also then, of course, probably reverse engineer this trick in the morning.
And this is another component of why you've been, I think, such a wonderful advocate for
light in the morning.
It does many things, but one of the things that it does is reapply that break on melatonin
and therefore you lose the signal to your brain of darkness.
That's what melatonin in some ways is doing.
We often call it the hormone of darkness or the vampire hormone. Not necessarily because it makes you look longingly at people's necklines and
want to bite in, which is great if you're into that, but it's really simply about
it's releasing melatonin, which tells the brain, my goodness, it's nighttime.
But if you've got bright light on, you come from your office, you're driving
home, so you've got artificial light during
the day, which is probably not strong enough to stimulate you and bring you awake.
You come home and you've got again bright light, but it's still strong enough now to
prevent the release of melatonin.
You start to shift in your timing and you may have problems with your sleep.
So that's the second piece of advice.
I would love to ask you about that morning light too
and the alertness benefits.
I'm, as a sleep researcher, more focused
on the evening component of light and decreasing it,
but you've done a great job.
I don't know if there's anything.
There are a couple of quick points that are based
on some, what I consider really nice studies.
There's beautiful work in humans showing
that bright light exposure in the morning,
especially from sunlight,
but if one doesn't have access to sunlight
for whatever reason, there are commercially available
so-called SAD lamps, Seasonal Affective Disorder lamps.
They range anywhere from 5,000 to 10,000 lux, very bright.
But certainly morning sunlight viewing and lamps of the sort I just described have been
shown to increase the amplitude of the morning cortisol spike by as much as 50%, five zero.
So people hear cortisol and they freak out.
They think that's not good.
I want my cortisol low, but you actually want your cortisol highest in the morning and lower
in the afternoon and evening.
And there's a lot of reasons for that elevated mood focus
and alertness in the morning and throughout the day
and ease of getting to sleep at night,
lower anxiety, lower depressive symptoms and so on.
So that bright light also serves to control the amplitude
of cortisol in the direction you want
in the early part of the day.
The other thing that's just more of a underlying dynamics
of the circadian visual system,
which is a system that I worked on for years,
these wonderful cells in the eyes
that are not for image forming,
but rather for detecting sunlight and bright light
for sake of setting circadian rhythm,
is that the sensitivity of that system early in the day
is actually quite low.
So you need a lot of that system early in the day is actually quite low. So you need a lot of bright light early in the day
to effectively wake up your system
and shut down the sleepiness signals such as melatonin.
But later in the day, it's a rather diabolical system.
It takes very little light, even from artificial sources,
to disrupt your circadian rhythm and quash melatonin.
As little as 15 seconds of bright light in the evening, I think Chuck Zeisler's laboratory
at Harvard Medical School showed, can quash melatonin in the evening. Now, I don't want
people to freak out and think that they go into a hotel bathroom, which oftentimes those are very
bright, in the middle of the night, flip on the light that they're going to completely screw up
their circadian rhythms.
But if I'm honest, they'd be much better off using
their phone as a flashlight to navigate.
People always say, well, wait,
but the flashlight on the phone is very bright,
but let's just get logical here.
A light shown into your eyes, such as a flashlight,
is very different than looking at a flashlight beam
on the ground.
Far and away difference.
So the point is that if you don't get enough bright sunlight flashlight is very different than looking at a flashlight beam on the ground. Yeah. Far and away difference.
So, the point is that if you don't get enough bright sunlight or light in your eyes early
in the day and then you're indoors under artificial lighting, you might think, well, this is really
bright lighting.
This is the kind of lighting that could disrupt my circadian rhythm at night and therefore
it's sufficient to wake up my system.
No.
Early in the day and throughout the day, you need a lot of bright light as much as it's
safely possible to avoid sunburn
and things of that sort, which you don't want.
But then as the evening comes around, after sundown,
you need very little artificial light
in order to disrupt your circadian rhythm.
And then just very quickly, light from candles,
fireplaces is okay.
This is kind of interesting.
It seems bright, but the measurements indicate that
that's not going to shift your circadian rhythm much. Candles are great, but of course don't
burn your house down. So the orange and red tones in the evening, way dimmed down, that's
the way to go early in the day. Bright, bright, bright light as bright as you safely can tolerate.
And what I like about firstly your mention of cortisol, you described how cortisol is
rising in the morning and that's a great thing and it is a good thing.
And in the evening it's starting to drop.
And if you look right around your prototypical bedtime, and we're going to speak later in
this episode as to what your real natural bedtime is versus the one that you may be
taking right now.
It's very interesting.
Cortisol will almost hit its lowest point, something that we call its nadir.
It's the lowest point in that trough of its decline right around the time when you should
be sleeping.
However, it was a great study that looked at people with insomnia.
And in subsequent episodes, we'll discuss this too,
but one of the ways that we think about
or conceptualize insomnia is in two different flavors.
Sleep onset insomnia, I can't fall asleep,
and sleep maintenance insomnia,
I wake up, I can't get back to sleep.
And what they looked at was essentially cortisol levels.
They had a catheter in the arm and they were sampling it from the bloodstream. to sleep. And what they looked at was essentially cortisol levels.
They had a catheter in the arm and they were sampling it from the bloodstream.
And they were able to do that every 30 minutes.
So it's a little bit like time lapse photography.
And you're getting a data point every 30 minutes across the 24 hour period, looking at cortisol
across now a full 24 hour period.
And sure enough, when you look at healthy controls
who can sleep well and insomnia patients,
they look almost identical across the day.
But then when it comes to falling asleep
right around that bedtime period,
the healthy controls are going all the way down.
The insomnia patients go down and down and down,
and then they have a rise back up right
around that sleep onset period.
And then they start to drop back down again just as the control group.
But then they also often will have a spike in the middle of the night which then comes
down and then both of them are staying low throughout the early morning period and then
it starts to rise back up.
So it's not as though net-net overall,
there is a higher level of cortisol
in people with insomnia.
It seems to be right at those trigger zones
that map very nicely to sleep onset problems
and sleep maintenance problems.
Very interesting.
As somebody who wakes up in the middle of the night
and sometimes has trouble getting back to sleep,
that resonates.
I have no trouble falling asleep whatsoever.
Yeah.
Knock on wood.
I'm superstitious about this at this point, but I use tools like non-sleep deep rest,
yoga nidra, long exhale breathing.
And I think these wake up episodes seem to happen more when I'm processing a lot of stuff
from my daily life.
That's right.
You know, it's the unconscious brain oftentimes is working through things and will wake us
up.
Yeah, I often think that sleep maintenance insomnia that you've just described is the
revenge of daytime emotions unresolved.
That's a great way to put it, yeah.
So that would be, so we've spoken about regularity,
we've spoken about darkness,
and we've spoken about the inverse of that in the morning,
which is light, a little bit of cortisol.
So the third out of the five is going to be temperature,
and the advice here is keep it cool.
As we mentioned a little bit in the first episode,
and we will go into great detail
when we speak not just about these conventional and unconventional tips, but we're also going
to go into the future of science and where sleep science is taking us to, in fact, optimize
and even enhance our sleep. We will speak a lot about temperature. Suffice to say that
you need to drop your core body temperature and your brain temperature
by a little less than one degree Celsius, two to three degrees Fahrenheit, to get to
sleep and stay asleep.
The general target that we have in sleep science, if you look across the literature, is somewhere
around about the 67 degree Fahrenheit, or I'm trying to do the calculation, maybe
18.5 ish degrees Celsius.
Now I know that that sounds cold and cold it is, but you can also wear thick socks to
bed.
You can have a hot water bottle at the end of the bed.
That's great too, but the ambient must be cold. The fourth piece of advice is walk it out.
And here, what I mean is do not stay in bed
for long periods of time awake.
And I think we mentioned this perhaps
in the first episode too.
When you are awake in your bed for long stretches of time,
because your brain is an incredibly associative device,
it will quickly learn that this thing called my bed is the place where I'm awake and not
asleep.
And what you need to do is break that association.
If you've learned that time and time again, because you've stayed in bed and the rule of thumb, it's just a rule of thumb, about 20, 25 minutes.
If you can't fall back asleep or you can't fall asleep, it's okay.
Just say, tonight is not my night.
It's not a problem.
Tomorrow is not completely shot.
It's fine.
I'm just going to get up, get out of bed.
If you can, if you're lucky enough, try to go to a different room.
And in dim light, read a book, listen to a podcast, whatever it is that relaxes you,
just do that.
Don't check email, don't eat, because if you start eating, that again trains your brain
to start waking up and feeding at that time.
And only return to bed when you are sleepy.
And there is no time limit for that.
I don't want you to come back after half an hour
when you are still awake and not feeling sleepy enough.
Why?
Because you're gonna get back into bed
and be in the same problem again.
And gradually, if you do this, and it's hard to do it,
you will relearn the association that you had,
I'm sure, as a child, which is that your
bed is this place of sleepiness.
Because often people will be saying, I feel so tired in the evening.
And then they get into bed and they say, but now I can't fall asleep at all.
I don't understand it.
In part, it's because of that learned association.
So that would be the fourth tip. The fifth tip makes me even more unpopular
as a personality and character,
which is try to be mindful of your alcohol and caffeine.
Now, in a subsequent episode,
we'll go into great detail as to how caffeine works,
its mechanisms, why it is sleep disruptive, and why in fact
I've even perhaps changed my mind on caffeine and its benefits, but it also does have significant
detriments to your sleep.
So the rule of thumb here would be try to cut yourself off from caffeine probably at
least 10 or so hours before you expect to go to bed and you can just
calculate back calculate that and
Try to limit it. So the dose and the timing make the poison
Cut yourself off after maybe two or three cups of coffee and then that timing component
Count yourself back. Put yourself off decaffeinated coffee. Not too bad if you find the right thing too, if you need that fix.
Alcohol is probably one of the most misunderstood sleep aids in quotes that there is.
It is no sleep aid at all.
Now if I didn't understand what I know about alcohol and sleep, I would think that too,
which is, look, when I have a nightcap just before bed or two, even though I don't wear
them, I may actually just fall asleep very easily.
It feels like I stay asleep very soundly across the night.
So it's a great sleep aid and it really helps me.
There are at least, I would say three issues with alcohol.
The first is that alcohol is in a class of drugs
that we call the sedatives.
And sedation is not sleep.
But when you take on board alcohol in the evening,
you mistake the former for the latter and you think it helps you fall asleep.
The second thing is that because it's
sedation,
actually it's probably related to sedation, if I were to show you the electrical signature of your deep sleep
when you're just sleeping naturally versus when you have alcohol in your system. It's not really the same.
It's not a naturalistic form of deep sleep.
It mimics it.
It looks not too dissimilar.
But if I really do my analyses and I almost like that Pink Floyd album where I take the
white light of electrical brain activity coming from your head as you're sleeping and split
it apart into all of the different components, There are some components that are no longer present
or some that are abnormally present.
The second issue with alcohol is that it fragments your sleep.
So it will litter your sleep
with all these punctuated awakenings throughout the night.
The danger there is that many of those awakenings
with alcohol you don't remember because they're too brief.
But then you wake up the next day and you think, well, I didn't have a problem falling
asleep.
I didn't have a problem staying asleep, but I just feel rough.
I just don't feel restored by my sleep.
And you don't add two and two together.
The final concern with alcohol is that it's quite a potent blocker of your rapid eye movement
sleep or REM sleep.
And in subsequent episodes, we'll go into great detail as to the incredible learning
and memory creativity benefits that come by way of REM sleep.
Also it's essential for our emotional regulation and recalibrating our moods.
So for all of those reasons, I would say two things. First, if you are struggling with sleep,
not feeling restored by your sleep,
keep in mind your alcohol intake.
And also just in general, be mindful of that
if you are thinking about your sleep
and want to preserve it.
So much of what you just said resonates.
I confess that in my lifetime,
I've had periods of pretty spectacular sleep.
I characterize myself as somebody
that could fall asleep anywhere, anytime.
But I've also experienced the extreme challenges of sleep.
And that relates to different things, life circumstances, et cetera. In fact, recently I've had some challenges of sleep. And that relates to different things,
life circumstances, et cetera.
In fact, recently I've had some challenges with sleep,
despite using the protocols that I and others suggest.
I hadn't heard some of the things
that you're referring to here.
And middle of the night waking has become more of an issue.
I communicated this to a former girlfriend of mine
who I was in relationship with when I was a junior professor,
meaning before I got tenure.
And she said, you don't remember, you had a, Andrew,
but I do, you had a pattern back then of,
after I would fall asleep,
you would continue working on your laptop,
probably on grants. And then I would fall asleep, you would continue working on your laptop, probably on grants.
And then I would fall asleep working.
And then according to her, I would wake up in the middle of the night and work a little
bit until I'd get tired again and then fall asleep.
And then this would repeat.
So really stamping down the associative learning element that you talked about before.
So that was probably the first period of time in my life
in which I created this rather deleterious association
of work in the middle of the night in bed, right?
And then more recently, I've had the experience
of waking up probably due to these like daytime things
that I'm waking up in the middle of the night thinking about.
And now because of our discussion during the course
of recording this series, I get out of bed
after even 10, 15 minutes so that I can start
to eliminate that association.
And another piece is that I've always felt
that when I get out of bed in the middle of the night
because I can't sleep and I go to the sofa,
I often can sleep very well. Proving.
Proving, right?
It's a control experiment.
Proving that the location of sleep is the, and the association of wakefulness and sleep
in bed as opposed to on the sofa is a clear component.
And this is in an environment that's of equal temperature.
I mean, it's not a perfect experiment, right?
It's anechidata, as we say. But I think that the associative piece is, oh, so strong for many people.
And so this is something to really take seriously.
I love that notion of—and people will often say, I just get up, I go to the couch or the
sofa, and that's where I'll wake up in the morning.
Also they'll say, when I travel and I go to a hotel room, I just can sleep fine.
Now, for some people, it's the inverse, but for those people, it's the contextual difference,
meaning the change of the environment is so unfamiliar that it has not been bound to the
association of wakefulness.
It's related to sleep or at least the opportunity to sleep.
Sometimes even I've heard from some people, and there's no studies or data on this, even turning
yourself around now, this is hard if you have a partner in bed, but you just switch top
to bottom of the bed and you take your pillow and you pull the duvet all the way down and
you put the pillow at the opposite end where your feet used to be and you get into bed. And even just looking around and sort of having a difference,
that alone is so subtle, but it can make a real difference.
So again, just keep these things in mind.
I know it sounds strange, this whole sort of get up,
get out of bed, break the associate.
And we'll come onto something,
well, actually I'll come onto it now because I think it's
one of the unconventional tips and you mentioned it.
A lot of people say to me, that all sounds great, the science makes sense.
I just don't, it's dark, it's kind of cold, I really don't want to get out of bed.
So give me some alternatives. I think the single best piece of unconventional sleep advice I can give you is do anything
that gets your mind off itself.
The principal reason that if you look at insomnia as a physiological condition, our current
working model mechanistically of how insomnia plays out, is that you are
in this state of almost low-level anxiety and you are somewhat stressed.
And when you go to sleep or you try to go to sleep or you wake back up and you try to
get back to sleep, you just have this rolodex of anxiety. In the modern world we are constantly on reception and very
rarely do we do reflection. And unfortunately for many of us, and I've been guilty of this,
the only time we do reflection is when our head is placed on the pillow and we turn the
light out and that is the last time you want to be doing reflection. That's the worst moment.
And at that point, I think everyone can empathize
with the idea of you turn the light out,
you're under stress, your mind goes to those few things.
In the darkness of night,
thoughts become almost 10 times worse than they do
in the bright of day.
And at that moment, you start to ruminate.
When you ruminate, you begin to catastrophize.
When you catastrophize, you're dead in the water for the next two hours.
So what do you do?
The problem is, as I said, your mind is on itself, and it's going through these repeated
loops.
Anything you can do, for example,
you can do some kind of a meditation.
And I, when I was researching data
for my book some years ago, I did look into meditation,
and I wasn't a meditator, I was a hard-nosed scientist.
I didn't really kind of embrace with that notion or even that group of people.
But time and again, I read paper after paper and the data was very strong and it was coming
from research groups that I respected very much indeed.
So I thought, well, okay, I should probably give this a try.
And that was six years ago.
And since then, I now meditate for 10 minutes every single night before bed.
I do a guided meditation because I'm not particularly skilled.
So I use an app that moves me through that.
But you can do whatever you, whatever meditation you like.
That's one example.
The second example is you can do breathing methods because again
you're focused on your breath and what are you not focused on? Your thoughts. And so
anything that will allow you to explore some other focus, maybe it's a body scan where
you start at the top of your head or you start at your feet and you work your way up
and you just say, you know, moving through now my neck,
what sensations am I feeling?
Now into my shoulders, moving down into my chest now,
I can feel the ends of my fingers, am I sensing anything?
And when you start doing that
or any of these types of things, the next thing that you remember
is your alarm going off in the morning because you got your mind off itself.
So I would say that that's probably one of the unconventional tips.
But let me come back to the conventional.
Anything else I've probably missed out or been unclear about there.
Actually, I should probably say one thing in terms of these, they're not tips.
I don't like the word.
I know you don't either or hacks or these are protocols and they're well informed scientific
protocols.
In all of this discussion today, you can get all of these things in place and still have
problems with sleep.
The reason is because you may be suffering from a sleep disorder.
So the analogy would be, let's say that I'm your athletic coach and you're a sports superstar.
I can perfect everything.
I can perfect your diet, your supplements.
We can perfect your technique.
We can perfect.
But if you've got a broken ankle,
none of those things are going to alter
your performance right now.
You've got to get to a doctor and get that seen to,
and then we can come back to fine tuning your performance.
It's the same with sleep.
If you've got a sleep disorder,
such as snoring, sleep apnea, or insomnia,
we need to get you to a doctor first,
and then only after that, come back once you're resolved,
then we can start to optimize.
That's the only other thing I probably should mention.
Yeah, this is all very useful discussion
because I think that, of course,
there will be those folks out there that just, like,
what are they talking about? I sleep so well at night.
You know, consider yourself blessed.
Many, many people struggle with challenges with sleep.
And I think it's fair to say that sooner or later,
most everybody experiences some challenges with sleep
for whatever reason.
If you look at the statistics, that's highly likely.
In your lifetime, you are more than likely to go through
either a period of challenging sleep
or in fact a bout of insomnia.
I'd like to take a brief break
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vitamin D3K2. Again, that's drinkag1.com slash Huberman. You talked about alcohol. I'm not a
consumer of alcohol anymore. Nor am I and it's not I it's not because I have anything against it.
Yeah, many people do enjoy it and know,
we're not calling judgment on them.
I mean, certainly much of the world enjoys alcohol.
Could we talk a little bit more about,
aside from demolishing REM sleep,
do we know that alcohol causes these disruptions in sleep directly, meaning by changing the
pattern of release of neurotransmitters like GABA, things of that sort, or is this an indirect
effect?
Is this through the gut microbiome that then impacts sleep?
The reason I ask is maybe we could get to some more specific do's and do not protocols.
So for instance, if somebody wants to have a cocktail, how close to sleep can they get
and not diminish their rapid eye movement sleep too much?
Because people are still going to want to drink.
And with that said, if people do have a couple of drinks and then they go to sleep, is there anything they can do prior to sleep
to try and rescue some of their quality sleep?
Great question.
So in terms of the mechanism,
it seems actually not to be the alcohol,
but some of the metabolic byproducts of alcohol.
We think that perhaps the main culprit
may be some of the aldehydes that are the metabolic
separate consequences of alcohol metabolism.
You make a good point though in terms of the dose response timing curve.
How late or how early do I have to cut myself off from alcohol?
People have done those studies and they have found that even an afternoon single glass
of wine, if you measure sleep in the way that we measure it at Bicenter with high fidelity,
you can see compromises and impairments.
I wish I could tell you otherwise.
I would say that based on that data,
the principal protocol advice I would have for you
is go to the pub in the morning.
That way, by the time you're about to sleep,
the alcohol is out your system.
You could, no, no, I would never,
as a public scientist, I would never advocate necessarily
for morning, I'm just kidding you.
But that's sort of one of the unfortunate consequences.
That does seem to be an impact to say that there isn't is just me not being truthful
about the data.
But again, if you think about the trade off here, if you're going out or you're having
friends over and you're going to make an incredible evening of memories and you're going to open a favorite bottle of wine and have a couple
of glasses of wine, is your sleep going to be compromised?
Yes, it is.
But maybe that's worth the trade off for that specific night.
I would just not wish you to, and you've spoken a lot and so has our dear friend Peter Atiyah
and others. There just doesn't seem to be any safe amount of alcohol.
But I would say, think about that trade-off simply,
however, don't make it a habit that you're doing it,
you know, multiple nights a week or more.
That would probably be the advice.
Great.
What about food and sleep?
How close to sleep?
Is it OK to have a meal if you want to optimize your sleep?
I like to eat my final meal somewhere around 6, 30 PM.
And I go to sleep somewhere around 8, 39 PM.
In an ideal world, sometimes I go to sleep a bit later.30, 9 p.m. In an ideal world.
Sometimes I go to sleep a bit later.
Sometimes I eat a little bit later.
There's some variability with these.
But put differently, what is the relationship
between food intake and sleep quality
in terms of timing of food intake?
And then perhaps we can talk a little bit
about food macronutrients.
It's very interesting.
There was somewhat of a dogma out there that we have to stop eating three or four hours
before bed for optimal sleep.
If you look at the data, the data is quite a spread, no pun intended.
There are some people for whom that works very well.
And if they eat even two hours before bed, they just get
disrupted in terms of their sleep. Some of that is about people just feeling too full
and not feeling comfortable. Other aspects are that when you become recumbent, when you
lie down, you have a higher risk of gastric reflux coming back up and therefore you get heart
burn and that's pretty miserable and people will describe that too by way of closer proximity
of food intake relative to when you're falling asleep.
Nevertheless, if you look at the data, and I did a recent very deep dive on this personally myself about 12 months ago.
It's not quite as extreme as the dogma makes out.
If you eat two hours before bed, on average, it doesn't seem to necessarily harm your
sleep.
Now, that's very different than saying what is best to improve or enhance your sleep.
But the way these studies were designed, it was looking at detriments.
They then went to 90 minutes before sleep onset, and even there, there didn't seem
to be marked imperments.
60 minutes, you started to see maybe some signs, but on average, the effect size was
somewhat weak.
But then when you get close to sort of 45 minutes or so, then things did
start to deteriorate.
I think it depends hugely on your chronotype and also just on your appetite, circadian
rhythm preferences too.
I am someone who I do not feel very hungry when I first wake up in the morning.
I don't feel very hungry throughout most of the day.
And I will onboard most of my calories probably in the hours, probably in about a four hour
period, maybe less, even three hour period.
And then I will cut myself off about 90 minutes before sleep.
So classically, I would have been considered as violating this sleep dogma of cutting yourself
off at least three hours.
I think it's very personal though.
Just experiment with it.
You will know the situation.
As for macros and specific food components, the data is a little bit mixed.
Certainly what we know is that if you're eating a diet that is high in sugar and low in protein,
your sleep is worse.
Why would that be the case?
Well, one of the reasons that we think is that if you onboard sugar, it can be somewhat metabolically
active and when it becomes metabolically active, it can increase your body temperature, your
core body temperature even just very subtly, but that's enough to disrupt your sleep as
we spoke about with temperature. But I think in terms of really the,
what would be the ideal macro nutrient
and even micro nutrient dietary recommendation
that I would have for you,
I don't think we have enough data yet
above and beyond that statement.
Yeah, I've experienced when I eat
a very low carbohydrate diet,
which I've experimented with in the past,
maybe even full ketogenic diet for brief periods of time,
although I'm an omnivore, so I eat meat and eggs,
and I also eat starches, pastas, rice, et cetera.
But we know based on beautiful work from, for example, Chris Palmer from Harvard Medical
School, who is a guest on this podcast.
I listened to that.
It was a great podcast.
Yeah.
Chris is spectacular and has advocated the exploration of ketogenic diets for the treatment
of various psychiatric conditions, not all, but psychiatric conditions.
And it seems, and he agreed with me on this, that when people go on very low starch, very
low carbohydrate diets, that sometimes they can experience a bit of hypomania.
Some people can and challenge this with sleep.
And sometimes there are psychiatric reasons why people stay on those diets anyway.
And then they have to do other things
to encourage their sleep,
either pharmacology or supplementation
or some combination.
But I can say anecdotally for myself,
if I don't eat starches for a extended amount of time,
a couple of days,
I find it very hard to get quality sleep,
as indicated by sleep trackers
it very hard to get quality sleep, as indicated by sleep trackers and just latency to fall asleep is longer than it is, et cetera.
So I've opted to eat most of my carbohydrates later in the evening, which violates every
rule of eat your carbs early in the day.
And I think there are some data to support that your carbs early in the day. And I think there are some data to support
that eating carbohydrates early in the day
may actually have certain benefits for weight maintenance
or weight loss.
So I realize that, but those aren't my goals at the moment.
Weight maintenance, yes.
Weight loss, no.
So I think I certainly feel after eating a dinner that
has a bit more starch, pasta, rice, these things of that sort,
and a little bit lower protein as opposed to the inverse,
like eating a couple of ribeye steaks and a salad,
but no starch, that my sleep is substantially better.
And I always attributed that to the relationship
between some of these starches
and the tryptophan slash serotonin pathway.
There is some data on that
with the carbohydrate intake in the evening.
And of course, that tryptophan and that carbohydrate intake will contain the precursor ingredients
to something else that we've spoken about, which is melatonin.
And so that may actually help healthily boost that melatonin signal.
And there's a little bit of data on that to support it too.
We also did a study where we were looking at night to night to night sleep and carbohydrate
intake the next day.
And it did seem to support what you're describing in terms of some of the carbohydrate benefits.
We also found a strange result that was almost the opposite prediction that we made.
Carbohydrate intake in the morning, too, equally help people wake up.
And we were a little bit uncertain as to why, but we're going to go into more detail.
The reason that you mentioned the suggestion of not take on carbs in the evening is in part based on the evidence that your body's ability
to dispose of sugar and obviously when you're eating carbohydrate you can have a higher
spike of sugar. Now that in part depends on what you're eating with that carbohydrate and also of
course the nature of that carbohydrate whether it's simple or whether it's complex, whether it's simple sugars versus complex, more starchy carbohydrate.
But the idea is that your body, even if you were to eat the same amount of carbohydrate
in the morning, in the afternoon, or in the evening, same carbohydrate dose and type,
but your body's ability to dispose of that without
having excessive spikes of glucose is worse in the evening, better in the morning, i.e.
if you're concerned about your blood sugar and your metabolic health, maybe that's what
you should do.
I think that that data is unclear on the basis of if you are glycemic normal, meaning that you currently do not
have signs of type 2 diabetes or you're not pre-diabetic, then that may not necessarily
be the case.
And so I think that's why it could be beneficial for you.
And I know that you think deeply about that.
And I've even been tracking blood sugar as well.
I don't have any signs of that.
But I'm just fascinated by some of that data and how it
interacts with my sleep because I'm a sleep nerd.
So I think right now we just don't have plentiful data to recommend a particular sleep quote
unquote diet for improved optimization.
I would say though that we can be a little bit more relaxed about the timing of our food.
Earlier you mentioned caffeine,
and caffeine is a topic that we get into
into substantial depth in episode three.
But there and now,
I will emphasize that caffeine
is the most commonly used drug worldwide.
I think the statistics says that 90 plus percent
of adults consume caffeinated beverages every day,
which is remarkable.
And a few years back, I recall there was an article
in The Economist that charted the countries
for which the caffeine consumption was highest
and way out on the peak, peak, peak of,
it was almost a tripler quadruple
what the second place country consumed each day was,
can you guess the country that consumes the most caffeine?
Could be tea, coffee, any form.
I'm gonna suggest it's a Scandinavian country.
No, but they're up there.
It was Switzerland. Now I don't know if that's still the case, but apparently the Swiss-
The reason I went, I was thinking it was, because I've seen the graph, I was thinking
it was Sweden, but it's Scandinavian.
Yeah.
And if I have that wrong, certainly someone will put it in the comments on YouTube.
No, I'm sure you're right.
But as I recall, the Swiss drink so much caffeine.
They have a lot to think about.
So I much caffeine. They have a lot to think about. So I love caffeine.
I drink black coffee, black espresso, and yerba mate.
I love yerba mate.
I've been drinking it since I was a little one because of the Argentines in my family.
And I drink it in the early part of the day.
Typically a couple hours after waking or so, I'll have my first sip of caffeine. And then I try to stop drinking caffeine
somewhere around noon or 1 p.m.
Occasionally I'll have a shot or two of espresso
in the early afternoon if there's important work to be done
and I need to do that.
But I've noticed that even that can alter my sleep
in ways that I don't like.
But that afternoon coffee for some reason
tastes so much better than the morning coffee for me. I don't like. But that afternoon coffee for some reason tastes so much better than the morning coffee
for me.
I don't know what it is.
So it's coffee yerba mate packed early into the day and a lot of it for me.
I have a high tolerance for it.
But then I let it taper.
Is that an optimal contour of caffeine intake?
Would zero caffeine be better if someone's just really committed to sleep
and they don't like caffeine?
Would zero be better than any?
And what about that afternoon coffee
or tea containing caffeine?
I mean, how disruptive is it for sleep?
So the profile that you described,
which is high peak early on,
first thing when you wake up
and then tapering off nicely down into the sort of early afternoon, ideal.
That sounds great to me.
As for that afternoon coffee, it really depends again on when you're expecting to go to sleep.
Now for someone like you, I would say I would love to look at abstaining from that or just
switching it out to if you're
using you know these pods or however you're brewing it. Let's just switch it out and do an
experiment for two weeks and we will look to see how much is that afternoon coffee really impacting
your sleep and will track your sleep with some degree of high fidelity with a wearable.
And let's test that hypothesis because you go to sleep
quite early, you are an early bird,
maybe bordering on an extreme early bird.
And we'll speak about, or we have spoken about
those different flavors of chronotype.
I would prefer you not to be having that caffeine in the afternoon based on how early you go
to sleep.
And I mentioned that preference because of what you described regarding your sleep maintenance
insomnia.
One of the issues with caffeine is that not only can it make it more difficult for you
to fall asleep, which you don't have in part because if you're waking up quite frequently throughout the
night and struggling to get back to sleep, you're going to be carrying a sleep debt into
every night and that debt continues to grow and it's almost like compounding interest
on the loan.
So you will not have a problem falling asleep.
In fact, sometimes the speed with which people fall
asleep and some of these sleep trackers will almost penalize you for falling asleep too
quickly is because in sleep science and clinical sleep medicine, it should take you somewhere,
you know, a healthy sleep onset, you know, five to 15, 20 minutes. But if you put your head on the pillow and you turn off the light and within a minute
or so you're dead to the world and you're gone, I'm exactly, I'm worried that you're
a carrying a sleep debt.
Now, not necessarily, but I would like to explore it with you.
And then I would say, even if you can fall asleep fine, this factor of waking
up in the middle of the night is also related to caffeine. Why? Because caffeine not only
can make it harder to fall asleep, not your problem, but it keeps you out of that deep,
deep sleep. And it puts you into a more shallow state of non-rapid eye movement sleep.
And when you are in the shallow state, it's A, easier for you to be woken up.
But B, and I think more of the problem, it's harder for you to fall back asleep because
your brain doesn't necessarily want to go back down into that deep sleep and nor has
it come up out of that
deep sleep.
So you're not in that wonderful, glorious, thick, treacly sort of sleepy state when you
wake up, you go to the restroom, you come back and you just know, this is going to be
great.
As long as I can fumble my way back to my mattress, I'm going to be asleep within another
two minutes going back to it.
Whereas for you, you probably wake up and you feel pretty wide awake.
I would like to see what happens when we negate that afternoon coffee on the frequency and
the duration of those middle of the night awakenings for you.
Yeah, I'm definitely making the effort to avoid caffeine intake in the afternoon.
And I think already starting to see some of the positive benefits of doing that as
evidenced by the days that I consume caffeine in the afternoon and experience the deficits.
It's a real thing.
And I believe you've given out the numbers on a different podcast previously.
Talk a little bit about the metabolism of caffeine and maybe even some of the variations
that exist between people in terms of the metabolic regulation
of caffeine.
So how long, let's say, drink a standard cup of coffee
or a couple of espresso and it has a,
gosh, I don't know, 150 milligrams of caffeine.
Is that 200?
Yeah, it could be 150, 200.
Let's say 200 because certainly, you know,
a barista these days is going to draw a beverage.
They're going to overindex.
Yeah.
So let's say 200 milligrams and somebody consumes that after lunch at 1 p.m. and their bedtime
is let's make them more conventional than I, somewhere between 10 and 11 p.m.
Yeah.
Okay.
So they're about nine to 10 hours out from their bedtime. They're having a nice strong, quote unquote, nice strong cup of coffee after lunch.
What does that look like in terms of their biochemistry and impact on sleep?
So caffeine has something that we call a half life of about five to six hours, meaning that
after five to six hours, about 50% of that caffeine is still circulating
in your bloodstream and thus your brain.
That means that caffeine has a quarter life
of somewhere between 10 to 12 hours.
Now this is on average and we'll come back to variations.
But think of it this way, if you're taking a cup of coffee,
like you described there,
at midday and then you're going to bed at, let's say, 11 or midnight, that would be the
equivalent, based on what I've just told you, the quarter life of getting yourself into
bed and just before you took yourself into bed, you swig a quarter of a cup of coffee
and you hope for a good night of sleep and the chances are that it may not happen.
Now again, that's a little bit sort of hyperbolic as a statement, but just try to conceptualize
it in that way.
You would never think about taking on, you know, a last quarter cup of coffee just before
you put your eye mask on.
No, but I have some friends and somebody actually who works with the podcast team and we'll
go out to dinner as a team when we're on the road and he'll order a big coffee right after
a 9 p.m. dinner and I'm like, can you sleep in this?
Oh yeah, no problem.
And that no problem is in part this, I don't have an issue with falling asleep, but if
we were to, based on the data, map their electrical brain activity, you would
be able to see this reduction in their deep non-REM sleep.
And it can reduce it if you look at the data somewhere between 15 to 20%.
Now for me to reduce your deep sleep by 15 to 20 percent
I would probably have to age you by about 20 to 22 years
Or you could just do it every night with a late night coffee should you should you wish so again?
I've and maybe we'll speak about this in in later episodes. I have changed my mind on caffeine
I think morning caffeine use or coffee,
I should say being more specific is fine
because I think there are health benefits
and we can go into in subsequent episodes,
why coffee and the coffee bean itself
can provide those benefits.
So I've become a little bit more bullish on morning caffeine,
but evening caffeine, I just think it's,
the data is just not supportive.
Even if you are, and there are variations
and you were very astute in your question,
some people, I said on average,
caffeine has a half life of about five to six hours.
For some people it's quicker,
and for other people it's slower.
Why is that?
It's based on a gene and we know
the gene. It's a gene that is part of a set of liver enzymes and the gene is called the
CYP1A2 gene. And there are variations in that gene, what we call polymorphisms. And you
can do these genetic tests that you can buy these kits and they will probably tell you which you are, are you sensitive, are you not sensitive, you probably already
know.
And so some people will not be as sensitive and therefore they can have a more compressed
timeframe of a half-life because it's moving out of their system in a quicker manner.
So again, I'm not trying to be skirmongering.
I think you can have coffee in the morning
and you'll be just fine.
That late night coffee, I would like to see you
obviate that if you are someone who's doing it.
And the afternoon coffee sounds like a, you know,
maybe only every once in a while
and try and make it mostly decaf or decaf for that matter,
if it's really just for the taste.
Yeah, if it's just for the taste, go decaf.
If it's not, I understand that in some ways
what I'm talking about is the ideal world.
And drum roll, it turns out that most of us
don't live in that.
We live in this thing called the real world.
And so if you are facing a circumstance
where if you're under pressure at work
or if you're a high-performing athlete and this is it,
this is the event, it's all in our think,
understand that you are going to sacrifice
some sleep at night,
but maybe that sacrifice is well worth it.
So again, I'm very open-minded.
I'm not trying to be simply too rigid with this.
I wanna take a brief break
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So you've talked about alcohol and its effects on sleep So you've talked about alcohol and its effects on sleep.
You've talked about caffeine and its effects on sleep.
And we talked about food and its effects on sleep.
What about THC and CBD?
Sometimes referred to more generally as cannabis.
And it's interesting, gosh, when I was growing up,
cannabis was illegal.
Nowadays, it's either legal or tolerated
or decriminalized in many places, not all.
But I would say there's been a tide shift
in terms of cannabis, meaning that many people
consume cannabis
who are consuming it legally and consume it
for a lot of reasons that other people consume alcohol
in a sedative effect, a slight hypnotic effect.
I mean, the actual definition of what these drugs do,
it goes by certain terms in the psychiatric literature,
of course, but in order to quote unquote mellow out,
to feel more relaxed, to reduce their anxiety,
it's far and away different than when I was growing up
where you would get into a lot of trouble
if you were caught smoking a joint
or taking a bong rip in the middle of the day,
but not, and I've realized most people
aren't doing that at work.
I guess it depends on where you work, but it know edibles tinctures. I mean the the consumption of THC and CBD is is quite
Quite robust in a lot of places. So
With all the issues of legality and the fact that people who young people
Should not be consuming them even people 18 and younger not just for legal reasons, but the brain is still developing.
What is the story with THC, CBD, cannabis, edible, smoked, tinctures on sleep specifically?
It's very interesting if you look firstly at the motivational reasons why people use cannabis. Based on the published study,
somewhere in the top two reasons, sleep.
To fall and stay asleep.
To fall asleep and stay asleep.
Obviously, usually the principle first reason
is just to get high and have the experience
and the pleasure of being high,
if that's what sort of floats you, floats
your train.
But certainly it's, you know, sleep and what we call a hypnotic to put you asleep from
the Greek derivative of the god for sleep.
That is high among the reasons that people will use.
We currently don't recommend it and here is why. Certainly THC helps you fall asleep faster, very clear in the data.
The problem is that first you start to develop a tolerance and to get that same sleep onset
benefit, you need to get, use I should say a higher dose.
So you start to develop dependency and your dose regimen starts to increase.
The second issue with THC is that it's very good at blocking your dream sleep, your REM
sleep.
In fact, many people when they come and they tell me, look, I was a heavy cannabis user,
even a light cannabis user for some time, and then I stopped using.
And one of the strangest things happened to me, I just started to have the most wild,
vivid, crazy dreams.
I didn't know what was going on.
And it's a very simple explanation.
As you've been using, your brain has been compromised in the amount of REM sleep it's
been getting.
And you've been building up chronically a REM sleep debt.
And your brain is smart in the sense
that it does try to clock to some degree
a counter of how much REM sleep you've lost.
And many people will say,
yeah, I don't really remember my dreams when I'm using.
But when they stop, the brain finally,
because it's been cleansed of the thing that's the
roadblock to REM sleep, not only do they go back to having the normal amount of REM sleep
that people would have, they have that, plus they have what we call a REM sleep rebound,
which is even more and more intense REM sleep, which leads to more intense dreaming. So it's a very, I suspect there's a lot of people who've had that experience listening
if they have been users and they've stopped.
So that's the second reason we don't advocate it.
The third reason is that when you stop using, you also go through a very vicious insomnia
withdrawal syndrome, often many people will do.
Now that depends on how much you've been using, for how long you've been using.
If you look at the data, and by the way, part of the clinical diagnostic, the psychiatric
diagnostic description of cannabis withdrawal is insomnia. That's how reliable this insomnia problem is when you come off cannabis.
And if you look at the data, one of the main reasons that people relapse and start using
cannabis again, even though they don't want to, is because they can't deal with the insomnia
that withdrawal has given them.
So you don't want to get into that vicious cycle.
Should you wish again, it's your choice.
So THC, I think is not to be advised right now.
CBD is interesting.
I don't think there's enough data yet for us to have a very strong opinion,
but I can at least offer mine. The data so far is a little bit mixed in what we call
the effect size. In other words, how reliable and how powerful is the benefit of CBD on
sleep? But it does seem to have some benefit. What's interesting is that it doesn't seem
to have the detriments that I just described
for THC.
You've got to be looking at the data a little bit careful with CBD.
It has what's called a U-shaped function to it, which is that if you're taking too little,
and again, I really am so mindful of not trying to be, okay, here are the numbers, but if you look at them,
I would say, you know, kind of cross your eyes,
squint your eyes, maybe less than 25 milligrams,
you run into the danger of CBD being wake promoting
rather than sleep promoting.
But once you get past, if you look ish,
50 milligrams and above,
then you start to go in the opposite direction
where it seems to be sleep promoting.
And I mention that just because,
at least here in the United States
and in many places in the world,
that industry is not regulated.
So it may say 50 milligrams on the bottle. You don't really
know. Now some of those companies will have what's called third party laboratory testing
where they'll send it out and you can scan a QRI code and you can look at an independent
laboratory that tested it and show you the purity of it. So that may be one way to go.
So CBD, I think has some favorable evidence right now. If that's the case, let's
just assume that you and I speak in another five years' time, and there's really good data now for
this. What could be the mechanisms? I think there's at least, there's probably at least two, maybe
three mechanisms. The first is an indirect mechanism. CBD has been demonstrated very
nicely in some fantastic studies to be an anxiolytic, which is a fancy term for saying
it reduces down your anxiety. And earlier you and I discussed that anxiety and stress
is one of the things that will keep you awake. So indirectly it removes this kind of gate that is preventing
you from moving down the royal road of sleep. And it opens back up the gate because it's
removed that gate mechanism which is high anxiety. And by way of being an anxiolytic,
it's softened that anxiety and it's easier for you to fall asleep. I think that's probably the principle, mechanistic bet I would have right now.
Another indirect mechanism, if you look at some of the studies in rats, and we do human
work at my sleep center, so we don't do animal studies, but if you look at the data in the
rats, CBD can be hypothermic, which means that it drops your core body temperature.
And just as we spoke about earlier in this episode, you need to drop your body temperature
to get to sleep.
So I think that's the second reason.
I think the third reason is that it could have a direct sleep promoting mechanism.
I think it's unclear right now exactly how it's interacting with the sleep machinery
of the brain. We've got some hypotheses. The danger is, again, it's just not a well-regulated
substance. So I am actually just full disclosure, I'm working with a company in the United Kingdom
in collaboration with King's College and the Institute of Psychiatry there to see if we can
Institute of Psychiatry there to see if we can create an analog, a clean analog of CBD. But I think the potential upside of it, not just for sleep, but for a number of different
psychiatric conditions like anxiety, could be beneficial.
So I would say that that's right now the sort of the skinny on THC and CBD. Okay, so just to make sure that I have the basic list
of sleep hygiene factors, correct?
I have regularity is king.
Yep.
Light and dark, meaning that one should optimize
or at least seek to optimize their exposure to light
in the morning and throughout the day
and then in the evening to make things dim and dark.
Yes.
Temperature, and there you have a little,
it's not a mantra, but what is it?
It's a warm up to cool down to fall asleep,
and then it's stay cool, like Fonzie,
stay cool to stay asleep, and and then warm up to wake up.
Yep.
We will come onto that I think in a little while again.
Then there's walk it out, which is if I understand correctly, if you're trying to fall asleep
or fall back asleep and it's taking you longer than about 20, 25 minutes, you should just
get out of bed and go elsewhere in the house, do something else.
Maybe even lie down on a different surface in the house to try and see if you can sleep there.
But don't stay in bed.
Don't create a paired association of wakefulness
and your bed, because that can lead to problems
in subsequent nights.
Yeah, and I would only say that try to resist if you can.
If you really want your bedroom to be the place
where you now become consistently asleep,
try not to start sleeping in some of the location consistently
because then all of a sudden you bond that with good sleep
and you unbuckle this notion that we're trying to relearn
which is know your bedroom is the place of sleep.
So it's fine to go elsewhere, try to stay awake
and force yourself to stay awake
until you are absolutely sleepy, then go back to bed.
Okay, and then we discussed alcohol, food, caffeine,
and THC slash CBD, AKA cannabis.
And with respect to alcohol,
it's clear that none is best if you're going to have some,
you don't want to drink too early in the day,
but you don't want to drink too much
or too close to bedtime
because it can disrupt rapid eye movement sleep.
Food seems that creating some sort of buffer
between your last bite of food and your to bed time
by somewhere between maybe two, three hours,
but for some people it'll be more like 90 minutes.
And of course that's going to depend
on the size of the meal, et cetera.
But eating a big meal and then going straight to bed, probably not a good idea.
Caffeine has this long half-life,
so if you're going to indulge, which I do,
do so early in the day.
Beware the afternoon caffeine.
Yeah, do the Huberman taper
is what I'm gonna call it right now,
which is not an interpretive dance,
it's simply the caffeine taper.
And then THC, CBD does nothing good
for your sleep architecture,
although some people have the impression
that it is good for their sleep
because it makes it easier for them to fall asleep,
but what they are unaware of is that it is disrupting
the quality and architecture of the different stages
of sleep in ways that are not serving people well.
That seems to be the case for THC.
And I think CBD, you know, has promise
and research must try harder, including my own.
And you very kindly emphasize
that you're not telling people what to do.
They just should know what they're doing
so that they can make changes if they so choose.
That's right.
I would always say that I'm not trained
to be a medical doctor.
Any advice that I give is simply
scientifically descriptive advice.
It's not medically prescriptive
nor lifestyle prescriptive advice.
I'm smiling because what I always say is
I'm a scientist, not a physician,
so I don't prescribe anything, but I profess lots of things. So, or as my good is I'm a scientist, not a physician, so I don't prescribe anything,
but I profess lots of things.
So, or as my good friend who's a musician,
Tim Armstrong said, I'm not a cop.
That's right.
So do what you want.
Okay.
What a wonderful list to leap off into the unconventional
and more advanced tools for sleep enhancement.
So let's go there. the unconventional and more advanced tools for sleep enhancement.
So let's go there.
So I think many people may have heard
of some of the conventional,
but what about the unconventional?
I would probably offer five or six.
The first one I would say is that
if you are struggling with sleep
and you have had a bad night of sleep,
the first recommendation is do nothing.
And what I mean by that is if you've had a bad night
of sleep, you're awake for three hours,
do not sleep in any later into the morning.
Do not go to bed any earlier.
Do not increase your caffeine intake to try to offset it and do not nap
during the day.
Why am I telling you those things?
If you wake up later that following morning, your adenosine clock that we spoke about,
this building up of sleepiness that happens when we wake up, is going to start later in
the day.
So when it comes time for you to fall asleep at what would then be the next night at your
normal time, you're not going to feel as sleepy.
Why?
Because you woke up that much later and you're setting yourself up for failure again.
Equally, don't go to bed any earlier.
If you have become accustomed and your brain, and your circadian clock has become accustomed
to going to bed at a certain time, and hopefully you're doing it regularly, then getting into
bed two or three hours early has the danger, it's not a certainty, but a danger of you
then getting into bed and thinking, well, I know I had a bad night of sleep last night,
but I still can't fall asleep straight away.
So now you're spending another 90 minutes in bed at the beginning because you've gone
to bed 90 minutes earlier thinking it's a good idea to compensate.
Don't do that either.
Hold out even if you do feel tired.
My recommendation would be after that bad night of sleep, hold out for as long as you
can as close to your natural bedtime as possible, then go to sleep
and you'll give yourself highest chance of success.
Don't overcaffeinate.
That's the obvious one.
Follow the beautiful Huberman taper.
And then obviously try not to compensate with a nap.
Why?
Because that nap, as happens when we sleep, is going to remove some of that sleepiness,
that adenosine, and
once again you get into bed and you're not as sleepy as you would naturally be.
So you again go through a bad night because you're struggling to sleep or you wake up
and you can't get back because you've got less weight of sleepiness on your shoulders
due to the nap that happened earlier.
So I know it's hard, but I would say when the alarm goes off after a bad night, you
just think, I do not want to get up.
It's been such a rough night.
I know it's a short term gain, but trust me, it's a long term loss because you're going
to then just get into this vicious cycle.
So that's the first unconventional tip.
Can I just pause you for a second? I'm a little wide-eyed over here because I did not
know any of that.
Typically, if I get a poor night's sleep,
I'll do whatever I can to recover that sleep, take a nap.
I'll adjust to bedtime the next evening.
So I hope everyone is paying careful attention
to what Matt just said.
I mean, that's an important list because I I hope everyone is paying careful attention to what Matt just said.
That's an important list because I think one of the very common things is for people to
just not get a great night's sleep.
I think most people think, okay, I'll drink a little more caffeine.
I will go to bed a little earlier tonight, maybe catching a nap in the afternoon, this
kind of thing.
Yeah.
I would have thought that too and maybe even suggested that.
If you listen to the first episode and where I, you know, I list in a doomsday manner
the things that can happen by way of a short night, you would think that that's what I
would then recommend.
But it was really imprinted on me by a wonderful sleep clinician, Michael Perlis, who sort
of described some of these features and exactly the reasons sort of underlying them.
And I think I've just tried to bake that out into a formula that makes sense.
Again, it's not about the rule.
It's about explaining it because when you explain it, at first it sounds contradictory
and paradoxical.
When you understand it, it hopefully sounds logical and actionable.
So that would be the first suggestion.
Could I just interrupt again?
My audience hates when I interrupt,
but I'm doing it on their behalf.
Oh, I love it.
Because I like to think that there's some value
in some of at least what you say in response.
I saw a really terrific post from Dr. Rhonda Patrick,
who we both know and admire for her public education,
public health education work.
And she described a study whereby if people are,
I think it was slightly sleep deprived,
maybe by a few hours, that some of the disruption
to morning blood glucose regulation
that is known to accompany partial sleep deprivation
and certainly complete sleep deprivation,
but in this case, partial sleep deprivation could be offset by still exercising in the morning.
That's right.
Which frankly, I have to say,
if I haven't slept that well, then normally I'm like,
oh, maybe today's the day I don't exercise.
But now having heard that information,
I make it a point to still exercise,
sometimes with a little bit less intensity
because I don't want to be completely exhausted
in the afternoon and go to sleep at 4 p.m. or something,
really disrupt my schedule.
But I thought that was really interesting
because it's a sort of partial inoculation
of the blood glucose disruption caused by sleep deprivation.
I'm so glad you brought it up.
It's a fantastic study and I, Rhonda,
and I think you've tried to discuss it
some years ago on a show, but I like it
because it does offer some degree of actionable hope
and a strategy.
Blood sugar, absolutely critical.
It is very sensitive to sleep when you don't get enough.
It goes in bad directions.
You used a very specific word, cleverly so.
That word was partially.
At first you hear or read that study, and Rhonda was never suggesting this to, I'm not
saying that.
You think, well, if it offsets blood sugar and the city was saying exercise can nullify
a lack of sleep, you conflate that single outcome benefit with the idea that, well,
but maybe it doesn't actually, or does it compensate for the deficits in immune function or cardiovascular disease concerns
or my hormonal health or my learning and memory or my emotional and brain health?
Maybe it does, but maybe it doesn't.
So I think I would always just caution people to saying when you hear a study like that,
it's very natural to think, oh, that must mean that it translates to everything else
in my body and everything else in my body
and everything else in my brain.
It may, but it also may not be.
Terrific, so if you don't sleep that well,
do your best to still get some exercise,
but just be mindful of the fact that, you know,
in the winter months especially, that might,
if you go too hard in the gym or on a run,
you might be a little bit immune compromised.
Just be mindful of the fact that you're a more vulnerable
being when you're sleep deprived and that,
but that exercise can help adjust things
in the right direction.
And if it's early in the day,
presumably that's not going to disrupt your,
the proper bedtime.
And if it's later in the day,
I suppose as long as you don't need caffeine
in order to do that exercise,
and or if you're familiar with exercising later in the day,
fine, I find if I exercise,
I'm not one of these people that can go for a run,
seven o'clock at night and then just showering go to sleep.
Because you're a morning type.
Because I'm a morning type, other people can.
Okay, we'll get into exercise a bit more
in a later episode. We should do.
We'll be sure to do that,
but nonetheless, just raise that now.
So what are some of the other unconventional protocols
for sleep?
So I think other suggestions I would have
after do nothing would be try to think
about limiting your time in bed.
If you are struggling with sleep,
this is something that is used in the,
probably the most well validated psychological intervention
for insomnia, and it's called cognitive behavioral therapy
for insomnia, or CBTI for short.
What happens is that you work with a clinician,
they interview you, they assess all of the reasons that you work with a clinician, they interview you, they assess
all of the reasons that you may not be sleeping, and then they create from the toolbox of many
different options a bespoke, tailored sort of Savile Roast Soup prescription for you
for your treatment.
If you look at the studies of that collection of different tools in the CBTI box for intervention of insomnia.
And you ask of all of those, which seems to carry the greatest impact on insomnia, which
has the greatest sort of gravitas?
It seems to be this thing that we call bedtime rescheduling.
It used to be known as sleep restriction therapy.
But obviously, if you come to me and you say, look, I'm not sleeping very well.
I've got insomnia.
I say, I understand.
And I've got a treatment for you.
It's called sleep restriction therapy.
And you say, no, no, no, you didn't understand.
I'm not getting enough sleep.
But it's not quite that.
Here's how it works.
If you are spending so much time in bed, too much time in bed, you are not forcing your
brain to be efficient.
And by way of constraining your sleep window, even to, let's say, five hours a night to
begin with, I brute force ruthless efficiency from your sleeping brain after several days.
So another analogy would be, let's say you're trying to make a nice thin crust of pizza
base and you put the dough on the table and you start rolling it out.
If you roll it too thin, it starts to get gaps and holes in it.
Why?
Because you've spread it out too far and you've started to create these absences.
That's the same thing that happens and it's very natural as an insomnia patient, you would
say I'm just not getting enough sleep so I'm going to start spending more time in bed.
It's the very worst idea.
Another way would be to say, look, I go to the gym and I spend about an hour and a half
working out, but if I were to videotape you, a lot of people are doing the, I think you've, I've coined it as your phrase, but the 11th rep,
where people, you know, do the 10 reps,
and then all of a sudden there's the selfie,
or there's the social media, and.
Oh yeah, they're texting, they finish the last rep,
put it down, and then immediately send it to their phone.
And if you look, they're only working out for about,
let's say, 45 minutes, and the other is wasted.
So what if the next day you came to the gym
and I said, look, I'm sorry,
and there's some big bouncer guys at the door,
you are only allowed to work out for 40 minutes
and then we're going to eject you.
And the first day you go back and you do the same thing.
And then you've only got through 30% of your workout.
So you get booted.
The next day you come back and you do a little bit more
and you get booted again.
After about five or six days,
you've built up such a strong desire
and hunger to get your workout in.
You walk in, you put your phone on silent,
you put it over in the corner and you just get to it.
And that's the same thing that we're trying to do
with sleep restriction therapy.
So you have to be a little bit careful, do it under supervision, especially if you're
driving or you're operating heavy machinery.
We just want to keep an eye.
It's not necessarily a big concern, but we would say, okay, Andrew, you're currently
spending almost total about, you know, eight-ish or seven and a half hours in bed.
Tonight I'm going to restrict you down to five hours a night.
And we're going to do this for the next week.
And the way that we normally do it
is I don't change your wake up time.
I change your to bed time.
Why?
It's easier to stay awake longer
than it is to wake up earlier.
So I put it on the front end of the compromise.
And at first, things don't change.
But after maybe about four or five days of going through this, I build up enough of a
short term debt in your system that your system all of a sudden thinks, gosh, I just cannot
be as lazy anymore.
I can't do this thing of waking up in the middle of the night and spending an hour and
a half awake. I don't have this thing of waking up in the middle of the night and spending an hour and a half awake.
I don't have the choice anymore.
There's so much physiological buildup and pressure to do this.
And gradually what happens is that you sleep longer, you don't wake up as much.
And after maybe about two weeks of doing this, all of a sudden, you go to bed at this later
time.
So for you, let's say you normally go to bed at eight, I'm going to, you go to bed at this later time. So for you, let's say you normally go to bed at eight.
I'm going to have you go to bed at maybe 10, 30, 11, but we're still going to have you
wake up at that 430 a.m. mark that you would normally wake up.
And all of a sudden, you go to bed at 10, 30, 11, you're out like a light.
And then again, the next thing you remember is your alarm going
off saying I'm sorry you've got to wake up.
And what happens by way of that reset is gradually we will then once you're stable we will start
to back it off.
We'll start to have you go to bed at 10 and if it stays stable then 945 then 930 and titrate
you back to where you were.
And if there's any sign that you're starting to not sleep well, we zip it back up again.
The goal here is in some ways almost like hitting the reset button on your Wi-Fi router.
I'm trying to retrain your brain to better sleep.
Because when you are not sleeping well, you've lost your confidence in your ability to sleep.
And when I do this technique with you,
gradually your system and you cognitively relearn
that you are a good sleeper and you can trust in sleep.
And now your sleep does not control you,
you control your sleep.
The hard part, however, is that it's not easy to go through.
And we have to be, we have to usually ask two questions
with individuals.
Firstly, what is your motivation for better sleep?
We need to know that you really are motivated.
And then second, you just stay with a high touch
white glove frequency, checking in on individuals
and motivating them to keep going
because it's very easy to fall off the wagon.
So that's the next suggestion,
sleep restriction therapy or bedtime rescheduling
as we would call it.
You said it's difficult for people to go through,
it takes a little bit of rigor, a little bit of attention
means in some cases getting less sleep than one would like
but as compared to something that, you know,
sadly I've experienced a lot in my life
of having challenges with sleep
and trying to get things back in order
and looking at the bed and just going,
oh my God, battleground, you know, battleground.
You know, I think it makes a lot of sense.
And I love the analogy to the gym.
Somehow if there's a restriction to one hour
in and out the door, or maybe 70 minutes in and out the door
because you need to put your stuff in a locker
or something like that, it always, at least for me,
gets done best when you just have those constraints.
I think there's something about the human brain
that we don't do well in unrestrained systems.
I really think guardrails are fantastic.
I love deadlines, for instance.
Yeah, discipline is essentially the...
Yeah, hard deadlines, or as they say in academia,
because we write grants all the time, drop deadlines,
which who made up that term?
But if you don't make it, that's it.
It's like, there isn't a, hey, I'll send this in tomorrow.
It's gone.
5 p.m. Pacific time, that website closes,
and you better have you...
And boy, do you get things done all of a sudden,
it's surprising how much distraction you can,
you know, pull out the noise and focus on the signal.
It's a great signal to noise ratio.
Yeah, and I love the idea that one can control their sleep
as opposed to sleep controlling them.
I think that that's, and this notion of sleep confidence,
one's confidence in their ability to sleep.
These are important terms and they're more than just terms
because I think that a field and an area of health practice
and gosh, what's more important than sleep?
It's the foundation of mental health,
physical health and performance, period.
Really thrives on a common nomenclature
and I really appreciate that you're peppering these episodes
with new nomenclature that captures a lot of the essence
of the protocols and the mechanisms.
So there, that's my editorial.
Please continue.
I would say that in terms of other things,
maybe just to go through them a little more quickly,
we've spoken some about a wind down routine.
Most people under appreciate the importance of a wind down routine.
We often think that sleep is like a light bulb, that we dive into bed, we switch off
the light bulb and sleep should appear just as quickly.
It's untrue.
Sleep in terms of a process is much more physiologically like trying to land a plane.
It just takes time to come down onto the terra firma of good sleep at night.
Whatever it is you enjoy as a relaxation method, engage in it.
Could be listening to a podcast, could be reading a book.
Maybe it's a meditation, it's light stretching.
Maybe whatever it is that you do, just build it
into your regimen.
You would never be driving down the road and then pull into your garage at the same 40
mile an hour speed.
You gradually decelerate and you come to a stop.
It's the same thing with sleep.
You need to find some way to decelerate. And we've
spoken about methods already as to how to do that.
The next tip is a little quirky and funny. Do not count sheep. There's a great study
from my colleague, Dr. Alison Harvey at UC Berkeley, and she put this to the test. Didn't
make people fall asleep faster. it made them take longer to
fall asleep. However, she did find an alternative. If you are not into meditation or podcasts
or sleep stories or whatever it is that you wish for, try taking yourself on a mental
walk. And it has to be a walk that you know very well.
So let's say that you walk your dog every day and you know there's a couple of walks
that you take with your dog.
Do it in hyper detail.
So close your eyes, you go to the front door, you clip in the dog to the leash, you walk
out, you go down the steps, out to the driveway, then you take a right, but you always cross
over and you look to the left and the right because that's the place where traffic always comes. You cross
over and now you're walking up and there's that strange sort of set of garbage that's
been outside of the house for a long time and you don't know why it hasn't been cleared.
And then you move that type of high fidelity detail allows you to do what we said earlier,
which is get your mind off itself.
And when you do that, again, typically,
you fall asleep faster, and that's what she found.
It was a great, great study.
I really enjoyed that.
I'm curious as to why it works so well,
and I'm not challenging that it works.
I can imagine, having just closed my eyes
and kind of imagine what that would be like.
It's very pleasant.
There might be, and here I'm just speculating something
about engaging one's procedural memory
because that's procedural memory.
You're trying to remember how you do something
as opposed to declarative memory, which is about facts.
You know, I remember this and this is gonna happen tomorrow.
I wonder whether or not there's something about
using a procedural memory
as opposed to a declarative memory visualization.
Somebody should do that study.
They should, and I think it's certainly possible
that when you're incorporating some aspects,
some aspects of the scene and the information
is more sort of veridical and maybe sort of episodic declarative memory.
But when you're taking yourself from a mental walk, what is the fundamental premise of that?
It's a walk, it's motion, it's procedural memory.
And so maybe it's something to do with being more attentive to becoming embodied. Because when you're out walking and you're moving,
it is a more embodied experience than just sitting there
at your desk, which is mostly your head
and very little your body.
So I think it's an intriguing idea.
And I think another tip that I now think of,
which also comes from the work of Dr. Allison Harvey,
when individuals come up to me after sort of public events or they see me at the airport,
they'll say, look, every night for some strange reason at 2.45 a.m. I wake up and it happens
three or four nights a week. My first question to them is, how do you know
it's 2.45? And they say, well, I look at the clock or I look at my phone. Best piece of
advice next, remove all clock faces from the bedroom. No matter how bad your sleep is going
to be that night, knowing what time it is, is only
going to make matters worse.
It is not going to make matters any better.
And that can create an anxiety trigger that you think, it's 2.45 and then you're tossing
and turning, you look back at the clock and now it's 3.14 a.m. and you think, I've got
to be awake at 6. I've got a big meeting and now it's 314 a.m. and you think I've got to be awake at 6, I've
got a big meeting and now it's 524. Don't do that to yourself. And I, even though I don't
typically struggle with sleep, I have no clock faces in my bedroom. The phone that I use
to help do the guided meditation is an old phone and it has only Wi-Fi connectivity and nothing else on it.
And I will only hit play and then I will never turn it around.
I will not look at the clock face.
Just doesn't help me.
Another incentive for keeping the phone out of the room if one can. I understand there are reasons when one would want
the phone in the room if it's potentially signaling
an emergency.
Well, I think it's a very important point
and we've done some work in this area too.
What that phone does is create a low level of anxiety.
It's what we call anticipatory anxiety.
One of the mechanisms separate from that,
well, it's related to that.
If you look at teen phone use,
one of the reasons that they don't sleep very well at night
is that they're constantly checking their phones
because of FOMO, a fear of missing out.
What has gone on as I've been asleep?
And it's stunning the data, but for most adults,
the other reason I don't like advocating for phone use,
when your alarm goes off in the morning,
what is the first thing that you do as you're in bed?
You swipe right or you unlock your phone
and you instantly start checking social media,
emails, text messages, and you instantly start checking social media, emails, text messages.
And this tsunami of stress and anxiety just floods over you.
It hits you like this wall of anxiety.
And I bring this up because it again trains your brain for expectation of that.
Anticipatory anxiety has a consequence on your sleep and everyone
knows this. Let's say that you've booked an early morning flight and you've got to wake
up at 5 a.m. when normally you wake up at 7 a.m. Two things will usually happen. First,
you know that you're just not going to sleep as deeply that night because you're on edge
and this is for an interview or it's for a critical,
this is a non-negotiable trip that has to happen.
You've got to wake up.
The second thing is that when you are expecting
that wave of sort of a need to wake up,
and maybe it's just, I'm expecting the phone again,
you will wake up just a it's just I'm expecting the phone again.
You will wake up just a few minutes before your alarm.
It's stunning how many people will say, I had this big flight the next day and you almost
know I'm going to wake up two minutes before my alarm goes off.
Why?
Because your brain has stayed in the shallow state of anticipatory anxiety and you don't
get as much deep sleep,
and we've now demonstrated that, we and others,
when you have that low level of anxiety,
the depth of your deep sleep is not as deep,
you don't get the good.
So again, not to be trying to dictate what people do,
just be aware that when you do create that behavior
and that regimen, it becomes almost like a knee-jerk, trained habitual
response.
Terrific.
Let's talk about some of the advanced tools for sleep enhancement.
What sorts of methods could one incorporate?
What are some of the data?
Is there any way that we can lump these into some framework or categories, because I know there are a
lot of different tools.
There are, and I suppose this would be, you know, I know our friend Peter Atier has spoken
about medicine 3.0.
I think this would probably be sleep optimization 3.0.
What is coming down the pike?
What is in the research?
And I think, you know, could make it to market or has made it to market, but
yet we're still right on the cusp.
We've seen, we again in the Royal We have been able to augment human sleep in at least
four different ways.
There are methods for electrical brain stimulation. There are methods for acoustic stimulation of sleep.
So electrical stimulation of sleep, acoustic stimulation of sleep, thermal manipulation
of sleep, and then finally kinesthetic manipulation of sleep, meaning movement-based stimulation.
Maybe I can just go into each one of those.
The electrical stimulation is probably the most well rendered
of all of those four.
In part because we started there and we,
and here it's not the Royal We,
we have done a lot of work on this
and I can tell you a little bit about a company
emerging from that.
But when
you're trying to manipulate the human brain, the principal currency in which the brain
communicates is electricity. Now there are lots of things that help it do that, such
as chemicals, but the principal language and verbiage of the brain is electricity. So if
you're going to manipulate the brain, why don't you speak in its currency of electricity?
So we and others have developed a method
based on something called direct current brain stimulation,
and specifically something called
transcranial direct current stimulation,
and I'll unpack that.
Trans meaning movement, so if you've heard of transport,
it's about moving things from one port to another. Transatlantic, moving across the Atlantic.
So here the start of it is moving. You're moving something from one place to the next.
Transcranial means through your skull. So we're moving something through your skull.
Transcranial direct current is the type of voltage or the
type of electrical impulse that we're putting in.
It could be alternating current or it could be direct current and early methods and those
we use have been direct current.
So transcranial direct current and then stimulation.
We're trying to stimulate the brain, specifically the cortex.
And the way that we do this is that we apply
electrode pads to your head and we insert
a small amount of voltage into your brain.
Now, it's so small that you typically don't feel it,
but it has a measurable impact
on that electrical brain activity.
So very early on, scientists, and we weren't the first
to do this by any means, there was a great paper, now a famous paper in my field by wonderful scientist Jan Born in Germany,
and they took a group of subjects and they applied these electrode pads specifically
to the front of the brain.
And I'll explain why we target the front of the brain with sleep electrical enhancement
or the electroceutical as it were, they applied
these electro pads to two groups of participants and then they let them go into sleep.
And as you'll remember, we described that in the first two or three hours of sleep is
when you get most of your deep sleep and they were targeting those deep, slow brain waves
that we spoke about, those big, slow, powerful waves that define deep sleep.
And what they did in one of those groups, the other group was the placebo group, they
still had the electrodes applied, they still went to sleep.
In the stimulation group, they waited until those individuals went into deep sleep.
And I told you in the first episode that those deep sleep brainwaves were going up and down
very, very slowly, maybe just once or twice a second.
So they started to stimulate the brain, inputting these stimulation pulses at a very slow rhythm,
trying to match the rhythm of the brain.
In fact, they were less than one hertz, less than one cycle per second in terms of a pulse. It's almost as though we're trying to act like a choir to a flagging lead vocalist.
And as these brainwaves are going up and down, you're trying to sing in time with those deep
sleep brainwaves.
And in doing so, you're trying to boost and amplify the size of those deep sleep brainwaves.
Now, to begin with, they just waited until they went into deep sleep and they started
to stimulate at that frequency.
And I'll come back to why that's important in a second.
But sure enough, what they demonstrated, they were able to boost the electrical quality
of that deep sleep by about 60%.
And they were also able to almost double the amount of memory benefit that sleep provided, which is very impressive.
That is impressive.
Now, I should note that there was more recently
a replication attempt of that paper,
and they did a very good job.
They really did it to the letter,
and they weren't able to replicate the effects as powerfully.
However, subsequent studies have now
taken a more nuanced approach, and it's the one
that we've taken too, and it's called closed loop stimulation.
Closed loop here simply means that I'm not going to just wait until you go into deep
sleep and then just take a chance and start stimulating your brain, not knowing of the
synchrony of my pulses into your brain relative to the brain waves
that you're experiencing.
Closed loop does do that.
So what I'm doing is I'm measuring the electrical brain waves that are occurring.
Because they're nice and slow, they're very predictable.
And I can program my algorithm and my brain stimulation machine to say I'm going to wait
and wait.
And as soon as you are on this peak of your slow wave, it turns out to be the negative
trough, but I'll forego that.
We then try to strike at that point of midnight when you're going through the biggest sort
of powerful sort of dip in the brain wave.
And we're trying to sort of enhance it.
And same with the peak. So this is where we get a stimulus from the brain,
your electrical brain activity,
and then we create a timed response.
So it's a stimulus response.
It's a call and response loop.
And by way of doing that,
it's a much smarter specific method
than a more generalized, I'm just going to stimulate
and hope I catch
those waves at the peaks.
The reason is important because different people have different speeds of their slow
brain waves.
They're all slow, but your speed of brain wave may be a little bit different to mine.
And if I'm off with my stimulation by, let's say, just half a second or a quarter of a second
time and time again I may be leaving some benefit on the table but closed
loops stimulation creates this personalized electrical prescription of
stimulation and when you do that you get very reliable benefits you can boost
those deep slow brain waves you get the memory benefits but also what we found is you not only boost those deep sleep brain waves
You boost another electrical signature that I spoke about in the first episode called sleep spindles
It seems to be the combination of those two things by way of electrical stimulation that provides the benefits now
I should know I haven't mentioned this, you can buy these devices on the internet
DIY style.
Do not do that.
If you go onto the internet too, you can also find some horror stories.
People have misappropriated the voltage.
They've got skin burns.
They've lost their eyesight for several weeks.
Do not do this at home.
I promise you.
Use, you know, wait until these products come out.
And that's one of the reasons why we've scaled it
into a company and we're trying to do this.
We've got a long way to go yet,
huge number of trials that we have to do
before I feel ready to really lay it on the table
and say, you should absolutely buy this.
It's well worth it.
But we're getting very, very close, I would say.
Great.
What about thermal manipulations?
Temperature.
I mean, there's such a tight relationship between temperature and sleep and wakefulness
for that matter.
What sort of technologies, tools, protocols exist that use thermal manipulation
as a way to augment sleep.
I love this topic because there are high-fi, low-fi,
and no-fi technologies that you can use.
The story of sleep and temperature,
as you mentioned before and reiterated,
in terms of the three-part standard,
that TERSET that I would describe is, again,
you need to warm up to cool down to fall asleep.
You need to stay cool to stay asleep.
You need to warm up to wake up.
What that refers to technically in sleep science are what we call the thermal trigger zones.
So warming up to cool down to fall asleep is what we call the sleep onset thermal trigger
zone.
Cooling down or staying cool to stay asleep is about the deep sleep trigger zone.
And then warming up to wake up is the activating alertness trigger zone.
Studies if you looked at them to begin with before they manipulated that found something
fascinating.
If I take you, Andrew Huberman, and I bring you into my lab and I remove your phone, all
your laptop, and you say goodbye to your friends and family, and I bring you into the center
and there are no cues as to what time of day, no windows, no nothing.
And I'm just going to say, look, I'll keep asking you, but at the moment that you feel
most sleepy, just let me know.
It turns out that before that, we'd done the delightful intervention of inserting a rectal
probe into you because that's the best way that we can measure your core body temperature.
So we're measuring your core body temperature. So we're measuring your core body temperature and sure enough, despite you knowing nothing
about what time it is, the moment that you will tell me I am ready to go to bed and I
am sleepy is the moment when you are on the greatest decelerating trajectory of your core
body temperature.
It is highly predictive of how sleepy you will feel.
The way that your body does this is by pushing blood out
to the surface regions of your skin,
notably your hands and your feet,
because these are these highly vascular regions.
And you had a great podcast from one of my heroes
and good friend, Craig Heller, who's
done some amazing work on this at Stanford.
So naturally, as we lie down, blood races to our hands and our feet and also our head,
and we start to release that heat trapped in the core of our body.
And by releasing that heat at the surface, our core body temperature drops.
Hence, the outer surfaces of you, hands, feet, feet and face have to warm up for your core to
cool down for you to fall asleep.
And in fact there was a great nature paper some years ago, they just measured the temperature
of someone's feet and they looked at how quickly they fell asleep and when they fell asleep.
Sure enough the warmer your feet the faster you fell asleep and when they fell asleep. Sure enough, the warmer your feet,
the faster you fell asleep.
Why?
Because the warmness reflects the blood dilation
and the pumping out of the blood to the periphery.
And then they did it in rats,
where they started to warm the pores of the rats
and the rats fell asleep more quickly.
I love this notion of, again, we don't do anamorphic,
I love the notion of, again, we don't do anamorphic, I love the notion of wrapping
a beautiful little rat up in a cotton wall and I'm warming its feet with this pad and
it's just blissed out and then poof, he's gone.
After all, she, I respect their privacy.
So that was the early evidence that then led to a series of manipulation studies.
The most notable is brilliant.
It comes from a colleague in the Netherlands, Oes van Sumeren and his group.
They created essentially what was a wet, think about a wetsuit, but that wetsuit is covered
with all of these thin tubes, almost like veins that go all over the suit to all territories of your body.
And then what they would be able to do is perfuse water, warm water or hot water, exquisitely
to different parts of the brain or the body.
Cool.
Amazing.
Yeah, no pun intended.
Thank you.
So what they did was then they started to manipulate these peripheral regions sort of
and sure enough when they did this, they were able to have individuals fall asleep 25% faster.
And these were healthy individuals who are normally sleeping within a very natural quick
period of time.
But they were able to lop off 25% of that time simply by warming these certain parts
of the brain to lift the blood away from the core of the body.
And by doing that, they accelerated the temperature core deceleration and therefore increased
or accelerated the speed with which sleep arrived to those individuals.
Sleep appeared with much greater alacrity
than it would have done otherwise,
even though it was quick anyway.
So then not being satisfied with that,
they moved on to the deep sleep trigger zone,
and this isn't, you need to stay cool to stay asleep.
And here now, they started to just continue to cool the core, the central aspects of the
body.
What they were able to do is increase the amount of deep sleep by somewhere between
25 to look at some of the data, almost 40 minutes they were able to boost the amount
of deep sleep with the thermal manipulation.
And when they were measuring the electrical brain waves and they decompose those brain
waves, even the power and the electrical quality of those slow waves was increased.
Very impressive too.
Next, not being satisfied with that, they turned to older adults for the reasons that
we've just described.
What they found was that in those older adults when they were not manipulated with this thermal
temperature, in the second half of the night, there was a 50% probability that they were
going to be awake for some part of the second half of the night.
When they did the thermal manipulation, they dropped that number down to 5%.
So they reduced a 50% probability of waking up down to 5% in older adults. And again,
they improved the quality of their deep sleep. Think about, by the way, why that was so effective
for older adults. I guarantee you, you've probably seen you've been in a warm climate
or you've been down on the beach, you know, here sort of in Los Angeles, and people are out in shorts and t-shirts
or crop tops.
And then occasionally there will be someone, and I love seeing these sites where, you know,
a child is sort of wheeling along their elderly parents, a beautiful sort of scene of caring.
But the older adult, they're not dressed in the same way that everyone else is dressed
on the beach.
They are wrapped up.
Some of them have a woolen hat on.
Why?
Older adults cannot thermoregulate anywhere near as well as young adults.
Is that right?
And it's the reason that older adults will always be saying, I'm just so cold.
My hands and my feet especially are always cold.
Now that's a problem for sleep.
Because if you cannot vasodilate at the level of your hands and your feet, you can't get
the blood out from the core, you can't drop your core body temperature as much.
And we started to understand from those types of data that part of the aging sleep-related
problem equation is not just that the brain deteriorates in sleep-related regions, which
we've been doing most of our work on.
It's also part of a body equation and a thermoregulatory equation.
There was also a great study unrelated from Australia.
They looked at insomnia patients, and they put their hands or their feet in warm water.
And by doing that, it's a manipulation.
You can see how quickly their hands and their feet, what we. And by doing that, it's a manipulation. You can see how quickly their hands and their feet,
what we call vasodilate, fill with blood.
Healthy people vasodilated very quickly
in response to that warm water,
meaning that their hands and their feet had this red,
or at least for my feet, they would be,
this red tone to them.
However, in the insomnia patients,
they did not vasodililate anywhere near as well.
So once again, it suggests that when you have problems with sleep, part of the equation
may be that you have impaired thermoregulatory ability.
And we do see this in insomnia patients.
So that was, I think, a brilliant causal manipulation. The problem is that most of us don't have access
to a sort of come to bed eyes thermal suit.
So what can we do as a concert?
Please don't cut that.
I'll get myself into terrible trouble, rightly so.
I should be punished.
You'll be all right.
What they did then was to say, well, okay,
let's look at this.
Is there something that we could do that's cheaper and more accessible to the general
public?
And if you look, there's a literature that preceded that manipulation.
And it's so reliable that we now have a term for it in sleep science.
It's called the warm bath effect.
And many people will say, look, I love to have a warm bath or a hot shower before bed.
And I think when I get out, I'm nice and toasty.
And it's because I'm nice and warm that I fall asleep and I stay asleep.
It's the exact opposite.
When you get out of the warm bath or the shower, you have once again vasodilated at the surface
of your skin.
You get out of the bath, you get this huge thermal dump of heat away from the core.
What happens?
You fall asleep and you stay asleep, more sadly.
Now there are other reasons that that has a benefit.
It's relaxing, you decompress, you're staying away from technology, et cetera.
But that is one of the thermal benefits.
And in fact, there were studies by a legend in my field who passed away just a few years
ago, Jim Horn at Loughborough University in the UK.
And they did some of these pioneering studies.
They were able to improve the amount of deep sleep by almost 40 minutes in some individuals.
What was the protocol there?
As I recall, I think they were in the bath for somewhere around, or the bath duration
time was somewhere around 30 minutes, but they were doing sort of segments where it
was, maybe it was 40 minutes, 10 minutes in and then you could sort of get out.
I think the temperature, because it was UK, was around about 40 degrees Celsius, somewhere
in that region.
I may be getting those numbers wrong because I know we would like to protocolize some of this,
but they were able to show some really pleasant benefits
to deep sleep.
It also helped people fall asleep,
helped them fall asleep by about 25 minutes faster
in those people who were really having
a hard time with sleep.
I'm gonna take a hot bath tonight.
I sometimes do the sauna in the evening before sleep.
I'm a big fan of cold in the morning, cold shower, cold plunge in the morning.
Because you're reverse engineering the equation.
You're trapping the heat into the core of your body.
You're waking yourself up.
Right.
And then the evening I've used sauna.
The one issue with sauna is I really crank the heat of the sauna.
And then sometimes if you do that right before bed, you take a warmest shower right afterwards,
you get into bed.
Oftentimes I'll wake up thirsty because it dehydrates you, and then if I drink a lot
of water to hydrate after I'm in the sauna, then I'm waking up too much in the middle
of the night.
So I think sauna is great, but right before bed-
I should try.
I would love to.
I don't have a sauna at home or an access to... I mean, there are saunas in and around where I live,
but what I want to do is have it proximal to my bedtime.
And my bedtime, because I'm a neutral type,
sort of around 11-ish, nowhere is open
and willing to allow me to sit in the,
how long do you sit in there usually?
I'm a little bonkers about this.
Well, if it's in the evening and I just want to relax,
I would say maybe 20, 30 minutes.
And I tend to go really warm,
warmer than I want to stay here.
What does Peter do?
Peter, is he our friend?
Is he about the same?
I've done a sauna cold plunge with Peter.
He usually does it in the evening,
goes sauna cold, sauna cold, sauna cold.
Okay.
Warm shower.
And I don't know how many nights a week he's doing that.
But in terms of the temperature of the sauna,
you know, generally somewhere between 175 and 210 degrees,
depending on how heat adapted you are.
But I think a hot bath is great, or a nice hot shower.
Yep, I've certainly done that.
And when I'm traveling with jet lag, I will absolutely,
that's part of my sort of jet lag protocol.
I'll make sure I do,
because I don't really struggle too much with sleep,
at least at present,
but when I go through jet lag and I go back home to London,
of course it's tough.
The worst.
The jet lag is the worst.
Protocolize the living daylights out of that
and do as much as I can.
So I think that's probably the end of the thermal story,
although we are now trying to see if we can take low-fi approaches where we're going to
do some foot warming, we're trying to develop some foot warming technology that can be built
into maybe a mattress and some mattress companies, there are some great ones.
I know obviously Matteo at 8 Sleep and they are doing amazing things.
I think his company, again, I have no affiliation, but we connect very well.
He's brilliant.
So they're doing something like that.
I do use and love my 8 Sleep.
Here's what I'd love somebody to engineer.
And we've got a lot of people who listen to the podcast who think about product development.
It would be wonderful to have a portable pair
of socks so that you can use them when you travel or when you go to sleep anywhere at
home or elsewhere that would warm your feet up at the beginning of the night.
So this is a place for us to recap.
Warm up to cool down to fall asleep, right?
Stay cool.
Stay cool.
To stay asleep and then warm up in the morning to wake up.
Yeah.
And so that is pretty straightforward to build into a pair of socks.
Somebody can do this. Somebody do this. Okay.
So that's, so we've done electrical, we've done thermal.
What about auditory?
Auditory. So acoustic stimulation in a very similar way to electrical stimulation where
you're trying to target that deep sleep and see if you... A better analogy is probably
a metronome and you're trying to see if you can kind of force the metronome further over
and back and forth with these types of technologies. So auditory stimulation came on the map again.
I think probably Jan Born's group in Germany was some of the first to do this.
They initially started with the same generalized approach where they would take acoustic tones
and they would first assess what is your level of awakening threshold so you'd be asleep.
And they would just have these tones, very light tones, like a sort
of ping, ping, and they would gradually increase the volume up and they would look to see what
is the point where that volume of the tone wakes you up.
And then they understood your specific threshold, what's called an awakening threshold, and
they would set the volume to a sub-awakening threshold.
Great.
So you've got that locked in place.
And now you start, and they did this within the first 90 minutes of people falling asleep,
they started to play these sub-awakening level, volume levels of tones, but they were playing
them at this very slow frequency, as if again, they're trying to sync and match
the slow dancing rhythm of the slow brain waves.
And sure enough, in that first study, and it was indiscriminate, meaning they just set
the tones, like a metronome, set the tone, set the volume, and then set the cadence of the volume, the speed, the frequency of
those tones to just a little bit less than one hertz, a little bit less than one cycle
per second.
And then off you drifted to sleep and they played it for the first 90 minutes because
that's the rich phase of deep sleep.
And they were able to increase the amount of deep sleep significantly.
The problem in that first study was that they also did a memory test because in all of these
studies including my own, even if I boost your sleep tonight, Andrew Huberman, my next,
if that's the result that you show me, I have four words for you as a scientist.
Yes and so what?
Is it functional?
Because if I boost your sleep,
but it doesn't change anything to you,
the organism the next day,
I'm going to suggest that that enhancement
is epiphenomenal, not functional.
So it has to improve some reasonable metric
in wakefulness that like improved memory,
improved task switching ability.
So it's outcome measures.
Grip strength.
Correct, yeah.
So even if I, for example,
lower your blood pressure with a new drug,
if I'm not changing your cardiovascular disease risk,
then the question is,
why am I just continuing on with the drug
if it's not really changing much?
Same thing here, and what they found
was that when they did the memory test the next morning, by enhancing
that deep sleep, there actually wasn't a memory benefit.
So perhaps what was happening is that this was just nonspecific.
So again, they then returned and now others have returned to the closed loop mechanism
where now I've got electrodes on your head and I'm measuring your slow wave brain
waves and literally I am next door in the room and I'm watching those slow brain waves
go up and down and then I've got a computer algorithm that is watching those, watching
in quotes, watching that too.
And it's predicting when the next wave is going to come and when it does, auditory tone
clicks, subawakening, you don't wake up, and sure enough, when you sort of
tone into the brain at that time, you boost the size of that brainwave.
And once again, they boosted the size of those deep sleep brainwaves.
They also improved those more quick bursts of activity, the sleep spindles, and now,
sure enough, they were able to improve memory.
However, if you look at that paper, and here's why I think the first method may not have
worked very well and why I don't suggest people start trying to set this up themselves.
When they kept stimulating the brain, slow wave after slow wave, after about three or four strikes of the metronome to boost those slow
waves, the benefits stopped.
And if they kept going, you started to inhibit the amount of naturally occurring deep sleep
brainwaves.
Why would it do this?
Deep sleep brainwaves, I told you in the first episode, are an act of incredible neural coordination.
It's mass coordination.
Now one of the extreme versions of mass coordinated propagated activity that is maladaptive, that
is pathological, is called an epileptic seizure.
And your brain has in place for the most part stop gaps to prevent that type of spread of vast amounts of coordinated spontaneous
electrical oscillations because the brain is such a conductive device that once you
get it going, you've got to be careful because it may start to conduct out of control.
So we think that these checks and balances that were in place, even though you can artificially
stimulate it for a while, after a while the brain the brain says, you've got to back off for a while because this is getting
a little bit out of control.
You do a breath pause and then you restart again and you get the benefit and then you
breath pause.
So you've got to do it a little bit intimately.
Now you've got to read what we call the supplemental materials of that paper.
You've got to go, it's like the fine print on a legal document.
If you dig into it, you can see that that was the case,
but it wasn't necessarily evident.
So those were really the data on acoustic stimulation.
Now with this closed loop acoustic stimulation
that we've got going on,
it seems to provide these nice benefits.
Some people then will probably be asking,
what about these noise machines?
What about white noise, et cetera?
I've taken a look at this,
and so far I think for white noise machines,
the data is equivocal.
There was a recent study, a review article,
I think it looked at about 37 different studies,
I could have this wrong.
And what they found was that there was no reliable, robust directional effect of white
noise machines on sleep. Some studies demonstrated that it helped sleep. Some studies didn't
change sleep. Some studies suggested it may make sleep a little bit worse. Just nothing
reliable.
But maybe it's masking external sound.
Correct.
So I think if, and one of the positive studies
in that scenario was a study that was done in New York City.
And it was in a region where there was a lot of
external sound pollution and noise,
as you could well imagine, it's New York City.
And sure enough,
that's where they got some really nice benefits of the white noise machine. So I think it is,
you're right, context dependent. There was an interesting recent study that came out from
Eaterman Learners Group at the University of Texas San Antonio. and they didn't use white noise, they used pink
noise.
Now what's the difference?
Pink noise has a little less what we call power or intensity in the higher frequency
ranges of the sound spectrum, and it's more enriched in the slower domain of that power
spectrum, which you could argue
is a bit more fitting with sleep.
And I think this study may have been a naps study, or I may be wrong, but anyway, what
they found was that they increased total sleep time by, I think it was close to 30 minutes
with the pink noise.
They did not change the amount of deep sleep, but they did enhance
the amount of stage two non-REM sleep, which we have spoken about before and we will in
subsequent episodes that is beneficial for things like learning and memory, including
motor skills.
And they increased the amount of REM sleep to a much more modest degree.
But those changes were significant.
So I'm not trying to rule out noise machines right now, and I have no affiliation with
any company or anything in that space.
I don't want to throw the baby out with the bath water.
I just simply think that right now we don't have enough evidence.
But as you and I know as scientists, absence of evidence is not evidence of absence.
Just because it doesn't exist doesn't mean that I don't think that it's still a potential
route these types of machines.
What about kinesthetic, stipular tools, protocols?
Body position is something that has an interesting relationship to propensity to fall asleep
based on brain cooling
that we talked about in another episode.
But what about manipulation of the body's movement?
Yeah, is there anything in that domain?
It sounds wacky at first.
Yeah, it does.
But I said it, so.
But, you know.
Wait.
I still wanna know.
Come on, social media, just be nice, be friendly.
I would say that if you look back in again,
the annals of human history,
from the very early inception,
you will see mentions of a child being rocked in a manger
or rocked in a crib.
Often parents will take their young infant and you will
quote unquote rock them to sleep. And we as adults will sometimes get in a hammock and
if you're rocked, what happens? You will fall asleep. It's that prototypical image of someone
with a hat over their face and in a hammock and they've sort of fallen asleep.
So it was very clear that something was going on in this space.
And then a group from the University of Geneva led by another fantastic sleep scientist,
Sophie Schwartz did an epic study that again, it's one of those studies that I probably
once more wished I'd done.
Here's what they did.
They took a bed frame and then they suspended it on chains from the ceiling.
Now stick with me.
I'm not going in that there's no hot candle wax being applied here.
Don't worry.
I'll keep it PG again.
And then the next thing that they did was connect a rotating arm to that bed at the
side of the bed.
And that arm would start to simply just push the bed laterally from left to right, left
to right.
And they started just swinging the bed in a very controlled manner.
But here, and I should ask Sophie exactly why they made this choice. They were rotating the bed not at this sort of around one hertz, which is what we've done
with electrical stimulation or acoustic stimulation.
They were doing it at 0.25 hertz, which is much slower still.
Almost imperceptibly.
The bed is rocking, you know, once every four seconds. It's a very slow lull.
And sure enough, what they found
in the first series of studies,
they did a nap study, a 90 minute nap study.
When you did this rocking motion
versus when the bed was still,
they increased the speed with which people fell asleep.
They boosted the amount of deep sleep
and they boosted the amount of those sleep spindle
oscillations that we described.
Not satisfied, they then said,
well, what happens across a night of sleep?
They did it then across a night of sleep.
They replicated the same findings
and now they got a memory benefit.
Now the memory benefit, you could argue is modest.
It was 10% of a memory improvement benefit
when you woke up from sleep relative to the already sizable benefit that sleep naturally
gives when you're not rocking the bed. But you think, well, 10%, if I were, let's say a student,
and I got a B and someone, the professor said, look, by the way, there is something that you can do
and we can increase your grade by 10%
and you can get to an A or an A plus
depending on the grading system.
Would you take it?
Would you take 10% benefit?
Absolutely, you would set a grade point average increase.
So it isn't trivial necessarily.
Well, I also, I'm positively surprised how important this
but so what condition is for you sleep researchers.
Yeah, and so what?
You know, that enhancement in say deep sleep
or rapid eye movement sleep needs to translate
to some daytime benefit in order to really get you guys excited.
But here's why, I think that's great.
It's always great to have a high threshold for excitement.
But one of the things that one could argue is that,
there are only so many tests that you can have
in a laboratory of daytime functioning.
I think I'm on board the fact that sleep is the bedrock
of mental health, physical health, and performance.
So, an improvement in, you know, a statistically significant improvement in deep sleep or REM
sleep to me just seems like that's got to be good for something.
We might not know what that something is to test in the laboratory, but it could be that
the threshold for improvement of, say, gut microbiome production of neurotransmitters is 0.1% improvement in deeps.
We don't know.
I made that up, so don't quote that statistic anyone.
But I so admire the extreme thresholds of what gets you guys excited.
Well, no, your point is a very good one because you could argue based on what I just went
back and said regarding the exercise
study with Rhonda Patrick, I've just reversed my own threshold logic.
I said to you, well, okay, exercise was able to overcome some of the deficits that occur
by way of sleep deprivation for your blood sugar.
But don't assume that that necessarily means it overcomes the detriments, the other detriments
that you'll have for your hormonal health, your thermoregulatory capacity, your cardiovascular
disease, your brain function.
So I've just said, look, simply, you know, one thing doesn't mean that you've assessed
all things.
And now I'm saying, okay, if you don't show that it improved that one thing, then
it's not functional. But Matt, by your own logic, you've said that, but you didn't assess
many of the other things. So even if it didn't improve memory, as you said, the bedrock of
all things health, you need to assess all of them before you make your conclusion of the yes and so what failed test.
So you're absolutely right to point that out.
So what was interesting after that data came out in humans, which is usually the opposite
way around, they started to look in animal models.
And you mentioned the vestibular system, this ability for us to understand motion and movement and there's
lots of mechanisms for that. They looked at mice and they started doing this rocking again
and sure enough the mice fell asleep faster. But then they found a strain of mice that
did not have the lateral vestibular sensation mechanism.
And they rocked them just the same way.
Zero change in their sleep.
Because you could imagine,
well, it's important to understand the mechanism here.
Is it that when you're rocking,
there is, it's not just about vestibular stimulation.
Maybe that rocking sort of modestly changes friction,
which changes temperature. You could come up with all sorts of wacky reasons.
This was a very clear causal manipulation of the lateral vestibular system.
And if that is not in place, you fail to get the benefit.
So it clearly has something to do with the vestibular system.
Can I venture a guess as to why that is?
Yeah, please.
I interrupted, but in case I happen to be right
by some chance, I previously talked about the need
to lose a sense of one's posture and relationship
to gravity in order to fall asleep.
Right, you have to go into this lack
of proprioceptive awareness in order to fall asleep.
Proprioception being the knowledge aware ones,
limbs are relative to the body
and body relative to other surfaces in gravity.
And this is something that can be accomplished
in these, you know, flotation tanks and things like that
and other ways go to outer space.
But...
The cheaper version.
The cheaper version.
So could it be that the rocking at that very slow frequency
is tapping into the vestibular system in a way
that proprioceptive feedback about body position
is somehow starts to vanish?
Because I'm intrigued by this idea
that you have to lose perception of your body's positioning
and proprioceptive awareness in order to fall asleep.
And maybe your description earlier of a protocol of going on a mental walk in order to fall
asleep.
I just feel like these things are starting to converge on some themes here.
Our central common pathway that could be the absence of probe.
I think it's entirely possible.
In some ways, right now, we think that these two things
are associated that as you're falling asleep,
gradually you will lose proprioceptive sensation.
But simply the fact that two things are associated
doesn't necessarily mean they're causal.
But your suggestion here is a very elegant way
of testing that hypothesis, which is that perhaps if you could show that the symmetric of proprioception
becomes compromised when you start doing lateral kinesthetic or movement stimulation, that's
a very powerful demonstration that it's not just so here with the study in the
mice they lacked the lateral vestibular sensation and you lost the sleep benefit.
But maybe there's one step down which is that when you lose that vestibular stimulation,
you lose the benefit on the thing that really is augmenting the sleep, which is the change
in proprioception.
So this is the first step in a chain of command,
and you've missed the final common transactor
of that ingredient called better sleep.
Interesting.
And those, I would say, are probably
the four current bastions of sleep augmentation.
Hopefully that describes to listeners
the range of where sort of sleep 3.0, sleep enhancement
3.0 is going and also describes the way in which we can come down the strata from high
friction, low friction to no friction.
And also in terms of cost where you can have high cost, minimal cost, low cost.
I mean hot bath or a shower is pennies on the dollars.
Especially if you take a cold shower in the morning
and save on your heating bill,
so you can take a little bit longer hot shower
in the evening and then you net to zero difference.
It's just my way of saying,
take a cold shower in the morning.
Feels great when you get out.
What about some ways to enhance rapid eye movement sleep
beyond what you've covered up until now.
So I think there are probably two emerging data sets that I've been intrigued by, one
of which we've been doing some work on, and it comes back to thermal.
What I failed to mention is not just that you need to warm up to wake up, which you
do, but you also need to warm up to REM sleep, but not too much. If you take an organism
or a human being and you strip them of bed sheets and strip them of clothes, so they're
basically almost au naturel, if you warm the body up to what we call the thermo-neutral
point, so it tends to be, and this sounds extreme and you don't have to do this because
you're under sheets and that makes a world of difference. But if you warm the room to
about 30 degrees Celsius, which gets close to at the surface ambient level for your skin,
something that can bring your core body temperature up, back up to operating. Because I told you when you go,
when you're in that deep sleep trigger zone,
the middle zone, your core body temperature drops
and it drops significantly.
And to wake up, you have to warm up.
But on the journey to warming up,
you also have to get to thermo neutrality
for you to have REM sleep.
If I keep you too cold, I can reduce the amount of REM sleep.
If I get you too hot, I can impair the amount of REM sleep. So it's a Goldilocks phenomenon,
not too little, not too much, just the right amount. If I keep you there in terms of your
thermal net neutrality, I can boost your REM sleep.
Now that's fiendishly difficult when you're trying
to solve that equation as a commercial device
because different people are under different blankets,
they run at different hot temperatures,
they've got different partner situations.
So you need a closed loop system again.
But it's something that we're very interested in
because almost all of the methods that I've described,
and you were smart to pick this up, all target deep non-REM sleep.
But we spoke about in the first episode, every stage of sleep is important.
And in subsequent episodes, I'll tell you exactly why REM sleep is so critical.
So how can we boost that?
That's one way that we're starting to explore it, but nothing, I think, solid yet.
The other is some of the drugs,
the newer sleep medications that have come onto the market.
And again, I think I mentioned, I did take the task
and I feel perhaps rightfully so
about the classic sleep medications
that if you look at the scientific data,
if you can avoid them, it's probably best to do so.
There's-
Things like Ambien, etc.
We call them the Z drugs because they all start with a Zed. Ambien, for example, has
a Zed at the start of it for its generic name, but I don't want to get into naming any necessarily
brands.
Sorry, they'll come after me. Yeah, Zolpidum, but for Ambien.
What's interesting about those medications, again, they're in a class of drugs that we
call the sedative hypnotics.
So again, sedation, not sleep.
And also there's been some great work again by Dirk Jan Dijk and colleagues.
If I were to show you that electrical signature of your deep sleep, it does look as though
those drugs kind of increased the amount of electrical activity
in that slower deep sleep range, except once you go all the way to the far left, to the
slowest of those slow brainwaves, which turns out to be the types of waves that are most
beneficial for most health related brain and body functions, you get this huge dent in your electrical brainwave activity.
It's almost as though those drugs take a bite out of that realm of electrical activity.
And of course there are issues with daytime sleepiness and some safety related issues
that's been health associations, not necessarily causal. And so I offered one scientific viewpoint
of those medications in the book and so be it. It's not as though I'm anti-medication,
as I said, and some of the new medications are very interesting. It brings me back to
REM sleep. There's a new class of sleep medications called the DORAs, and it stands for D-O-R-A, small s, and it stands for dual
orexin receptor antagonists.
Oh my goodness, mouthful, that just sounds like word salad to anyone who's not a neuroscientist.
Orexin, which is part of that set of words,
is a chemical in the brain.
And orexin became prominent with the study of narcolepsy.
And what we, we as the Royal We,
people like Emmanuel Mignot and others at Stanford,
what they discovered was that narcoleptic patients
have a profound deficit in this chemical, orexin.
Also called hypochretin, and in the receptors.
Also called hypocretin.
Also called hypocretin.
Yeah.
And it has a function both, it turns out,
for wakefulness and a function for feeding
and eating-related behaviors.
Hypocretin was probably more related to it
when it was termed,
because it was discovered right around the same time.
So really two thousand.
Two different groups, yes, exactly, beautiful.
Two different groups named it differently.
But narcolepsy, as some people may know,
is it's a condition to sleep disorder.
And one of the symptoms is called
excessive daytime sleepiness,
where you have inappropriate invasions of sleep
during the day when you want to be awake.
Why?
Well, it turns out that this chemical orexin
acts like a finger on the light switch
of all of the apparatus in your brain that switches on to force you awake. It reaches
down into the, it's released from a central part of your brain called the hypothalamus
and it releases down into the brainstem to activate what we call the ascending arousal
system or the reticular ascending arousal system of the brain.
And when that lights up, it's like the light switch
which says on for waking brain activity.
And so what was happening was that this erexin up higher up
was not forcing the finger of wakefulness on during the day.
So almost instead of a switch, which is what you want,
it was more like a dimmer switch.
And you know, when you get to that dimmer switch point
right in the middle where it's flickering,
it's on, it's off, it's on, it's off.
That's almost the state in which the narcoleptic brain was
because they had a deficiency of orexin.
So that was the orexin story in narcolepsy.
So why is it relevant for insomnia?
Well, people realized the problem with narcolepsy is So why is it relevant for insomnia? Well, people realized the problem
with narcolepsy is that they're asleep during the day when they want to be awake. But the
opposite problem is true of insomnia patients. They want to be asleep at night, but they're
awake. So why don't we selectively develop a drug that goes after this finger that flips
the light switch on for wakefulness,
but now let's block it at night.
So we flick the switch back in the off position, we turn out the lights for the brain, and
we remove the problem of insomnia, which is excessive wakefulness at night, which is one
of its problems.
And therefore, when you remove that, indirectly indirectly what comes in its place is this thing called
more naturalistic sleep, and that's why it's been more favored now as the principal drug.
It's still not necessarily well known by physicians or it's not very well prescribed.
It's not very well covered here in the United States, unfortunately, with insurance, so
it's a very expensive option right now.
Health providers will choose not to do that, unfortunately.
So what's interesting about that drug though,
is that it's mixed in terms of the studies,
but quite reliably, it does seem to improve sleep,
very much so, but it seems to,
unlike those classic sleeping pills,
which artificially look like they're increasing deep sleep,
even though they're not doing sedation. These drugs can improve most all
aspects of sleep but including REM sleep which those classic sleeping pills did
not. Why is it doing that? We still don't know but one of the things that the
these Dora drugs do that block the erexin that take off the the on position
of the light switch and flip them
off.
When you switch it off, it can actually then allow the activation or the stimulation of
something called melanin concentrated hormone or MCH in the brain.
And that when it is triggered on can stimulate another chemical called acetylcholine in the
brain, which is a neurotransmitter.
If there is one neurotransmitter in the brain that seems to be responsible almost exclusively
for this thing called REM sleep, or dominantly, I should say, for REM sleep, it is acetylcholine.
This was discovered way back in the 1970s by one of my former mentors, Alan Hobson at
Harvard.
And what this drug may be doing is indirectly boosting the amounts of acetylcholine in the
brain, particularly in a region of the brain called the basal forebrain, which is a REM
sleep regulating region.
And that's the reason that you get boosts in REM sleep.
And people also report dreaming a little bit more too on those medications.
Thermal manipulation, getting you to net neutral thermal zones helps increase REM sleep, but
also there are some medications that were not necessarily designed for REM sleep, enhancements
selectively, but there is evidence that they do that.
If you ask me, where are we at with REM? It's certainly more bereft of methods
than deep non-REM sleep, but we are starting to find some now.
Given what you just told us about the role of acetylcholine in rapid eye movement sleep,
what about taking precursors to acetylcholine? I mean mean certainly a good number of them exist. You know, even like over-the-counter supplements like alpha GPC and then of course there are
choline donors and things like that that can increase cholinergic transmission.
Is that getting to issues of, you know, if one does that globally, is it possible that
you increase arousal and have trouble falling asleep? because some of those cholinergic agents can be activating.
So that's one of the problems.
The second is you may stop because you're going to have to take them before bed.
You may force REM sleep to arrive earlier and you may therefore come at the cost of
deep non-realm sleep.
And so you'd have to get some kind of timed release capsule, which you can do.
You can coat these capsules and you can get a timed release.
And you would want to take it before bed.
And then maybe after about four or five hours, you would want to kick it into gear because
now you're in.
So it's a little bit tricky.
It gets tricky.
Yeah, this is one of the reasons why I personally,
this is just my experience, I'm not a fan of supplements
that tap into the serotonergic system for sake of sleep,
because certainly serotonin plays an important role
in sleep, but anytime I've taken something,
you know, 5-HTP or something like that
to try and improve sleep, I find that I fall asleep
and then I wake up very deep, deep sleep, and then I wake up very deep, deep sleep and then I wake up very alert
and I have trouble with the later phases of sleep.
And I think that is because yes, serotonin is involved
in sleep, but it's involved in sleep at a very specific
point in this, as you refer to it, this like symphony
or ballet of different sleep stages and how they evolve
and interdigitate with one another across the night.
So while I do think there are things that one can use pharmacologically or supplement-based
to improve sleep, generally I like to think of those as the kind of thing that kind of
pushes a wavefront of the whole sleep process as opposed to trying to tap into one specific
neurotransmitter within the sleep ballet.
Exactly.
Yeah.
I like that way of thinking and you do have to be careful because in biology
It's often rare that there are any free lunches in truth
Nature has optimized our system so exquisitely that when you start to try and game the system for one thing
Be very mindful that it may come at the cost of something else and that's why
be very mindful that it may come at the cost of something else. And that's why whenever we're doing these types of sort of developments of technologies
for sleep, we are very cautious not just to say, did we improve the thing that we're targeting?
But first call of business in medicine is not will this drug help you, but firstly,
is there any downside in terms of will this drug hurt you?
And then you have to understand the cost ratio benefit between those two things.
Yeah, just one more anecdote that is in agreement with what you said.
Nowadays there's an increased excitement around peptides, the use of peptides.
And I currently don't use any, but I did a short run with occasional use of sermorelin,
which is a secretagogue, which is a growth hormone.
That's right.
It promotes the secretion of growth hormone,
not growth hormone itself.
I took it not many times and I was tracking my sleep.
And what I noticed is it put me into a little bit
of a hypnotic state.
Dreams were very intense, but deep, deep sleep.
But according to my sleep tracker,
and I only ran this for maybe three nights but according to my sleep tracker, and I only ran this for maybe three nights,
according to my sleep tracker,
it completely eliminated all my rapid eye movement sleep,
at least as measured by the sleep tracker.
But the amount of deep sleep, of slow wave sleep,
just massively expanded.
So that can't be good.
That can't be good.
I mean, you know.
No, you don't want to mess with that cocktail ratio
that we described in the first episode.
So I see.
Presume that it's emerged as the correct,
you know, DaVinci code of sleep stage recipes.
And there may be a time and a place where you want to
over-index on one of those things for whatever reason, but to do it consistently and permanently,
I would again say if you think within the space of a lifetime that you know something
that 2.6 million years of evolution has not understood,
chances are you're probably wrong.
I agree.
And certainly later in this series,
we will touch into some of the over-the-counter supplements
and other things that one can do in order to augment sleep
that do seem to have some benefit
because there are such things.
But in the meantime, thank you for providing
this incredible arc of description of basic sleep
hygiene and regularity, light, dark, temperature, getting out
of bed when you can't sleep, alcohol, food, caffeine,
cannabis, unconventional protocols,
and let's call them advanced protocols, electrical protocol, brain stimulation in other words,
thermal manipulation, auditory stimulation, kinesthetic,
and then these rapid eye movement enhancing drugs
and on and on.
Matt, I can't thank you enough.
This has been just replete with actionable tools
and considerations.
And I love that you took us to the cutting edge
of what's happening now.
I think it's wonderful to talk about the history
of the field and what was discovered.
It's wonderful to talk about the present,
but it's wonderful that you've put our eyes
a bit into the future of what the technology
for sleep enhancement and monitoring holds.
So, once again, thank you.
You're so welcome.
If folks haven't already seen or listened to episode one, I highly recommend they do.
And of course, we will be back soon with episode three, which is going to get into all the science and
actionable protocols related to napping and caffeine and some
other exciting things that I know impact people's daily lives
and that they can get moving on should they choose right away.
And by moving on, I mean to sleep.
Thank you again.
Delight.
Cannot wait for the next recording. Thank you for joining me for today's episode with Dr. Matthew Walker.
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