Ologies with Alie Ward - Somnology (SLEEP) Part 2 with Dr. W. Chris Winter

Episode Date: October 23, 2018

Have you listened to Part 1 yet? No? Go on, git. Go do that. Now if you have, this Part 2 is a bonanza of problem solving from neurologist and somnologist Dr. W. Chris Winter. He'll cover: if you shou...ld be taking sleep supplements or pills, sleep talking, apnea, why sleepiness makes us hungry, narcolepsy, the difference between insomnia and sleep deprivation, how to lucid dream, the dangers of shift work and some tactics to lull yourself to dreamland without any medications. ALSO: I share a family secret: my mom's insomnia buster -- newly dubbed the "Sleepy Fancy Nancy" -- that has literally never failed me. Dr. W. Chris Winter's sleep clinicDr. W. Chris Winter's bookFollow twitter.com/sportsleepdocBecome a patron of Ologies for as little as a buck a month: www.Patreon.com/ologiesOlogiesMerch.com has hats, shirts, pins, totes!Follow @Ologies on Twitter or InstagramFollow @AlieWard on Twitter or InstagramMore links at www.alieward.comSound editing by Steven Ray MorrisTheme song by Nick ThorburnSupport the show: http://Patreon.com/ologies

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Starting point is 00:00:00 Oh, hey, it's still your little stepbrother who tries to trade you their calcified banana flavor now and later. It's for your mini Reese's Peanut Butter Cups, and you're like, dude, little dude, step all the way off. How dare you? That's not how life works. Ally Ward. Back for the second half of some knowledge.
Starting point is 00:00:15 Did you listen to part one yet? Deep sleep versus REM versus REM versus light sleep. Which is the ugg? Which is the glittery dress loafer? Do you regularly disco with the night hag? How lucid is your property brother's experience? Does C-3PO give you PTSD? If you have no idea what I'm talking about, I have exposed you as having skipped part
Starting point is 00:00:35 one. So go listen to part one. Part two will be here for you. When you're done, it will make way more sense. Come on, kid. Okay, so part twoers. It's just us now. We get it.
Starting point is 00:00:45 We have the basics on how sleep works, what happens when we don't have enough of it, and what our brainwaves do and why insomnia is a product of fear and anxiety. This episode answers Patreon questions to help you get better sleep and includes, yes, the secret insomnia buster from your pod dad's mom, your pod nana, fancy nasty board. So I'm earnestly so excited to share it because I swear it works so well for me. Okay, but before we get to the episode, a few things we always do and you know it. Really quick, Los Angelinos, if you happen to be in LA November 3rd, there is a comedy benefit for multiple myeloma research.
Starting point is 00:01:21 If you listen to the hematology episode with Dr. Brian Dury, which was all about blood and multiple myeloma, which is a cancer that my dad has, this is a great way to support. It's a comedy benefit. So it's a whole comedy show. It's hosted by Kevin Nealon and Natasha Legerro, Cristela Alonso, Jim Jeffries, Gabriela Glacis, Sashir Zamata, Shanta Wans are all performing. And I'll be there just hosting the red carpet live stream, but tickets start at 50 bucks and they are available at comedy.myeloma.org.
Starting point is 00:01:52 You can also go to my Instagram and I have a link to their Instagram there. Okay, so thank you to everyone who supports on patreon.com slash oligies. Even as little as 25 cents an episode gets you into that club, you get to hear what episodes I'm working on, you can submit questions. I may read your name on the show. Now this is my favorite job. You all pay my salary and you make this free to everyone. So thank you for that.
Starting point is 00:02:15 Just to everyone who gets pins and shirts and hats and totes at oligiesmerge.com and you can support for no coin just by tweeting and gramming, tell your mechanic, spread the word also by star rating on iTunes or other platforms or leaving reviews, which I read and cherish like notes from the feedback very and to prove it, here's a fresh one. I just plucked. Great dad jokes wrote in if Bill Nye the science guy and dirty jobs had a love child, it would be this podcast. It takes a deep dive into a variety of specialties, but explains things in a way that makes you
Starting point is 00:02:51 super excited about things you never thought you would get excited about like bugs and anatomy and primate butts. Great dad jokes. You get it. Thank you. Okay, so some knowledge. Part two. Let's get your questions with Virginia based neurologist, sleep whisperer, author of
Starting point is 00:03:09 the sleep solution, why your sleep is broken and how to fix it. And of course, some knowledgist, Dr. W. Chris Winter. Can we do a rapid fire round? Oh yeah. Oh my God. Okay, so I asked for questions on Patreon as I do. I say patrons. Get me with your questions.
Starting point is 00:03:44 And typically I get 50 to 80 questions, maybe. I got 255 questions, 25 pages worth of questions, clearly we're not going to hit them all. Here we go. So I'm just going to run through. Megan Yance wants to know, why do some people have different circadian rhythms? So Megan, Megan, that is a genetic trait you probably inherited from your mother and father as either being a night owl or what we call delayed sleep phase or a morning person or morning larko.
Starting point is 00:04:14 So probably the simple question is you acquired it from a parent. Now it is modifiable, so there may be aspects in your life that allowed you to change it. But to me, I think it's a trait like eye color that we can work to overcome, but it's kind of always there. And I'm a believer, just on the side, that our sleep need, how much sleep do we need and our timing as Megan's describing, when do we like it, night or late or early, tends to push us into certain careers. Teacher likes to wake up early in the morning, maybe needs a little bit more sleep, more
Starting point is 00:04:44 consistency in their life. So, and night owls tend to travel better, deal with jet lag better, and by some studies are smarter. Isn't that interesting? Really? I didn't know that. This is kind of the follow up question to that. Paul Huck and a few other people asked, I was a lifelong night owl and I just woke up
Starting point is 00:05:01 one morning, a morning person. How does that happen? Well, Paul, that's interesting. I don't know. For me, a lot of times, things that I've involved in my life can push me one way or the other. One is like exercise first thing in the morning. I was training for like a triathlon a long time ago and meeting a group of people to do it really early and I hated it, I dreaded it.
Starting point is 00:05:21 But after a few weeks, I was waking up like at 4.55 in the morning, an hour or five minutes before my long clock went off and felt really good and was falling asleep at 10 o'clock at night. It can be certain things in your life or as our bodies mature, we tend to become less night-oriented in general and more morning-oriented. The high typical high school student stays up at 3 o'clock in the morning watching YouTube videos, wants to sleep until 2 o'clock in the afternoon, is really upset with mom when she comes in and opens up the blinds before lunchtime.
Starting point is 00:05:50 Then you look at grandma and grandpa living down in Sarasota, they get the NutriBullet out at 3 o'clock in the morning making kale smoothies, and you're like, grandma, oh my god, what are you doing? It's 3 o'clock in the morning. I know this is when I wake up, isn't it great? We have a tendency to move towards that as we get older, so maybe Paul, let's just move there very quickly. Side note, like Paul, I too have recently come to enjoy waking up early when I do it.
Starting point is 00:06:14 I thought this meant I have finally gotten my shit together, it's happened, but Paul, it looks like it just means we're old and marching ever closer to death. We win some, we lose somebody, I don't know what to tell you. The steely blue gloaming and the morning mist belongs to the olds, so come join our wise wrinkle party, let's whittle spoons at 7 a.m. over our third cup of percolated vultures. Tyler Key wants to know, is it possible to tell the exact point someone starts being asleep or is it just a gradual blurring of lines into unconsciousness?
Starting point is 00:06:45 So you can see it on a sleep study and there is a sense of gradual, so when you look at the brain activity, what you start to see is a slowing of the brain activity. The eye movements that characterize wakefulness become slow and rolling. So the answer is generally over about a 30 second period. That's how we score sleep. We look at 30 seconds of sleep at a time and when you start to see a predominance of that intermixing of sleep with the light wakefulness, that's when we say sleep happens. So it's a gradient, but it's a very short gradient for most people.
Starting point is 00:07:24 30 seconds is pretty short. And you can see it very clearly, it's not hard to find. Skype a scientist wants to know, why do some people make weird noises as they're falling asleep and what can we do to stop them from doing it or what can they do to stop doing it? That's a tough one. So one of my favorite weird noises at night is a phenomenon called catathenia, which is a prolonged expatory moan.
Starting point is 00:07:53 PS, thanks Jay Lydiker for creeping on your vulnerable sleeping boyfriend and putting it on YouTube. So 36,000 strangers and counting could enjoy what sounds like a constipated puppy or a very frustrated porcupine struggling to understand tax paperwork. So for a lot of people when they go to bed, this is super, super fun that when you find out the person you've, you've committed your life to does this, they will actually kind of take a breath in and all of a sudden I go kind of like a fog horn all night long. So these can be, you know, there's also somniloquy, which is sleep talking, which can be sort
Starting point is 00:08:39 of gibberish or it can actually be, you know, fully formed sentences that people have no idea what they're talking about. These things can be treated. Often there's underlying sleep problems that are causing them. So if you can figure out the underlying sleep problem, like with the sleep study, you can sometimes get rid of the underlying, you can get rid of the sound that the patient's making, but they can be kind of difficult to get rid of sometimes. What can the underlying problems be?
Starting point is 00:09:03 So for instance, like somniloquy, sleep talking, a lot of times what happens is an individual sleeping along, they'll have a little breathing disturbance. And as they kind of, they kind of wake up, they're conscious enough to have a conversation. And one time my wife woke up in the middle of the night and said, we've been watching the X files for this show a long time ago. Much as you try to bury it, the truth is out there. She woke up and said, Hey, could you just go out there and get all those dead bodies off the lawn real quick?
Starting point is 00:09:33 And I was like, what are you talking about? And then she would get real upset with you if you tried to rationalize what she was talking about. So you figured out very quickly, the best thing would be like, Oh yeah, I'll be, I'll be right back. I'll take care of that. She'd fall asleep and not remember anything about the next day. So you know, but a lot of times you would hear like a little breathing hiccup that would
Starting point is 00:09:50 kind of wake her up. It could be a little acid reflux. It could be a little, a random leg movement, you know, coughing fit. There's lots of things that can do it that would wake people up to do it. And Cedars, there was a great video one time of a young woman who was very, you know, sort of proper and, and, you know, raised right as my parents would call it, who would wake up in the night and just say awful things, curse, make these very vile sexual references. PS, I tried to find a clip of this video, but Googling quote, woman obscenities in
Starting point is 00:10:22 sleep only turned up a ton of gross tutorials about how to sleep with women and scrolling through this deluge of pickup artist DIY videos made me too sad to keep looking. So sorry. Had no recollection of doing it the next day and it turns out she was having seizures just at night and that was the manifestation of the seizure. Oh my God. Yeah. I just thought she was a rude girl.
Starting point is 00:10:45 Rude girl. That's right. Yeah. She got that treated but I also hope to like let her be herself. That's right. You know what? She's like, you know what I learned from this? It's a freak flag fly, sister.
Starting point is 00:10:54 That's right. Bob Carleton asked, and we kind of touched on this a little bit earlier. I've heard that it used to be common for folks to wake in the middle of the night, do some reading and then go back to sleep for the rest of the night, basically bisecting nightly sleep. Is this something that really happened and we should bring it back? It did happen and it's a bit of a denser read, but it is absolutely fascinating. A guy named Roger Eric wrote this book and it's like a day's end or at night's end or
Starting point is 00:11:21 something like that. It's a journey into the history of sleep or something like that. I've always butchered the title. I'm really apologize because it's such a good book. I shouldn't do that. Okay. So the real title is at day's close, night in times past by A. Roger Eckertsch. I'm going to admit it.
Starting point is 00:11:38 That does not roll off the tongue. So I get why Dr. Winter could not figure that out. But it's all about what happened during nighttime in pre-industrialized eras from like masquerade balls to crime, to ins and taverns and brothels, yarn spinning circles. And I feel like now I need an episode on nocturnology, maybe to shine some light on the topic. Okay. Dr. Winter explains. But he writes about sort of sleep throughout antiquity and there was sort of this first
Starting point is 00:12:09 sleep and second sleep. We would go to bed when the sun went down. We would sleep. We'd wake up. We'd walk around at night and greet neighbors and fallen holes that we didn't see and these passages that he's found or I think it took him years to write this book and you read a page and you almost have to close the book and just think about, oh my God, it's so cool that people used to do that.
Starting point is 00:12:28 So should we bring it back? I don't know that we should voluntarily bring it back, but I do think it does provide a little bit of this idea of, hey, look, if you want to have a siesta during the day and break your wakefulness period up with a little spot of sleep, I think that's okay. And some would argue natural. I think it's okay if your night period is broken up by a little period of wakefulness. That's not a big deal. What is insomnia?
Starting point is 00:12:54 It's not a person who can't sleep. It's a person who can't sleep when they want to. That's part A. Part B is you have to have an emotional response to it. So if waking up in the night is kind of a fun thing for you and you don't mind it, then I think it's perfectly fine and a great way to sort of view an awakening during the night. It's not the end of the world. Just your way. Go with it.
Starting point is 00:13:16 And it doesn't do the kind of damage that like a C3PO alarm clock on your bed would do. Very different. You know, you're not buying, screaming, we're doomed, you know, going off over and over. It made the craziest sounds. Oh my God. I can't believe we did that to people. It was C3PO. I always thought it was funny.
Starting point is 00:13:31 I was like, if we had had R2D2, probably better, but this random robot screaming at you at three in the morning was often just what people needed to wake themselves from a deep sleep immediately. Again, if you missed part one, the midnight terror of a mechanical C3PO does await you. Don't forget to run the clock so we can wake you again tomorrow. I bet you'll get a lot of people who ended up not liking Star Wars after that. That's right. It's kind of a visceral response to the new movies.
Starting point is 00:13:59 Levi, I like the jeans and Ron Smith both asked about shift work, that it's awful for your health, and what can you do to negate the negative effects of that? Levi and the other individual are absolutely right, Ron are right. The thing that terrifies me the most about sleep and sleep science is not insomnia. It's not the person who went 18 months without sleeping. It's the person who is the shift worker who thinks that they're doing okay with the fact that they work a day job and also have a night job to make ends meet. These are the conversations we have in our clinic.
Starting point is 00:14:34 I really think you shouldn't be doing this great. You're going to be my mortgage doctor when you know I can't do that. Okay. Then shut up. People often get into a position of, they almost feel like they don't have a choice, and the World Health Organization classifies shift work as the class 2A carcinogen now. I think it's incredibly devastating to our health. Real quick, what is shift work exactly?
Starting point is 00:14:55 I wanted a clear definition, so I asked the internet. Now according to the National Sleep Foundation, shift work is work that takes place on a schedule outside the traditional nine to five every day. Work can involve evening or night shifts, maybe early morning shifts, rotating shifts, and yes, the World Health Organization does classify shift work as a carcinogen. If you heard the surgical oncology episode about breast cancer and its concern, the stats say that women whose work involves night shifts have a 48% increased risk of developing breast cancer.
Starting point is 00:15:31 Prostate cancer risk is also elevated along with a host of other cancers, medical ailments. According to my good friend Wikipedia, this may be due to alterations in circadian rhythm, so melatonin is a known tumor suppressor, and it's generally produced at night, so late shifts may disrupt the production of it. One study I read reported that the underlying pathophysiological mechanism, which just means why does this happen though, is that exposure to light and darkness at weird times leads to disruption of normal sleep wake rhythms. It's called chrono-disruption.
Starting point is 00:16:09 It means I'm sleeping at the wrong times, my brain is confused. So it's like who's afraid of the dark? Who's afraid of falling asleep with the lights on? That seems more dangerous though. But what can shift work like Dr. Winter himself experienced during his medical residency due to a human? When you look at individuals who are engaged in shift work, we know that they have much more difficulty with their weight, much more difficulty with the blood pressure, more heart
Starting point is 00:16:34 attacks, more strokes, more mis-work, more GI issues, more psychological issues. It's just a very difficult thing to sustain. I remember when I was in residency, when we were talking about that a while back, that I felt that I was clearly at my most unhealthy point in my life, and that this were my job. This is what I'll do for the next 30 years. I don't know that I felt like I would have lost 10 years in my life. Even my kids, when we look back at pictures of myself during that time, thank God we didn't have a lot of digital cameras around at that time, but the pictures that we do have, my
Starting point is 00:17:09 kids are like, oh God, dad looks terrible, pasty white, just looks really unhealthy, and I think it's because I was. So if you're a shift worker, talk to a sleep specialist. There are medications that can help alleviate that. And I would say the other thing too is to talk to your employer about ways you can make the shift work more humane. I mean, hopefully you're working for somebody who says, look, I don't care how you do it, we just need to cover these shifts.
Starting point is 00:17:36 There's ways you can construct your work environment. There's ways you can construct the way the shifts move from day to day that are a lot easier in our body than others. And a lot of times it's a matter of doing a little bit of research or talking to somebody about how ways to make that better. The other thing too is try to work towards not being a shift worker. That sounds really flip, but being very genuine in that even if you like it, and there's a lot of things to like about shift work, you know, working at night for some people, there's
Starting point is 00:18:04 not a lot of administration around you just show up and do your work. It's kind of quiet and some people feel good at that time, but just understand just because you're good at doing it and you like it doesn't necessarily mean it's probably a really good thing for your body. Got it. Same for jobs that involve a lot of jet lag asking for a friend. Yeah, absolutely. Again, there are things you can do to treat jet lag.
Starting point is 00:18:25 There's some really cool goggles that you can wear that shine green light into your eyes that kind of trick your brain circadian rhythm. And a lot of them have these little jet lag calculators associated with them. So if you're getting ready to go to Stockholm for three days and then over to Brussels and then back home to New York, you can use these lights at certain times of the day to help you acclimate more quickly to that. Cool. Yeah.
Starting point is 00:18:47 I got a lot of questions. Carlos, GX Barnett, Paul Hawk, Katie Spino, Maria Kumro, Abigail Campbell, and more all asked how can some people sleep for five or six hours and feel fine and other people need eight or 10? Like why do some people seem to need less? So that once again kind of goes back to the earlier question about how come some people are night oriented and some people are day oriented. So when you think about your sleep, everybody's listening to this has a certain amount of sleep
Starting point is 00:19:17 that they need that's individual to them. Not only that, but it's also individual to you at that time. So if you're a 20 year old, that time might change when you're a 70 year old. So not only do we have a time that we need or a duration we need, but we also have a timing. So those are the two variables I want you to think about. And so what the answer to the question is there are some people out there who need eight hours of sleep.
Starting point is 00:19:40 And we talk a lot about that in the media being sort of an average. I think that average is probably closer to seven, seven and a half, but we can agree to disagree. So whatever that average is, it is an average. So when you're planning your picnic, there might be a statistic out there that says the average picnic attendant will eat two hot dogs and a hamburger. That is awesome information to have as you are buying your supplies because now you've got a little bit of an algorithm for figuring out how to feed people.
Starting point is 00:20:07 Now that does not mean that every person who walks to your pick comes to your picnic is going to eat two hot dogs and a hamburger. So we need to get outside of this idea that eight hours of sleep is somehow magical. It is if that's what you need. But if you're somebody who needs six and a half hours of sleep, seeking eight is going to create an hour and a half of dead time that's going to be very unpleasant to you and might even be interpreted as being insomnia. Well, I'm trying to get my eight hours, Dr. Winter, I go to bed at 10 o'clock and it
Starting point is 00:20:36 takes me like an hour to hour and a half to fall asleep every night is driving me crazy. My first question I always ask people like that is why have you chosen 10 o'clock as your bedtime? And they look at you like, I really never thought about that, sort of like saying my lunch time is at 10.30 a.m. Wow, tell me about your lunch. Well, like 10.30, I leave my office, I go to the restaurant, I sit down, the waitress comes.
Starting point is 00:20:58 She says, what would you like? I say, I'm not that hungry. And she keeps coming back and coming back and coming back. Finally around 12.30, I say, I'll take a chicken sandwich, please. Like that's crazy. Nobody does that. The waitress at some point is going to say, honey, leave. Why do you keep coming at 10.30 and just sitting there taking at my booth?
Starting point is 00:21:14 Like go shop or go do some work and come back when you are hungry. So for the person who asked the question about sleep duration, we're all different. So if you're getting six and a half hours of sleep and you feel great and you don't feel like falling asleep in movies or in meetings or things of that nature, then you're probably doing exactly what your body needs to be healthy. Okay, that's good to know. Travis Gary, Julie Noble and others asked back side or stomach, which is best and why? So it depends on how you define best.
Starting point is 00:21:45 Most people would describe sleeping on your left side as being best because number one, our body's blood return comes mainly through the rights of our body if we're engineered correctly. So there's a thought that if you sleep predominantly on your right side, you kind of compress that passive return of blood to your body, which can be especially important for pregnant women. So left side sort of alleviates that our airways want to collapse more when we sleep on our back. So sleeping on your side puts our airway in a little bit more of a favorable position,
Starting point is 00:22:19 although kids who have big tonsils sometimes it doesn't. But for an adult that works out well, the problem with sleeping on your side is orthopedically. A lot of people find that it hurts their shoulders, it hurts their hips or knees to sleep on their side. So orthopedically, the best position to sleep is on your back. So the answer to the question is if you're saying from a sleep perspective, I would say left side or on your back with your head somewhat elevated to keep your airway more open. But there's all kinds of studies about sleeping positions.
Starting point is 00:22:50 If you're worried about wrinkles or you're a woman with larger breasts and you're worried about them sagging, then you really shouldn't be sleeping on your side of your stomach. It should be back all the way, it keeps our skin looking healthier, it keeps our bodies looking more toned. So it really depends on what you mean by which is best. So I would say in my world, left side of your body is probably the best on some sort of mattress that maybe eliminates that kind of pressure feeling from your joints. Okay.
Starting point is 00:23:17 What about on your face? Sleeping on your face is tough. I mean, a lot of people sleep on their stomach. It's fairly rare to find somebody who's a stomach sleeper who likes their face into the pillow. It's a little dangerous, but they do make pillows that kind of are almost like the little massage. When you go have a massage and your face down, you have your little face in the little donut
Starting point is 00:23:36 hole or whatever. So they do make pillows that facilitate that. I would say that if you're going to sleep on your face, just try to make sure you're eliminating the amount of air that you're getting or whatnot, or just gently turn your head to one side or the other. Okay. Good to know. I was asking for a quote friend.
Starting point is 00:23:52 I'm pretty sure I sleep on my face. Okay. Quick aside also on sleep apnea. There are a few different types with different causes, but how do you know if you might have it? Okay. Do any of these sound like you daytime sleepiness or fatigue on refreshing sleep insomnia, perhaps morning headaches?
Starting point is 00:24:10 Okay. Here's what you do. You throw a lavish slumber party and then over cereal the next morning, you just hand out questionnaires to your friends asking if they heard any loud or frequent snoring, silent pauses and breathing or choking or gasping sounds, or you could just request a sleep study. If the doc's like, yep, you got it. They might work out some treatment that involves lifestyle changes like ditching booze or cigarettes,
Starting point is 00:24:38 maybe losing weight, side sleeping or mouthpieces. Some folks have to get surgery for sleep apnea or use a breathing device like a CPAP, which stands for continuous positive airway pressure because it forces air past any floppy throat obstructions you might have. I was doing some digging and it may not be a cure-all for everyone, but tons of folks who have finally treated their sleep apnea with a CPAP say it's life changing. And also, if we're not busy making this podcast, I would go into the side business of aftermarket medical equipment and sell CPAP upgrades that look like glistening face huggers from Alien
Starting point is 00:25:20 or maybe Bane masks. Oh, you think darkness is your ally? Shannon has three questions, but I'm going to ask, well, they're all good. Can you die from sleep deprivation, yes or no? Yes, but it's not something that you would be able to do yourself, meaning you'd have to employ friends with stun guns and cattle prods. And the reason I'm saying that is because there are people out there who have insomnia, who feel like they're not sleeping, that the fear of the situation creates the situation.
Starting point is 00:25:54 So I would say to this person, you are in no danger of not sleeping. In fact, even people who come to our clinic and I say, well, you have to have a sleep study. Well, I can't sleep in my own bed. How can I sleep in a sleep study? I always tell them, why don't you go to the sleep center? They're going to hook all these wires up to you. And I want you to lie in bed.
Starting point is 00:26:09 I do not want you to sleep. Just lie there awake like you normally do for seven or eight hours and we'll see what happens. Nobody ever does it. In fact, they usually sleep more than they do at home. They'll come back and say, I told you I didn't sleep. And I hear you slept for six hours and 13 minutes. One night I showed a judge her video and she said, oh my God, I really thought that I was
Starting point is 00:26:28 awake all night long. In fact, I'm looking at this thinking maybe you superimposed my face on another, you know, she was kidding. But so, no, you are not in any danger of sleep deprivation. I always tell people insomnia is the worst condition in the world that has almost absolutely no medical consequence. Really? It doesn't, uh, it doesn't lead to plaques in the brain and sleep deprivation does not
Starting point is 00:26:53 insomnia and insomnia and sleep deprivation are two very different things. So yes, if you're working, you're a nine to five job, you come home, sleep for two hours and seven o'clock, you go off to clean office buildings all through the night and go right back to work the next day. Yes, you are putting yourself in position of, of having trouble. However, is that person going to completely sleep deprive themselves? No, they're going to do that job for a period of time. And what's going to happen is they're actually going to fall asleep on the job.
Starting point is 00:27:19 They're going to fall asleep in their office the next morning. So it's very difficult to sleep deprive yourself because, you know, like I said, sleep always wins. You're, you're going to sleep and unlike hunger, which is a primary drive and thirst, which is a primary drive sleep, your brain can actually control yourself doing that. So think of sleep as being a vital resource that you don't even have to hunt or search for or gather. You could just make it yourself if you just chill out and let it happen.
Starting point is 00:27:46 So imagine if you're like, man, I could really go for a lobster roll. Well, I'll just sit really still and breathe and it'll appear. Not sleeping enough is like being hungry all the time when we could just conjure lobster rolls. Now, why are we saying no to sleep, but yes to scrolling for so many hours before bed? I'm asking myself this. PS, if you hate lobster rolls and this analogy doesn't work for you, I don't care because it was for me.
Starting point is 00:28:11 I was talking to me. This aside was a private moment between my heart and my brain and my mouth. Anyway, so sleep happens. So at some point it just takes the decision out of your hands and you fall asleep. Shannon also wanted to know, does lack of sleep make you fat? It does. So sleep, poor sleep in a lot of ways makes you fat. It makes you too tired to want to go to the gym.
Starting point is 00:28:35 You're sitting around more, which creates a problem. We actually burn less calories when we're sleeping poorly. But the biggest thing is we start to create this biochemical cascade of chemicals that make us feel full go away. Chemicals that make us crave really bad foods or an abundance. I always tell people when I was in residency and really struggling and sleep deprived, I would go to this little convenience store in the hospital and there were these little packages of chips, always cookies.
Starting point is 00:29:01 And then they had like the 33% more family size bag and I would lie to the Phyllis, this little woman who worked there be like, oh yeah, some of the doctors are wanting some cookies. I want one or two, but no more than three. But I need the family size bag. And by the time I got out of the convenience store, I'd eaten the entire sleeve. And so when I look back on those days, I think, oh God, it was so driven by something, I didn't want that many cookies. It makes me kind of sick to think about right now, but oh man, I could put a herding on those
Starting point is 00:29:27 cookies at the time. Then of course, these cookies put a herding right back on you. So why does this happen? Let's blame a trio of hormones, shall we? There's leptin, which tells your brain's hypothalamus like, nah, I'm good, man. I'm not, not really hungry. So this appetite controlling hormone, leptin, is supposed to peak while you're asleep. But if you've been snoozing weird, it goes a little wonky.
Starting point is 00:29:51 Now there's also ghrelin, which is the flip side of the leptin coin and it signals to your brain this chow time. And two little sleep means a veritable monsoon of this hormone. Also insulin, the third one, stores fat and yes, our insulin gets disrupted when our sleep sucks. I am no medical person, but I can confirm this research because once I was very tired on a flight and I asked a stranger if I could have some of his sour patch kids and he gave me the rest of the bag, I think out of pity and also fear.
Starting point is 00:30:25 So there's your anecdotal evidence. Also they were really good. Julie Noble wants to know, I've heard that women are typically lighter sleepers and men. Is there a science behind this? I think there are. There are actually some studies that show that and also some studies that kind of relate it to childbirth, male species going out to find food, female species protecting cubs and whatnot.
Starting point is 00:30:46 So there are some studies that sort of look at that. So I think that that's not an unreasonable thing to think for sure. What do you tell new parents who are like, I can't sleep, this baby's crying, but I cannot just ignore the baby. What do you tell them? Yeah, I always tell parents, look, you know, for the first few months of the child's existence, it's gorilla sleep. Not gorilla like the animal, like gorilla, like the, you know, freedom fighter in the
Starting point is 00:31:26 jungle somewhere, meaning you just get it when you can. You know, I think it's very important for parents from the get go, even maybe even before the child is born to start thinking about scheduling, not only in terms of the child, but your own schedule. So if a mother who's pregnant is exercising at the same time every day and is on a good schedule herself, baby pops out often having sort of picked up on that too, you know, body shaking and the babies in there kind of moving around during the Zumba class, but not when your mom is sitting still.
Starting point is 00:31:55 So, you know, parents can, child rearing out, and this is my next book is I'm writing a book about kids and sleep, which I think is a lot of fun, but you got to be very careful because you're kind of straddling this line of sleep expert doctor. And let me tell you how to raise your kids kind of thing. So I have to be very careful not to step on any parents' toes, but one of the fundamental questions you have to answer with a kid is, are you going to schedule their life or do you let the kid kind of decide what's going on? You're going to tell them, this is when they nap, this is when they nurse, or you're just
Starting point is 00:32:25 going to basically pull it out and they can suck on it anytime they want to, which a lot of people do and that's, that's perfectly your choice. But when you don't build in some sort of structure or a schedule to a little baby, it doesn't develop a schedule. So again, is there a baby out there that's not sleeping? No, there's not. Is there a baby out there who's sleeping so inconsistently and so unpredictably it's driving mom and dad crazy?
Starting point is 00:32:48 Absolutely. So if you can predict your kid's sleep or quiet times, you as a parent can get anything done. So to me, that's really the goal of this first few months of life is really being careful about the messages you're sending. Okay, nap time is from 10 to 11. What happens if the baby goes down, screams is that off until 1045? What do you do at 11 o'clock?
Starting point is 00:33:09 You're going to wake the baby up because that's the end of the nap time, or do you just go ahead and let them sleep for the hour because, well, they, they didn't sleep. They didn't say, so I would say you wake them up at 11 o'clock and you do it with a smile and you have fun with them. Now the baby's trying to fall asleep in the car seat, going to the store and you don't let them. I always kept these little wet washcloths in my car and when my kids started falling asleep in the car, I would take their shoes off and mess around with their feet, which
Starting point is 00:33:31 made them cry. They hated that. And when that didn't work and they were still falling asleep as I messed with their, I would just take a wet washcloth and throw it in their lap and they would get all upset about it. No God, now I've got this cold wet thing on my lap or they'd play with it or suck on it. I didn't care as long as they weren't sleeping because this is not the time we've
Starting point is 00:33:47 determined to sleep. You had your time about an hour ago and you screamed and rocked your cage, your cage. Your crib the entire time. So to me, get your kids on a schedule. That's step one. P.S. Dr. Winter is not alone in seeing this visual correlation.
Starting point is 00:34:02 I found an article titled, quote, why cribs kind of look like cages on fatherly.com. And it said that cribs have evolved from the 1700s. There was an Italian practice of popping a slatted half shell of an old whiskey barrel over your wee one, kind of like a protective cage. So you wouldn't roll over it and kill it in bed. Oh, simpler times. 18th century state of the art baby technology was just a liquor soaked splinter cage for parents who care enough to provide the best.
Starting point is 00:34:36 Mike Melchior and Ashlyn Todd McLaren all kind of asked, why can you sometimes sleep for a really long time and feel super lethargic and sluggish? Like, can you not catch up on lost sleep? Like, is it not like a bank account? So those are two different things. And so you can. And there's some really interesting new research that says individuals who might struggle to get the perfect amount of sleep from time to time, as long as
Starting point is 00:35:01 relatively quickly to try to make it up with the nap. That's a good thing. So you're going to catch a flight. It's delayed and you don't get home until three o'clock in the morning and you thought you were going to get home at 10 and you got to go to work the next day. I think it's perfectly fine to make up for that lost sleep with a nap or some sort of supplemental sleep period or sleeping in. When we sleep in unusual time.
Starting point is 00:35:22 So I always like to look at people's schedules and college students are the worst. You know, Monday was a Friday. I got more organic chemistry class that starts at eight. I couldn't get anything other than eight o'clock class. It really was the pits. And then Tuesday and Thursday, I don't have a class until noon. And then on Friday night, Saturday and Sunday night, I don't even go out until two in the morning, let alone, you know, Waffle House, whatever the next morning.
Starting point is 00:35:42 So when people have these schedules that are kind of all over the place, the brain adopts this position of what do you expect of me at nine a.m. On these days, we're sound asleep. On these days, we're already an hour into an organic chemistry lecture. And on these other days, we've just gone out a couple hours ago. So your brain, I always say, this is this is my term. Makes no sense to a lot of people, but your brain, your brain just kind of goes gray. There's no black. There's no white.
Starting point is 00:36:11 It just kind of adopts this. You know, it's how people feel. You live in Portland or Great Britain. It's gray all the time. There's no sunlight. So you're just kind of like, I'm not terribly depressed, but I'm also not super happy either. So unpredictable sleep patterns can give you a real case of the morises. And, you know, so you just kind of this kind of melancholy all the time.
Starting point is 00:36:35 I think people feel that way. So to me, the answer to that is probably number one. There is this entity of sleep inertia. We try to sometimes make up our sleep and we have these massive sleep blocks. So our brain doesn't exactly know how to feel when we wake up. So a lot of people will feel worse after a night of sleep or even a nap if it sort of surprises the brain. So the best way to sleep, the best way to nap is to try to have your sleep period
Starting point is 00:37:00 end at the same time every time. So it's a very difficult thing to get somebody to say, look, you know, the opportunity to sleep till noon, it'd still be better if you woke up at eight, had a little something to eat, went outside with her sunlight, walked the dog, all but a physical activity. And then if you wanted to supplement your sleep, take a nap at a designated time. So that way we don't interrupt what your brain is sort of expecting. You know, we don't get hungry generally because we need food.
Starting point is 00:37:28 We often get hungry because our brain is saying, oh, it's noon. This is when we usually have the chicken sandwich. So here we go. Let's get ready for it. It's not over, calorically needing food a lot of times. So we're just trying to create a good rhythm for our brain. So for meals or in rhythm or exercises and rhythm, often our sleep will fall asleep. So you can make up for a lack of sleep. So if you stayed up all last night doing some great project for work,
Starting point is 00:37:55 as long as you can make it up pretty quickly, you'll, you'll scientifically live just as long as the person who always gets the right amount of sleep. Okay. Booyah to them. Booyah. Corey Navas, Michael Sadambuga, Emily Mancus, Melissa Brewer, Janella Lindauer, John Worcester, all asked kind of about sleep supplements, about melatonin, about ambient, about taking something to sleep. Is that good or bad? What are we dealing with?
Starting point is 00:38:22 So I will, my disclaimer will be, I'm not a big fan of sleeping pills. I think that they certainly have their place. And I guess I would think of a sleeping pill like an appetite stimulant. You probably don't know that many people who take appetite stimulants, they do exist. They're out there, but when we all go out to lunch and we're sitting around, everybody's ordering food and you don't feel hungry. What do you do? My guess is you don't say, oh gosh, hey guys,
Starting point is 00:38:47 does anybody have an appetite stimulant because I'm really not hungry for lunch right now. And I know if I don't eat, I'll starve to death. And I've seen these videos on the internet of people starving to death. It looks terrible. I don't want to do that. So please look around, find something for me to take. So we don't think that way when it comes to our food. We think, huh, it's unfortunate because this food looks really good. And I'd like to eat, but I'm not that hungry, but oh, well,
Starting point is 00:39:08 I'm sure I'll get hungry at some point in the future. So I think for a lot of people, sleeping pills become a crutch that is completely unnecessary and kind of this weird lie that you need something to fall asleep that other people don't. Now, the flip side of that is a shift worker. You work 7A to 7P for four days. You have two days off and you go back working 7P to 7A. So you're constantly moving backwards and forwards.
Starting point is 00:39:30 You're a traveler. You fly to Shanghai every two weeks to do business and you have struggle to adapt. I think those are perfectly appropriate ways, reasons to take medications. Melatonin, in particular, because it's such a good drug at helping us adjust our circadian rhythm. OK, so quick aside, melatonin is that hormone. It's produced by a tiny pea-sized midbrain little nugget called your pineal gland, and it makes you sleepy.
Starting point is 00:39:59 It helps you dream. And for a long time, we thought only animals made melatonin. But it turns out it's in a bunch of plants, you guys. So now we have melatonin supplements and gummy vitamins and over-the-counter access to it. But some experts warn against using the supplements long term because it can cause next day groggyness or grumpiness. But what is a big melatonin cock blocker, you ask?
Starting point is 00:40:23 Good question, and it's blue light. So to boost your natural melatonin in your brain, this is why people say lay off the screens after dusk. Newfangled light sources like screens and phones blast daytime rays into your brain at the wrong times. It's very confusing. And firelight and incandescent bulbs have these warmer wavelengths that don't mess with you, by the by,
Starting point is 00:40:47 just in case you want to be like next level hipster and bring back those really long creepy nightcaps and maybe carry a candle around from room to room. I'm kind of feeling that in between that aesthetic and whittling spoons at dawn. I'm kind of smelling a real Alliward Instagram rebranding over here. Just coming over the sunrise horizon, my friends.
Starting point is 00:41:09 Who's into it? No one? Fine. OK, so why else might someone take a sleeping pill or a supplement? Death of a loved one, you lost your job, some emotional upset. Do you have a big problem with a sleeping pill? I don't. But the plan should be, hey, here's a sleeping pill. I'm really sorry this thing happened to you. This will help you kind of get to this immediate, you know, burn of the of the situation.
Starting point is 00:41:32 But then we're going to do things to move us away from it. You know, it's amazing how many people I talk to. All right, why do you take Ambien? Well, I can't sleep without it. When that start and start, you know, it's because of the divorce. Oh, I'm sorry to hear that. Has that been hard? Well, it was 17 years ago.
Starting point is 00:41:45 Like number one, she's not coming back. You know, stop carrying that torch. Number two, the reason why you're taking the Ambien has nothing to do with a divorce. It's because now the divorce precipitated a problem that something is perpetuating. So let's get down to the bottom of what that is. So if you're taking melatonin every night, be careful with that.
Starting point is 00:42:02 It can actually make you feel like you're constantly traveling east because most people take the melatonin right when they go to bed. If you're giving your kids melatonin because it helps them sleep. I've got a big problem with that as well, too. So pills and sleep, I think that they don't really belong with with each other. And ask your doctor the next time, you know, what is the evidence that this medication works? It's surprising some of the answers that you'll get.
Starting point is 00:42:26 Or if there's even an indication for this drug, a lot of people take the drug cerakill, which is a heavy duty anti-psychotic to help them with their sleep. And not only is it not indicated for sleep, it's actually recommended that people not take that drug for sleep. Just be careful about the medications you're getting. Doctors, their heart's in the right place. They want to do something.
Starting point is 00:42:44 And for you to say, I'm not sleeping, they feel very compelled to do something. And often that comes in the form of a pill. OK, so remember blue light from our phones and TVs and laptops is just not something we've evolved to see at night. Our brains process blue light as like, OK, daytime or weakness. Now, if blue light is the cock blocker of melatonin, then it might be helpful to block that cock block with cool blue blocker glasses.
Starting point is 00:43:11 And by cool, I mean warm toned. Now, which brand of glasses should you buy? There are a million. Research them first. I found an article on consumer reports that tested three different brands and they ranged in price from eight dollars to like fifty five dollars. And the ones that cut the most blue light, they found out were the cheap ones. One brand called Uvex Skyper rated the highest.
Starting point is 00:43:34 So the most expensive ones cut about half the blue light as the cheap ones in this particular study. So look it up first. PS, if you are researching these glasses on your phone in bed right now, just just let it wait till tomorrow. A couple more questions and then I'll let you know. Here's Carl and Hale's parcels asked about blue lights on cell phones. Should we be turning our phones to yellow?
Starting point is 00:43:57 Should we be taking our phones and throwing them into a landfill? What should we be doing? I don't think we need to throw our phones into a landfill, although if you'd like to come to my house into my kids' phones into a landfill, I would not fight you on that one. I would actually disappointed, but secretly be like, oh, thank God Miles came over and threw the phones in the landfill. So to me, I think it's just about managing our phones.
Starting point is 00:44:18 Phones are great. They really help us kind of keep connected. They keep us safe. There's all kinds of fun apps and whatnot and audiobooks, etc. To me, the biggest thing is as we start moving from dinner to our bedtime, that sort of period, we really want to start looking at lighting in our house, our routines and finding a way to sort of move away from computers and cell phones at that time.
Starting point is 00:44:40 OK, it's 11 o'clock. If somebody needs me, they can get a hold of me. But I'm going to plug my phone up in a kitchen. I'm not going to take it into the bedroom with me as something I can do and I can look at when I'm having trouble sleeping. So I think that good hygiene with our cell phones is really important. If you're somebody here, you're a nurse and you may get called in the night. So you can't really separate yourself from your phone at night.
Starting point is 00:45:02 You're installing things like dimmers on our phones or employing the little night settings or even getting little blue blocker glasses. Uvex makes some, Swanwix makes some that you can keep on your bedside table. So when you're looking at your phone, you put the little blue blocker glasses on. So those harmful wavelengths of light are not keeping you up at night. Brie Johnson wants to know what's the difference between hypersomnia and narcolepsy? So that's a great question, Brie. Hypersomnia, you can think of as being sort of the umbrella term
Starting point is 00:45:33 of the hypersomnia is narcolepsy. It would be a specific one. And asking that question because of this term, idiopathic hypersomnia, which is thrown about in sleep, which is essentially your sleepy. You don't seem to fit all the criteria of narcolepsy. And the doctor has no idea what to do with you. So they call you idiopathic hypersomnia, which kind of drives me crazy. So lots of things can make us hypersomnic.
Starting point is 00:46:01 Narcolepsy is a situation where you're not making chemicals in your brain that stabilize wakefulness. So a typical narcolepsy patient will sleep eight hours, wakes up, feels pretty good, goes to his favorite art history class, sits down the front row, because he thinks if I sit in the front row, I won't fall asleep and immediately nods off and doesn't even feel sleepy to begin with. This literally happened to me in an art history class in an auditorium of 600 people. I sat in the front row to stay awake and I fell asleep.
Starting point is 00:46:30 So either every person on earth has done this specifically in an art history class about double barrel vaulted ceiling architecture in Clunale villages. Or I'm just more and more convinced that Dr. Winter guessed this because there is a glitch in the simulation. We're all living in an alternative universe. Anyway, so some people get tired. So these are individuals who are largely outside of control of their own sleepiness. How do you know which you are?
Starting point is 00:46:55 So that would be something that would probably require visiting a sleep specialist. But we've talked about some things already that kind of indicate it. Number one, you're a hypersomnic. You're excessively sleepy, which is different from being fatigued. You're saying, no, no, no, beyond fatigue. I can't read without falling asleep. I fall asleep watching shows. I don't go out on dates because I was not off and it makes me feel uncomfortable.
Starting point is 00:47:20 So you're expressing a lot of drive to sleep despite adequate sleep. Sleep paralysis can sometimes go along with it. An entity called cataplexy can go along with it. When somebody is wide awake, often feels some sort of emotional upset or elation. They're happy and all of a sudden feels paralyzed. Like their knees want to buckle or they can't hold their head up or their hands become very limp. People have very vivid hallucinations as they're falling asleep or waking up
Starting point is 00:47:46 at a young woman with narcolepsy who had this hallucination that her husband was like rummaging around or underwear drawer and so she confronted in the next morning and said, why were you, what were you looking for? Why are you in my underwear drawer? He's like, I was not in your underwear drawer. And she's like, I'm certain that you were. He's like, honey, I would tell you if I were, I wasn't. And she came to understand that over time, she was having these very vivid
Starting point is 00:48:05 hallucinations as she was waking up that really weren't real. So a lot of people with narcolepsy struggle to discern reality and something that's not, meaning I thought I did a podcast with Ali, but I ran into her and she's like, no, we haven't done it yet. It's coming up next week. So you start to doubt, did I pay the bill? Did I have the conversation with my neighbor about barring the lawn mower? Did the podcast ever happen?
Starting point is 00:48:31 They sort of live in this weird place in between reality and dreaming and difficulty understanding, which was real. Are there any movies about sleep that you love or hate? I remember a movie called Insomnia. I think it was like with Al Pacino and Robin Williams. I always thought it was really interesting because it was it was mainly filmed in Alaska when it was always dark. I always said that was kind of interesting.
Starting point is 00:48:53 Are you doing okay? I mean, you haven't been sleeping much, Detective. Now, the night up like this, you're really going to lose it. Don't worry, Will, you can sleep when you're dead. So this movie seems kind of scary, but very Al Pacino-y. That's my official scholarly review. Also, his character's name is Detective Dormer, and it's about sleep. Dormer literally means sleep in French.
Starting point is 00:49:19 I only watch a trailer, but if there is not a scene in this movie where two cops are like eating apple fritters in a squad car, being like, it's so weird that this movie is about sleep and your name literally means sleep, then I refuse to see the film. Generally, Hollywood tends to treat things like narcolepsy as almost comical. You know, it's a funny character that every time something happens, he falls over. Maybe the one that I would like the most is Inception. Because it sort of touches on this idea of lucid dreaming,
Starting point is 00:49:50 which I thought was really cool and really took it to a neat place. I think lucid dreaming is a fascinating topic. So maybe that's the one that I would choose. Is lucid dreaming something you can choose to do? It's something that you can you can it's a skill. Now, some people just do it if you've never had lucid dreaming. So lucid dreaming is simply being aware that you're dreaming when you're dreaming. As long as I'm so horny for etymology in this episode, lucid comes from
Starting point is 00:50:16 the root word for light or clear. And it was coined by Dutch psychiatrist, Frederick van Eden, in a 1913 paper called A Study of Dreams. So exploring free will in different states of consciousness was pretty progressive for an old and timey dude. But he also thought the demons caused nightmares. So, you know, and then dream control is sort of the next step of, oh, wow. I'm dreaming that I'm, you know, doing this thing.
Starting point is 00:50:44 I'm staying on top of a building. Dream control would mean you could actually just control yourself, jump off the building and then fly. So you can do it. And the way to do it is to really start becoming aware of your own reality. And so what I would do when I was going through this phase of trying it out and writing about it for this outlet, I would, during the day, I would take my ring off, my wedding ring off, I would turn it around and look
Starting point is 00:51:11 at it and kind of look at my hands and say, this is a real thing I'm doing. I'm not dreaming and that would put it back on. So I could actually do that in my mind as I drove or as I was talking to patients. And then what you start to do is you start to question reality in your dreams. And so what happened was I would have these dreams. I had one dream that I was going to a circus and all of a sudden I was like, wait a minute, and I would look at my hands and they were all distorted. I was like, this is, this is a dream.
Starting point is 00:51:37 I'm doing it. And that would wake up because I was so excited. But eventually you get to this place where you just kind of make it a habit to sort of question your reality throughout the day. And you bring that behavior into your dreams. And as you start to realize, oh, wait, this isn't a dream. You can do a lot of really cool things. One is look at your hands.
Starting point is 00:51:55 Our brains do a very poor job of rendering our hands in our dreams. So you'll have like 12 fingers or like two massive monster fingers or something. So side note, I look this up and there's this whole wiki site and forum on lucid dreaming wherein people shared their weird finger experiences. Here are two of my favorites. One is I remembered to do a reality check. So I looked at my hands and realized that they're actually claws. Another person said, quote, my fingers appeared jumbled as if I had no bones.
Starting point is 00:52:27 OK, so all ward is no Edwardian era mental health professional, but I'm fairly certain that these people are just afflicted by demons. The other thing you can do is like, you know, pull your skin or push your finger into the palm of your hand. A lot of times it will pass through or your skin's very flexible. If you look down at your feet, your feet often don't touch the ground, which is probably where they are not to touch the earth. Your feet don't touch the ground.
Starting point is 00:52:53 Our brain has trouble rendering our body in three dimensional space. It's really cool to look up at the ceiling of your house, which often looks like the sky. Everything that when we look up typically looks dark during a lucid dream. My favorite thing is try to find a mirror in your dream and look at your face. That is absolutely a total freak show. Oh, my God, it's cheaper than drugs, too. I would imagine so.
Starting point is 00:53:16 Yeah. And it's and you can get better at it. I had a swim coach, one of my son's swim coaches told me one time he was such a good lucid dreamer that he could actually plan out he could use the time in his dreams constructively like he would think, OK, well, we're going to swim this team next week. I'm going to construct my relays this way. I'm going to actually sacrifice this relay because I don't think we would beat them anyway and we'll put them in these events.
Starting point is 00:53:40 Like, so we have it all worked out by the time we woke up. Oh, my God. It was really interesting. Yeah, that's billable hours. That's good. That's exactly right. And any flim flam you'd like to debunk anything, any myths that you want to dispel? Alcohol is terrible for your sleep. Have as much as you want to have with breakfast. Do you want a mimosa?
Starting point is 00:54:00 Yeah. In general, you always tell people look sedation and sleep are two different things. Michael Jackson, Heath Ledger, a lot of people figure these things out the hard way. And it's always upsetting to me that I know people like that and people out there are going to people for help. And it just seems to be this arms race of how much sedation can we give somebody? So be very careful with that. P.S. So speaking of alcohol specifically, it can help sedate you into light sleep.
Starting point is 00:54:27 But do you remember how REM sleep happens in the second part of the night? And it's the one that's restorative for your memory. It's good for your mood and concentration. So alcohol disrupts that. It's kind of like the friend who leads you to a party and then ditches you there. And the party sucks. Do not trust it. Alcohol can be kind of a dick that way.
Starting point is 00:54:47 I think the idea that if you in your dreams, if you you're falling and you hit the ground, you you die, I don't think that's really the case at all. That's not true. I don't know. There's so many great questions. You're you're I feel like we've covered everything. What about what about things to like counting sheep or the the method where you breathe seven in four out?
Starting point is 00:55:09 Absolutely. So this breathing exercise was developed by Dr. Andrew Wheel, who kind of cribbed it off of Pranayama, which is an ancient technique. So that just is you do this. You exhale completely through your mouth and you make a whoosh kind of sound. And then you close your lips and hail through your nose as you count to four in your head. So four count, hold the breath in for seven seconds and then over the next eight count in your head, make a whooshing exhale from your mouth.
Starting point is 00:55:44 So you practice this pattern for four full breaths. You inhale for four, hold for seven, exhale over eight. It's supposed to distract you from anxiety and calm your nervous system. You're breathing, you're getting oxygen, you're doing math. You're not thinking about whether or not the thing you bought for the office gift exchange was too cheap. But what's my mom's big insomnia trick? Here it is.
Starting point is 00:56:10 I feel like it deserves a soft drum roll. Okay, good. We're going to call it the sleepy fancy Nancy technique. My mom does this thing. She taught me that works like a charm where you think of a category like fruits or boys' names or electronics. And then you go with something that starts with A, okay, Apple, B, Blackberry, C, and then you go down and I never make it past like L, I'm out.
Starting point is 00:56:37 But do you have anything else like that? I think that's awesome. Some sample categories you can use for this alphabet game, types of fruit, boys' names, girls' names, gender neutral names, cities, snacks, vacation activities, clothing brands, materials, items you would keep in a purse, animals, really anything. I've done so many of these. Let me know what some of your sleepy fancy Nancy categories are. I'm here for them.
Starting point is 00:57:04 I will probably use them next time I'm jet lagged and awake on the wrong coast, which will literally be tomorrow. So to me, what you're hitting on is something very important and without getting too crazy into it. As you go back to the idea of what insomnia is, it's really not the inability to sleep. But when people who have insomnia really start to struggle, they really start to try to sleep. If I'm sitting out watching television, finishing up watching Bachelors in Paradise, I can never make it to the Rose finale because I always fall asleep.
Starting point is 00:57:36 Katie, I accidentally called out the wrong name, but I would like to extend to you the option of staying. I'll stay and see how things go. Sure. Thank you. But then I wake up, I get into bed, and I can't fall asleep. Why is that, Dr. Wynn? Because when you're watching the Bachelors, what are you trying to do?
Starting point is 00:57:51 You're trying to figure out if Astrid is going to stick with this guy or she's going to dump him because he's such a dog or whatever. That's what you're trying to do. You're not trying to sleep. When you go to bed and you turn the lights off, a lot of people suddenly really start to try to sleep. So you've struck upon something that's very important. Give yourself a task that's not trying to sleep.
Starting point is 00:58:12 You're kind of giving yourself a complicated task. You're trying to visualize the letter of the alphabet, okay, B, what's a fruit? Blueberry. Okay, great. C, that's a toy. Cherry, I guess. And so now you've decided you're not going to try to sleep, you're just going to relax and name fruit or name boyfriends.
Starting point is 00:58:28 We tell our professional athletes all the time, look, when you go to bed, professional pitcher, I want you to throw 30 perfect pitches before you fall asleep. Oh, wow. Visualize the stadium around you, your favorite catcher, you're on the mound. Everything your pitching coach shows you, your arm slot, your movement of the ball. Go, visualize the ball in real time, flying through the air and landing your catcher's mitt. Look around, scratch yourself, catch the ball when he throws it back to you and do it
Starting point is 00:58:53 again, what you do it 30 times, then you're allowed to fall asleep. What's so funny is they'll come back and say, man, doc, you know, I'm trying to do that thing you asked me to do and shoot those free throws before I go to bed or throw those pitches before I go to bed. And I can only throw about four or five pitches. The next thing I know my alarm clock's going off, right. So I don't tell them, well, there, that's the point is that, you know, that I'm trying to get you away from this idea of let me think about trying to sleep.
Starting point is 00:59:14 I don't know if I'm not asleep yet, what am I going to do and try to find something else. The other cool thing is that when you pick an activity, so if you're somebody who has a pitcher or basketball player you like to do, you like to run or you do some sort of special skill, if you visualize yourself doing that at night, your brain doesn't differentiate practicing something and actually visualizing it that well. So if you're somebody who likes to, you know, play basketball, visualizing yourself shooting those free throws will make you a better ball player.
Starting point is 00:59:44 So I love the idea that either way, even if you make it through your 30 free throws and want to do 30 more, it's not wasted time. There's a really cool device called Muse, which is a little headband or it's a pair of sunglasses that measures your brain activity and feeds it back to you through your earbuds is the form of like the sound of the rainforest. So when you sit there at lunchtime, you finish up your lunch, you put your little Muse thing on, you do a little meditation session, you can practice the ability of quieting your mind down.
Starting point is 01:00:13 So you can learn what it takes to make the sound of the ocean get really quiet. And then when you think about your mother log, it's really loud again. So you can. So now when you go to bed at night, you've gotten very good at this ability to quiet your mind, which either help you fall asleep or allows you to sort of assume this sort of meditative state, which by some studies is just as good as sleep. Wow. And the cool thing too is I love this story you gave because you've got this little mechanism
Starting point is 01:00:39 that gives you confidence. Like you know what to do. I'm going to fall asleep usually no problem, but if I can't, I'll just do what you described. And what's funny is I was talking to a magazine editor one time I was describing her the benefits of resting and how sleep is great, but resting is very good too. So I just don't believe that, you know, even though you're telling me all this research and I said, yeah, I said, if you just rest it all through the night, you'd be okay the next day.
Starting point is 01:01:02 You wouldn't be perfect, but you wouldn't, you know, the F word in my clinic is function. You wouldn't be dysfunctional. And she said, gosh, you know, why don't you do that? Like prove it. Like why don't you just rest all night and write an article about it. I was like, sure, I'll do that. I've been trying to write this for two years for exactly what you said. I get in bed.
Starting point is 01:01:21 I'm like, okay, I'm going to start off with state capitals. I'll start with Maine. I think it's Augusta, Maine. I think is that right? And then by the time I get to like Virginia, I'm out cold and the long card goes off. So I'm trying really hard to be in a dark room with my eyes closed, but not sleep. And it's amazing how quickly sleep comes when you try not to do it. That's a very good parting words.
Starting point is 01:01:43 Let's repeat that. And it's amazing how quickly sleep comes when you try not to do it. Now, what's your least favorite thing about your job? What sucks the most? What sucks the most about my job is, this is a great question. I'll step on my soapbox. I love treating patients. I love helping people sleep better.
Starting point is 01:02:06 But in our current medical climate, it is very difficult, and I'm not trying to paint a sob story here, but it is very difficult for doctors to spend time with patients and get enough money from insurances to keep the lights on their clinic. I read an article in Forbes about how many doctors are literally living paycheck to paycheck, which was funny because one time my wife and I were watching the bachelor speaking to the bachelor and the host comes out and says, oh, and ladies, he's a doctor and like all the ladies are like, oh, it's so great, and my wife literally audibly groaned. She's like, oh, it's not the cash cow you think it is.
Starting point is 01:02:41 But the issue really is that the biggest thing I struggle, what sucks is that I don't feel like I have the time to devote to my patients sometimes because I've got to see a certain number of people to pay to my office staff. Now, being able to lecture, being able to write a book and talk to people like you, work with sports teams takes a tremendous pressure off my clinic that a lot of practitioners really good practitioners don't have. So hopefully, you know, we'll be able to kind of work around this and make healthcare affordable, but also allow doctors to practice their craft in a way that they can help patients and not
Starting point is 01:03:15 feel like they got to see 30 patients in a day. Right. I don't think patients like it either. They don't. And, you know, we, and I talk pretty freely about it with my patients, like if I'm late or running behind or whatnot, you always try to make sure that every patient can say what they want to say, even if it means I'm going to be a little bit late. And for most people, they're, they're, they're a pretty patient.
Starting point is 01:03:33 They're pretty patient. So thanks for your patients, patients. Oh, fuck. Do I have to do another etymology for this one? I do. I do. I can't not. Okay.
Starting point is 01:03:44 So I just looked this up and the root for both patients and patients is the Latin for suffering. So next time someone thanks you for your patients, they are saying literally, thank you for suffering for me, which is kind of endearingly emo. I like that. And being able to suffer evidently is a virtue. And what's your favorite thing about your job? My favorite thing about my job is the idea that sleep, everybody likes to talk about
Starting point is 01:04:09 sleep, you know, sleep. And it's one of those things. If I go to a party and introduce myself as a neurologist, you know, I got a grandmother's got Parkinson's or whatever, but if you talk about sleep, everybody's got a story to tell. It's sort of this universal thing. And I love to tease other doctors about, you know, I missed that article on Time Magazine that said mysteries of the spleen, you know, like in this poor guy's like devoted his life to understanding the spleen, but, you know, also, I mean, it was a National Geographic
Starting point is 01:04:36 we subscribed to. Just recently there was back to back issues on athletic performance, which is near and dear to what I do. And the next issue was sleep. I mean, people love it. It's fascinating. It's cool to talk about the brain's awesome. So, you know, if you're like the toe doctor or the spleen doctor, it's not fair.
Starting point is 01:04:53 I'm telling you, I get it. It is not fair that media does not pay as much attention to you and all the awesome things that you're doing. So to me, it's just the diversity of different things you can do with sleep or so much fun. I get to talk to people like you and hang out and talk to a baseball pitcher. It's like every day is different. So much fun. Well, I'm so excited you did this.
Starting point is 01:05:10 Thank you so, so much. It was my pleasure. Yeah. Anytime. So what have we learned? Ask smart people stupid questions because it just might change your whole life and your dreams. So once again, Dr. W. Chris Winters is at Sport Sleep Doc on Twitter.
Starting point is 01:05:25 W. Chris Winter on Instagram. He runs the Charlottesville Neurology and Sleep Medicine Clinic in Charlottesville, Virginia. And his book is called The Sleep Solution, Why Your Sleep is Broken and How to Fix It. So if you like his voice, he also reads his own audiobook. I have a copy of his book. I bought it legit style before even booking him. It's really funny, shockingly funny and down to earth and a really great read, but it's packed with tons of neuroscience and tips.
Starting point is 01:05:52 So it's really good. This is at oligies on Instagram and Twitter. I'm Ali Ward with 1L on both. I'm also on Did I Mention Invention every Saturday morning on the CW in case you want science content that's a little more polished, kid friendly, has zero F words or talk about butts. You can find oligiesmerch at oligiesmerch.com. Sales help support the making of the show and also helps you find other oligites in the wild.
Starting point is 01:06:20 Perhaps you'll spot someone in a shirt. Thank you, Shannon Feltas and Bonnie Dutch, who reached out to me after episode one to offer to help me make that a reality. Also thank you to the mystery person who sent me an envelope of cash in the mail to help support the show and signed it. Ken, damn it, I mean, Steve, I'm buying rechargeable batteries for the Zoom recorder like a sensible Uncle Wood. The oligies Facebook group is popping off full of kind, curious, funny people.
Starting point is 01:06:46 Thank you to my dear friends, Hannah Lippo and Aaron Talbert for helping run that. I love you both. Thank you to Nick Thorburn for writing and performing the theme song and of course to sleep deprivation poster child Stephen Ray Morris for editing these episodes all together. He also makes the podcasts The Percast about cats and see Jurassic Wright about dinosaurs. So seek him out for sure. As long as we're on the topic of other podcasts. This week I'm a guest on one called Wine and Crime.
Starting point is 01:07:13 Now these are hilarious ladies, Lucy, Kenyon and Amanda. They are oligites. They reached out. It was an honor to be on. I can't even see fake blood on TV without psychologically barfing. And they were kind enough to let me talk about science frauds instead of any stabbings. So if you want some heavy duty gossip about medical bamboozlery, some hardcore myth busting on the shadiest gastroenterologist the world has ever known, do take a listen to this week's
Starting point is 01:07:40 episode. They are great. If somehow you're like, what is this podcast? Here's a primer. Hey True Crime fans, have you listened to Wine and Crime yet? We're a True Crime comedy podcast hosted by three childhood friends who chug wine, chat True Crime and unleash our worst Minnesotan accents. Each week, us gals pick a True Crime topic and pair it with a delicious wine before delving
Starting point is 01:08:02 into the background in psychology behind the crime. Then we share and speculate wildly about a couple of bonkers cases related to the topic. Past episodes include necrophilia, cults, crimes of passion, cruise ship disappearances, narcissism's gone wrong, all this over a bottle of wine, or let's be real, three. Listen anywhere you get your podcasts, you can also follow us on Facebook, Twitter and Instagram at Wine and Crime Pod and check out our website and blog at wineandcrimepodcast.com. Cheers! Okay, at the end of the show on oligies, I tell you a secret and this week's secret
Starting point is 01:08:42 is that this morning I found three eye masks aka pinned socks behind my bed and my other secret is I had this epiphany the other day that when it comes to doing things we've never done or are too scared to do, being scared of doing them and not doing them is way more painful than doing them. Even if you get it a little bit wrong and it's not perfect, you can always do it again. So I started a page in my notebook. I made myself write down all the things that I'm afraid to do and I let them just kind of pour out of a pen, unjudged.
Starting point is 01:09:14 And I was surprised that among them were say no, go to sleep for real. I actually wrote that, so please see part one on sleep procrastination. And then another item was do more live science and comedy events. So I will let you know how I do with tackling those, particularly the last one. And if you have a few minutes and a piece of paper and a writing utensil, just make yourself write down what you're a little afraid to do because it might surprise you what you write down and maybe just give you a little gentle kick in the tush to do them because it's so much worse to hold back than it is to do to try and fail again.
Starting point is 01:09:50 So we might as well just do things as long as we're live, right? Okay. So that's my secret for you this week. I'll let you know how I'm doing on those. And meanwhile, kiss and sleep, get a little snooze in. Okay, bye-bye. Bye.

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