Ten Percent Happier with Dan Harris - 444: How to Sleep Better | Diane Macedo

Episode Date: May 2, 2022

Sleep may be the apex predator of healthy habits, so why are so many of us getting terrible sleep? Guest Diane Macedo launched a very detailed personal investigation in order to fix her sleeping habits and joins us for the first episode of a month-long “Mental Health Reboot” series we’re doing to mark Mental Health Awareness Month. Diane Macedo is the author of the new book The Sleep Fix: Practical, Proven, and Surprising Solutions for Insomnia, Snoring, Shift Work, and More. As an ABC News anchor and correspondent, she appears on Good Morning America, World News Tonight, and Nightline. She’s also the daytime anchor for ABC News Live. In this episode we talk about: Key signs that you’re not getting enough sleepDo sleeping pills really workWhen and how to find a sleep specialistHow to deal with performance anxiety around sleep The difference between sleep deprivation and insomniaMindfulness and sleepAnd the biggest sleep mythsFull Shownotes: https://www.tenpercent.com/podcast-episode/diane-macedo-444See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

This is the 10% happier podcast. I'm Dan Harris. Hey gang, if you're not sleeping well, it's harder to do anything you care about. It's harder to get healthier, to be more focused and productive, to be happier, to be more successful, to have good relationships. All of it. Sleep may be the apex predator of healthy habits. And yet so many of us are getting terrible sleep

because we don't prioritize it or because our work lives or our children make it seemingly impossible because maybe we're trying so hard to get more sleep that we are in our heads about it. Or because we've told ourselves a whole story about how we're just not people who sleep well and so we just live with it. Today, you're going to meet somebody who decided she was not going to live with it any longer and she launched an extremely detailed personal investigation

in order to fix it. And luckily for us, she is a journalist, so she documented the whole thing and gathered extremely useful, heavily vetted information and insights we can all use. Before we dive in, I should say that this is the first episode in a month-long series we're doing to mark mental health awareness month, May. The statistics are not pretty. Four in 10 adults reported symptoms of anxiety or depression during the pandemic that's up from one in 10 before.

And the pandemic has hit teenagers and young adults, especially hard, nearly one in three young people between 18 and 25 had a mental illness in 2020 and more than one in 14-age girls reported that they had seriously contemplated attempting suicide during the pandemic. That's twice the rate of teenage boys. So for the next four weeks,

we're going to do a series we're calling the Mental Health Reboot. This is the longest and most ambitious series we've ever done on the show. Here's how it will work. Every Monday, we'll bring you a brand new interview with a mental health memoirist. Somebody who's got a personal story

on everything from shame to grief to trauma to sleep. And then on Wednesdays, we're going to bring on a top notch scientist to help contextualize the story you've just heard and to provide some evidence-based advice. Our first guest is a long time colleague and friend of mine, Diane Miseido. She's the author of the new book, The Sleep Fix, Practical Proven and Surprising Solutions for Insomnia, Snoring, Shiftwork, and more. As an ABC News anchor and correspondent, she appears on Good Morning America, World News Tonight with David Muir and Nightline. She's also the daytime anchor for ABC News Live, the streaming service. In this conversation, we talked about key signs that you're not getting enough sleep, whether

sleeping pills work, when and how to find a sleep specialist, at home, sleep solutions, how to deal with performance anxiety around sleep turns out there's actually a name for that, orthorexia, the difference between sleep deprivation and insomnia, mindfulness and sleep, and the biggest sleep myths. Before we jump into today's show, many of us want to live healthier lives, but keep bumping our heads up against the same obstacles over and over again. But what if there was a different way to relate to this gap between what you want to do and what you actually do? What if you could find intrinsic motivation for habit change that will make you happier

instead of sending you into a shame spiral? Learn how to form healthy habits without kicking your own ass unnecessarily by taking our healthy habits course over on the 10% happier app. It's taught by the Stanford psychologist Kelly McGonical and the Great Meditation Teacher Alexis Santos to access the course. Just download the 10% happier app wherever you get your apps or by visiting 10%.com. All one word spelled out.

Okay, on with the show. Hey y'all, it's your girl, Kiki Palmer. I'm an actress, singer, and entrepreneur. On my new podcast, Baby This is Kiki Palmer. I'm asking friends, family, and experts the questions that are in my head. Like, it's only fans only bad. Where did memes come from? And where's Tom from MySpace?

Listen to Baby, this is Kiki Palmer on Amazon Music or wherever you get your podcast. Diane Miseido. Hello. Hi Dan. Welcome to the show. It's so interesting to have an ABC news person on here. Did you sleep well last night? I slept terribly last night, but that's because of my kids, not because I couldn't sleep. Somebody was actively conspiring against your sleep.

They haze me. It's like being in fraternity in my house every night. Yeah, I've been going through it about of Insomnihan, my end. So the timing of this discussion is good, I'm a maturity in my house every night. Yeah, I've been going through it about Evan Somnion, my end. So the timing of this discussion is good, but I do want to start with you. Can you just give me your backstory?

How did you get into trouble with sleep in the first place? It started when my hours changed. I'm a biological night owl, which I now understand, but at the time I didn't. And so when my hours switched and I started working early morning news hours, I started having a really hard time falling asleep and I started having a really hard time waking up.

And that's just sort of snowballed. And it ended up being this year's long struggle with sleep that at first I just sort of dismissed as, oh, well, that's just me, that's just how I'm built. I'm just a bad sleeper, et cetera. And then it got bad enough that I couldn't ignore it anymore. So I started seeking out articles about sleep and television segments about sleep and reading popular sleep books. Everything that I found, all the tips that I found, they didn't work. If anything, I felt like I was actually worse off after trying all this stuff. And then every now and

then I also came across things. It just seemed really unrealistic to me. For example, that I should quit my job and find a schedule that was more in line with my circadian rhythm. I just kind of thought, well, lots of people work overnight and work strange hours. Is every surgeon gonna only work between the hours of nine and five?

That doesn't make sense. So eventually I went to my doctor and she convinced me to start taking Ambien. And I was so hesitant to take a sleeping pill, but she convinced me to start taking Ambien. And I was so hesitant to take a sleeping pill, but she convinced me that it was fine, that it was, you know, harmless, and if anything just take it after a string of bad nights. And for a while, Ambien was like magic to me. I would take half of this tiny little pill, and in half an hour, I was out. No matter what was happening, no matter what time I was trying to go to bed, you know, Super Bowl party in the next room, I was out falling asleep on a plane, I was out, and

the more and more I read about sleep and how doomed I was if I didn't get enough of it, and if I didn't get the quote unquote recommended eight hours, the more I started relying on the ambient to sleep because I was so worried about what my sleep problems were doing to my body. And then one day the ambience just stopped working. I took it and I still couldn't fall asleep. And I waited about two weeks, you know, in hopes that it was sort of clear my system. And mind you at this point, I was only taking it twice a week.

So I waited two weeks, I tried again, and again, nothing happened. And when I called my doctor to ask her for advice, her advice to me was to take more ambience. And I just sort of decided right then and there that that was not going to be the way forward for me. And so first I got screened for sleep apnea and when that came back negative and it was evident that I didn't have sleep apnea, I then just sort of turned into a sleep nerd. I kind of put on my journalism hat and I started really digging in and instead of reading the best sellers, I started reading sleep textbooks and books written by clinicians who actually treat people with sleep problems. And that's where I found my answers. And when I started applying some of these techniques, it was probably about three and a half weeks

before I started seeing a complete turnaround. And when I got my sleep evaluated about three and a half weeks later, I was getting six and a half hours of quality sleep in the middle of the day because I was working the overnight shift at the time. And so it kind of blew my mind one because so much of the stuff that I was doing was actually really practical and simple, completely drug free. And so much of it was completely the opposite to what I thought I was supposed to be doing. And what I know so many other people out there think they're supposed to be doing. That was kind of the really early stages

of what became this mission that I'm now on. I started talking to more and more sleep experts and interviewing the people behind the research. And more and more, they said, you know, we've been trying to get this message out there, but for some reason, this isn't what makes it into the headlines when people talk about sleep and sleep problems and sleep solutions.

So I eventually ended up writing the book that I wish had existed when I was struggling. And my hope is that by writing this, that I can save other people from going through what I went through. I've been reading it on some sleepless nights and it's helpful to hear you describe accurately what I'm experiencing.

There were a number of questions that came up in my mind as I was listening to everything you just said. First had to do with Ambian. In a sleep-oriented episode we did on this show several years ago, a sleep researcher said the words to me that I've never gotten out of my head. The words were, there is a difference between sleep and sedation. So is Ambian not really sleep? It depends on who you ask.

And the reason why I didn't put this in the book is because of that. I wanted the science in the book to be impeachable, and I got a few different answers. But I think there is sort of a general consensus that the quality of sleep that you get on a drug like Ambien is not the same as you would get just sleeping regularly. So bottom line, it might make sense in some circumstances to take a ambion, but you should know it's likely not the quality sleep you'd be getting if you were sleeping drug-free. And it's not addressing the problem. So I equate sleeping pills to like crutches if you have a broken leg.

You might need them for a short time, and there are certain sleep specialists that depending on your specific case, they may include sleeping pills as part of your long-term treatment, but they're generally used as a bridge to a long-term solution, not as the solution. And so I equate it to, you know, if you had a broken leg and the doctor just prescribed you crutches, and that's it. Now you're just supposed to walk around on crutches all day, you'd say, well, okay, fine for now, but shouldn't we actually fix my leg? And I think the same is true when it comes to sleeping pills. And unfortunately, a lot of primary care physicians, any of them really

that aren't trained in sleep, are not well-educated when it comes to sleep. The last survey, the average, for your med school, spent two hours on sleep education. And most of that anecdotally is spent on sleep apnea, which is a sort of a very straightforward, breathing condition, it has a very straightforward set of treatment options. And so when you talk about something like insomnia, for example, or any other condition that you would actually take a sleeping pill for,

your primary care physician is not the best person to decide what the best course of treatment is for a sleep problem. And so that's why in the book I say, if you are taking any substance on a regular basis for the purpose of helping your sleep, it should really be under the guidance of a sleep specialist because sleeping pills aren't necessarily the enemy,

but they should be used in a thoughtful and strategic way and not painted as a solution to the problem because they can make some sleep problems worse. They can be dangerous in certain aspects and despite the claims they can be habit forming. And I am actually helping a friend right now who reached out to me after reading the book and confessed that for decades now,

she's been addicted to Ambien. And in her words, it has ruined her life. And she's now trying desperately to get off. And when I reached out to the sleep experts that I've now become in contact with, the sad truth was they said they see cases like this all the time. So I'm very wary when it comes to sleeping pills. I think they need to be used thoughtfully strategically and under the care of a sleep

specialist. I appreciate that. You mentioned sleep apnea and that you got screened for it. Can you give us a little bit more information on what exactly sleep apnea is and whether we should all get screened for it. So yes, sleep apnea is a disorder that causes you to stop breathing in your sleep. Sometimes up to 100 times an hour. I think it should be called sleep suffocation

because that's essentially what's happening. And if you had someone smothering you in your sleep 100 times an hour, you would probably make it a top priority to solve that problem. But one of the big problems with sleep apnea is most people who have it don't notice that it's happening. If you've ever heard somebody snore and then they sort of stop

and you hear this period of silence and then all of a sudden they sort of gasp or choke a little and kind of start snoring again, that's sort of the most apparent way of hearing that somebody has sleep apnea but it can occur in people who don't snore. And there's a misconception that sleep apnea is something that only affects older overweight men.

And it's absolutely not true. Sleep apnea can affect children, it can affect women, it can affect thin people. It is more prevalent. As you're older, it is more prevalent if you're overweight and it is more prevalent in males and females. But there are lots of children, women, thin people walking around with sleep apnea who maybe have even gone to their doctor and complained about other symptoms and not been sent for a sleep study because of that misconception.

As for who should get screened, when it comes to obstructive sleep apnea, which is the most common form, there are certain risk factors to keep an eye out for. Snoring is a big telltale sign, especially if you snore loudly. I think anybody who snores loudly and is constantly getting hit in the ribs by their partner, 100% get screened for sleep apnea, but also just generally, this goes for any sleep disorder. Even if you think you sleep fine, if you walk around all day feeling like you need a nap, or if you're that kind of person who will doze off in a waiting room, or if you think if you turned on

the TV and you have a tendency to doze off, that's a sign that you're not getting enough sleep. And so if you feel like, well, I don't know, I go to bed at a normal time and I sleep through the night, I wake up in the morning, I feel fine. If you can't think of why you're not getting enough sleep, then that's a sign that something is disrupting your sleep without you realizing it.

And I nickname those secret sleep disorders and sleep apnea is just one of them. But the point is if you have that feeling of sleepiness, then that's a sign something's wrong. And I think that's a good signal that it's time to get checked for sleep apnea or any other sleep disorder that may be disrupting you while you're sleeping or something like hypersomnia, which is making you feel sleepy when you shouldn't be. So how do we get checked? You mentioned a sleep study where you go sleep in a lab

overnight and they measure you. Is that the screening? So I'm so glad that you asked this because yes and no. There are full-blown sleep studies, which are great if you can find them, if you can afford them, if your insurance covers it, if your doctor recommends one, by all means. And you'll need to go for that kind of a study where you are in a lab overnight for things like periodically movement disorder, narcolepsy. There are lots of sleep disorders that can really only be detected with that kind of a sleep study.

But sleep apnea, you can actually get tested for at home. And so if you have the warning signs that I described in terms of that sleepiness, but you will also check some other boxes for sleep apnea, especially if it's not easy for you to get into one of those overnight sleep studies, just get a home sleep study. There are sleep specialists who can send you

these tests in the mail. You just wear something on your finger or some of them include a nose cannula, and it will send the data directly to the sleep specialist. You never have to leave home. And it's just so simple now to get tested, which is why I want people to realize one that you don't have to spend the night in a lab to get tested for sleep apnea. And two, there are a lot of people who I think avoid getting diagnosed for sleep apnea, even if they suspect they have it because they don't want to sleep with that CPAP machine on

their face. And I don't think a lot of people realize that there are other options for treating sleep apnea. CPAPs are the gold standard, but the sleepy auntie who I interviewed for the book and who actually helped in my own treatment, he said, you know, the CPAP is not going to do my patient any good if I know my patient's not going to wear it. And 50% of diagnosed patients with sleep apnea who have a CPAP machine don't use it. And so there are lots of sleep apnea patients, including my father who called their CPAP

a godsend, and they may hate the thing. And then suddenly they wear it and they realize how good they feel the next day and they're committed to it. But if you're one of those people who is either not getting diagnosed because you don't want to wear the CPAP or you have one and you're not using it, he should talk to your doctor about other options, including a mouth guard that's specifically meant to push the jaw forward. It's an FDA-approved treatment. And for some people, maybe much more comfortable and a much more doable solution.

Say more about this allegedly diabolical CPAP machine. Well, why do people not like it? The easiest way I can describe it is, imagine a garden hose that instead of spitting out water, it spits out air. And now you have to put that on your face. And what a lot of people might not realize is you can have more than one sleep disorder and sleep apnea and insomnia

often coexist. And there have been studies that show that people who have sleep apnea and insomnia have a particularly hard time wearing a CPAP because your senses are so heightened when you're suffering from insomnia that almost any little thing can disturb your sleep when you're in that state. And so trying to wear anything on your face, let alone a machine that's, you know, pushing air into the airway can be really difficult and really disturbing. That said, sleep masks have lots of different masks. They all have different fits. So I also encourage anybody who has one and hates their CPAP, go back to your doctor, ask about getting a different mask. It usually takes a little bit of trial and error in the beginning,

but generally people who stick with it say once they find the right mask, the machine is an absolute godsend. And you look at someone like my dad, for example, who first did not like sleeping with the CPAP. He now says that he has a hard time sleeping without it, and not just meaning sleeping without it because he'll have, you know, apnea episodes, but just even falling asleep without it because he's gotten so used to it. Having said earlier that many doctors only get two hours of training in med school on sleep, should we be trusting our primary care physician at all, and this should we be instead if we're suffering from any sort of sleep disorder,

just go right to a sleep specialist, and if so, how do we find one? When I said doctor in that context, I mean your sleep doctor. If you have a CPAP and you're getting treated for sleep apnea, that should be under the care of a sleep specialist. And a good primary care physician should be referring you

to a sleep specialist more often than they currently do. In terms of finding them, there are organizations and I specify these in the book. For example, behavioralsleep.org is the site for the behavioral sleep medicine organization. And so if your problem is insomnia and that's the kind of problem that you suspect you have where you have trouble falling asleep or staying asleep at night, you wake up, you have that racing mind, you want to behavioral sleep specialist. And that organization will be able to show you accredited behavioral sleep specialists. Sleep apnea, because it's so straightforward, it's actually much easier to find providers

who treat sleep apnea. And because it's sort of such a straightforward physical condition, it should be a pretty straightforward treatment as well. The only part and why I write about this in the book is I want people to know that they have the option to ask for other treatments. In case you get someone that's sort of just doing the paint my numbers thing and saying, oh, you have sleep apnea, you get a CPAP, I want people to know that other options that they can ask about if the CPAP's not working for them.

So the order of operations here if I'm understanding you correctly appears to be if you're having trouble sleeping and you're worried about it, first stop, talk to your primary care physician. And maybe the first thing to do is to rule out sleep apnea as you did, but if that's ruled out and you're still having trouble sleeping, you need to go find a sleep expert and be treated by that person. Do I have that right? Yes, and the hard part to that is there's a huge lack

of behavioral sleep specialists, especially, so people who treat conditions like insomnia. And so that's where things get complicated and that's part of the reason why the sleep fix and lots of other books by clinicians exist to try to help people in the areas where you can do this at home, because there are lots of solutions that can be done at home. And so I think step one for most people is, A, yes, you go to your doctor and you wanna rule out that there's any other

underlying condition that's causing your sleep issues, right? If you can't sleep because you have chronic pain in your leg, then you're gonna wanna get that checked out. If you can't sleep because you have horrible acid reflux, there may be something else going on and you wanna get that checked out and so on. Often times a lot of these conditions can coexist with the sleep disorders themselves. So if you feel like your doctor is not giving you the answers

that are providing a solution for you, then push harder. And so one of the reasons why I start the book where I do in identifying the problem is I think step one has to be in trying to identify what it is that's keeping you awake, because there are lots of different things that can interfere with your sleep, and each one of them is going to require a different set of solutions.

And so I wanted to arm people with a basic knowledge of here are some of the common issues that affect a lot of people. So that if you read through those, you might hit a light bulb moment where you say, oh, that sounds like me. And now you at least know the sphere that you're in, of what options to explore, of whether you do need professional help to get a solution for that, and what to ask that professional about.

Because unfortunately, since this isn't something that's widely covered in medical school, it's really only sleep specialists, and the right sleep specialists, because the other unfortunate part is if you get a sleep specialist who's well trained in sleep apnea, they may not know very much about insomnia. Coming up, we're going to hear more about how Diane ultimately overcame her multiple sleep problems, and the evidence behind something called a worry list after this. Raising kids can be one of the greatest rewards of a parent's life. But come on, someday, parenting is unbearable. I love my kid, but is a new parenting podcast from Wondry that shares a refreshingly honest

and insightful take on parenting. Hosted by myself, Megan Galey, Chris Garcia, and Kurt Brown-Oller, we will be your resident not-so- so expert experts. Each week we'll share a parenting story that'll have you laughing, nodding and thinking. Oh yeah, I have absolutely been there. We'll talk about what went right and wrong. What would we do differently? And the next time you step on yet another stray Lego in the middle of the night, you'll

feel less alone. So if you like to laugh with us as we talk about the hardest job in the world, listen to, I love my kid, but wherever you get your podcasts. You can listen ad free on the Amazon Music or Wondery app. I do want to get back to your story. After you ruled out Sleep apnea, what happened next? How did you actually land this plane? How did you solve the issue? For me, for example, I was working an overnight shift at the time.

So I knew that my circadian rhythm, my body clock, had to be part of the mix of my sleep problems, right? I was trying to sleep during the day and I was trying to be awake at night and you don't have to be a sleep expert to know that our bodies are not wired that way. And so I knew that that was at least part of my problem and so that was going to have to be at least part of my solution.

And so when I started reading about all these different sleep techniques, I decided to start with a focus on that. And when it comes to circadian rhythm, you know, your body clock, the thing that makes you feel jet lagged when you travel because your body still wants to sleep on your old time. If you are either a shift worker or if you're a night owl just working normal hours or if you're an extreme early person trying to work an evening shift or just trying to stay awake with your kids at dinner, you can be essentially jet lagged every single day. But we do eventually adjust to jet lag

when we travel. Why? Because of when we see light, when we see dark, when we eat, when we sleep, when we exercise, and when we wake up. And so I dug into research that looked in there and tried to figure out how do we apply those same tools, but at home in your everyday life. And it turns out that in a very similar fashion, light is the most powerful tool for your circadian rhythm.

And so for me, I couldn't quit my job like everyone was telling me to and just find a schedule that was closer in line with my circadian rhythm. And so for me, I couldn't quit my job like everyone was telling me to, and just find a schedule that was closer in line with my circadian rhythm. So the next best thing is to trick your body into thinking. You change your schedule to something more inline with your circadian rhythm. And the common advice to do that is to get bright sunshine in the morning, which of course I couldn't do because I worked an overnight shift. And I still can't do because I have other things that I have to do in my mornings other than sunbathe.

But there's a really easy work around, which is I have a therapy light in my bathroom. And it mimics sunlight. And so while I'm getting ready in the morning, brushing my teeth, washing my face, doing my hair, if you're shaving, whatever it is, you just have this light on. And by hitting your eyes at that first sight of your wake up, it's communicating to your brain that this is morning, this is time to wake up. And that helps you to start getting wake signals

at the right time. Now your body starts to want to wake up at that time every day. And because it's setting your body clock, it also then helps you to start getting sleep signals at the right time when you want to feel sleepy. So this is a great, great solution, not only for shift workers,

but also for anybody who feels like they struggle to fall asleep at night because they feel like they're still too awake. And for anyone who then struggles to wake up in the morning because they're trying to wake up when their body's still sending them sleep signals, super easy, super practical, and it's so incredibly powerful to help to set that body clock if that is in fact your problem. That was one great tool and then I used food timing and a few other tricks to help on that front. But the biggest eye opener for me, the more I started reading about sleep and about insomnia, was that there was another element to my problem and it was anxiety, which surprised me because

I'm not generally an anxious person. And so, if you ask friends, family, whoever, they will, I think, almost surely relate to you that I'm the kind of person who's very calm under pressure, that I'm not a big warrior, I don't generally see what the small stuff. And yet, here I am reading this description of what is essentially an anxiety problem and I'm thinking, check, check, check, check, that's me.

And so what often happens is when we have trouble sleeping. So in my case, it was due to a circadian rhythm issue because I was trying to sleep at a time when my body wanted to be awake. When we try to force sleep when our body isn't ready for it and we spend a lot of time laying in bed, awake and frustrated, our brain has this mental autopilot feature that recognizes patterns in our behavior

and starts to prepare for what's next. So if you were to walk into your favorite restaurant that you go to all the time, you might start to salivate before the food even hits the table, maybe even before you see the menu, because your brain says, oh, I know this place. This is the place where we're going to have a great meal. And it starts to prepare for what's coming next so that it can then divert its attention to other new things that it needs to focus on. That same mental autopilot feature kicks in when we spend too much time awake and frustrated in bed. Your brain starts to recognize bed as a place for wakefulness and frustration. And instead of bed becoming this safe space where you can calm down

and unwind and peacefully go to sleep, bed becomes this place where, oh, I know where we are, we're in that place where we have to be alert. And that's something called condition to rouse-o. And you'll recognize this if you are one of those people who is on the couch, you're dosing off, your eyelids feel heavy, your head feels droopy and you think, okay, I'm really sleepy,

I'm going right to bed. And the second your head hits the pillow, you suddenly feel wide awake and your brain is going a mile a minute and you start thinking about, you know, some pointless, horrible conversation you had five years ago or something you have to do tomorrow or whatever it is. That is the calling card of condition to rouse-ul. And I think the key and the reason why so many insomnia tips out there fail is they don't address this.

And you can address lots of different things in your sleep problems. But if you have conditioned arousal and you don't address that, you are still going to have a sleep problem at the end of the day. So your problems appear to have started with circadian rhythm disorder and then insomnia, more specifically, a conditioned arousal kicked in because you were freaking out about being unable to sleep. And that became this toxic cocktail that was operating for you. Do I have that right? Yes.

And I hate using the terms disorder even though they are, right? Circadian rhythm disorder is the absolute correct term. Insomnia disorder is the correct term for what I had, because I had chronic insomnia. But I think when people hear the words disorder, even sleep apnea disorder, they think, well, I don't have a disorder, because I get up every morning, I go to work, I still function, you know, and so we think people with disorders

can't complete their daily functions of the day, and most of us with sleep disorders do. And so I just want to caution people from hearing that word and thinking, well, that doesn't apply to me, because for a long time, I functioned, quote unquote, completely well and still had three different sleep disorders because I also discovered in the process of writing

the book that I also have Ressa's leg syndrome, which is much more common than people think. So, yeah, so what started for me as just, you know, my work schedule and my body clock were on two completely different time zones. And so that made it really hard for me to fall asleep early because my body still wanted to be awake. All of the effort I put into then trying to force myself to fall asleep at a decent

hour so I could wake up for my crazy early morning shift and eventually my overnight shift, all that time and effort that I spent trying to force sleep when I wasn't ready then gave me insomnia as well. And so then I had two problems that I had to deal with. And then a third, which is restless legs syndrome, which I want to talk about because I think I might have that too. But let's go back to condition to rousal. You said if that doesn't get solved, all the other hacks for insomnia aren't going to do much because your mind is going to be working against you. So how did you solve that? So it's a two pronged approach. One, then the hard part is you need to lower the arousal

that's fueling that. And so I like to describe it like a sleep seesaw. Imagine on one side you have your sleep drive. Sleep drive is super straight forward. It's like hunger. The longer you're awake, the more your sleep drive powers up. It's like a gas tank building up throughout the course of the day. The more sleep pressure builds up, the chemical adenosine builds up in your brain and that makes you sleepy. And then as you sleep, that adenosine dissipates and takes the sleepiness away. On the other side of your sleep seesaw is your wake drive. And that is powered not only by your circadian rhythm, so there are certain times of the

day where you'll feel more or less energetic regardless of whether or not you slept. That's just your body clock doing its things. Any awake signals at certain times, sleep signals at certain times. But your wake drive is also powered by things like stress, anxiety, excitement even. And when you try to go to sleep and you are too stressed or excited or anxious about something, including being worried about the fact that you might not sleep, that powers up your wake drive. And even if your sleep drive is pretty high, it can power up your wake drive enough that now we're overpowers your sleep drive and it tips your sleep seesaw back into a wake

territory. Now what we often do to respond to this, and I was guilty of all of this, is because we think about how doomed we are due to the lack of sleep because we had a bad night, we then try to make up for that, by sleeping in, by napping, or by going to bed earlier the next night. But all that means is now you're depleting

your sleep drive once again. So come bedtime, you're not that sleepy, your sleep drive is not that high. And you need it to be extra high to overpower that wake drive, that stress and the anxiety and everything else that's sort of powering up your wake drive. So what we often do, we put ourselves at an even more disadvantage because now not only are we still sort of stressed about the fact that we're not going to sleep and that's powering up our wake drive, but now because we took that nap or we're trying to go to bed too early,

we're just not that sleepy. And so we have to reverse that whole course. One, we have to lower the arousal that's powering up our wake drive, that's the hard part, and we have to power up our sleep drive. And so, I'll start with the easy part. Powering up sleep drive, very straightforward.

Doesn't sound very fun, but it's counterintuitive to a lot of the stuff that you've heard. Instead of trying to sleep in nap or go to bed early, you do the opposite. I like to call this the reverse curfew. You actually give yourself a time. Usually, some time a little bit later than you would normally go to bed, and you say, I cannot go to bed before X time. What this does is, one, there's a Jedi mind trick in there where now, because instead of forcing yourself to try to go to sleep, you're challenging yourself to stay awake,

it helps to alleviate some of the performance anxiety that often fuels insomnia. But also by setting these limits for yourself and making sure that even if you had a bad night, you're still going to go to bed at X time and not before that, and you're still going to wake up at your normal wake up time and not sleep in. You're now ensuring that even today's bad night is going to mean tomorrow your sleep drive is even higher. And that's going to make it easier for you to fall asleep tomorrow night. And if it doesn't work tomorrow night, that will continue to build until eventually you

get to bed and your head hits the pillow and you fall asleep fairly quickly. And once that starts to reverse, now you get more confident in your ability to sleep. And sleep is a weird thing because sleep confidence, just simply your confidence in your ability to sleep once you get to bed, actually makes it so. The more confident you feel in your ability to sleep, the more likely you are that you're going to just go to bed and hit the pillow. And so it helps on a physical level, but it also helps on a psychological level. And then the other part of it is to try to lower that arousal, all those spinning thoughts,

all that anxiety that's building up around bedtime, you want to find something that will help you lower it. And this may be different for different people, but the technique that I loved and that a lot of the clinicians that I spoke to also love is something called constructive worry. I call this a brain dump or a worry list. And it's so simple and I know it sounds kind of dumb, but you just, you take a notebook, you divide a page down the center.

On the left-hand side, you write down anything that's on your mind. The kind of stuff that will be swirling around in your head when you're trying to go to sleep and you can't. And then on the right-hand side of the page, you write down the very next step to resolving that issue. You don't need to know the ultimate solution, just what you can do to move that issue along in the right hand side of the page, you're right down the very next step to resolving that issue. You don't need to know the ultimate solution, just what you can do to move that issue along in the right direction.

It might even be as simple as call a friend who knows more about that issue than you do. Or to fit something that's out of your hands and hypothetical, then you have to accept and move on, write that down to. And when you can't think of anything else that's on your mind, you're done. Now, when I first read about this, I thought, well, ambient doesn't put me to sleep anymore, but this notebook thing is going to, but it really helped me, and here's why. When we let our minds do this kind of processing,

our thoughts and feelings from the day before bed, we alleviate the need to do it in bed. Because so many of us are go, go, go, go, go all day long, we don't really have that moment of stillness to think about, oh, I really don't love the way that conversation went. Maybe I'll talk to someone so about it tomorrow. And so really the only opportunity our brain has to do that because we haven't given it a chance to is when our head hits the pillow.

And by that point, we're exhausted. It's the end of the day. And our brain doesn't have the capacity to handle that in a good, nice, measured, rational fashion. Instead, you go immediately to the most catastrophic possible result imaginable. So by giving our brains the opportunity to do this in this moment, we alleviate the need to do it when our head hits the pillow. The other part is that mental autopilot feature, that same thing that's keeping our insomnia going. Now that starts

to kick in. And it says, oh, this is where we think and worry about things, not when my head hits the pillow. And you start to form a new association and you start to divorce that old association, that that's what we do in bed. We often also get repetitive thoughts when we're laying in bed in that insomnia loop. And part of that is just because your brain is trying to remind you to deal with these issues. So by writing everything down, you will leave you the need for that reminder. And then finally, the exercise itself gets you more focused on solutions, rather than ruminating on problems, which we so frequently do when we're struggling again in that insomnia cycle.

And so it can actually not only help with sleep, but even just general kind of well-being, because your mind starts to think, oh, okay, let's think about how to solve this problem. Instead of just, I have this problem, I have this problem, it's so terrible, I have this problem. And so, the best part about this thing, and what kind of blew my mind, is that I had to do it for two weeks, and then I didn't have to do it anymore, because my brain just started doing it automatically. And once I started writing the book and asked clinicians about this, they said, yeah, we generally

tell our patients, you're going to probably have to do this for two to three weeks. And then you don't really have to because your brain starts to do it automatically. And so for me, it felt like my brain got the memo. Head on pillow means it's time to sleep, not that it's time to think and worry about the day. And so I do keep the notebook in my nightstand and if I have a particularly stressful day

where I feel wrapped up at night or if I, for whatever reason, wake up in the middle of the night. And I feel like, you know, my thoughts are going a mile a minute and I can't go to sleep. I'll get out of bed. I'll jot down my list. And that normally does the trick to just sort of take the temperature down on all of that racing mind-feeling. And I'm able to drift off a few minutes later.

So I'm here in two main tactics for dealing with your hydra-headed sleep problems. One of the heads was this circadian rhythm disorder. We've already talked about that with the power of light. The second head that we're on now is insomnia and condition to rousal. So one of the powerful techniques you use was what you called a brain dump, writing down your problems and the immediate next step toward solution. And then the other was this reverse curfew. And I just want to hear a little bit more about the reverse curfew, which if I'm getting

this right, you basically say, I am not going to go to bed until X time say it's midnight. And I also have the same wake up time every day. So whatever it is, 6, 7. And if you can't sleep, if it doesn't work, you're not gonna break out of that sleep window, you're not gonna sleep in, and you're not gonna take a nap, and you're not gonna go to bed earlier the next night,

you're just gonna keep powering through until you're so tired that on the third night or whatever it is, you get into the bedroom and you crash because the body just takes you there Do I have all that right? Yeah, you do and reverse curfew is just sort of my simplified nickname for a few different Methods in what's called cognitive behavioral therapy for insomnia, which is the gold standard treatment for insomnia And so that's just sort of a simplified method of something called stimulus control, which is a set of rules. Essentially, you use your bed only for sleep

that you, after a certain period of time, I like to just say, if you're in bed long enough to feel frustrated, you get out of bed, you do something enjoyable, relaxing, and you come back later when you feel sleepy, and that you sort of stick to that allotted bedtime, and that you wake up consistently every morning. There are other versions of that

called sleep restriction and sleep compression. And so with sleep restriction, you look at how much you think you sleep in a night. So let's say you go to bed every night at 11, but you feel like you only actually fall asleep at 1 a.m. and your wake up time is 7 a.m. or whatever it is. Your bedtime is now 1 a.m. and if after doing that for let's say a week, you're still having trouble sleeping, now your wake time shrinks even more. And so that sleep window is going to increase and decrease depending

on what kind of results you're seeing. And what's called sleep restriction, you sort of cut it down to the minimum, and once you start seeing results, you start to expand that window a little bit more and more. The method that I prefer because it's a bit more idiot proof for lack of a better term is something called sleep compression, which even in all of my reading that I had done when I started writing the book,

I had never heard of sleep compression until I actually read about it in a behavioral medicine sleep textbook. And sleep compression is just doing it the other way around. Instead of saying, okay, I'm going to cut everything down to the bare minimum of, say, six hours, and then expand from there, sleep compression, you do the opposite. You start off from what feels like a comfortable amount of a sleep window. And then if you're still having trouble sleeping, you cut back a little bit more.

Let's say 15 minutes a week, and you cut back a little having trouble sleeping, you cut back a little bit more. Let's say 15 minutes a week. And you cut back a little bit more. And you cut back a little bit more. And you keep doing this until you feel like you finally hit a point when you're sleeping efficiently. Meaning you go to bed, you fall asleep in a reasonable amount of time. You're not waking up a ton of times throughout the night and you wake up in the morning and you feel refreshed.

So you keep sort of cutting it down and down and down until you think you hit that sweet spot. And if you cut maybe a little bit too far and you feel like, okay, now I'm sleeping efficiently, but now I'm still sleepy, I don't feel like I'm getting enough sleep. Now you slowly expand the window until you think you're getting enough sleep, but still sleeping efficiently. So you can do it a few different ways, but the idea is the same. You want to cut out the amount of time you were spending a wake in bed. And so I kind of think whatever way feels like it works for you to do that, that's really the goal here. Because a lot of people I think think of insomnia and sleep deprivation as being the same thing. And they're really not. Sleep deprivation is about a lack of sleep, whereas insomnia is about sleeping

inefficiently. You are spending much more time in bed compared to the amount of time you're actually sleeping. And we want to get those numbers closer together. And so when it comes to things like the reverse curfew and the techniques that all revolve around it, the name of the game is just to reduce the amount of time you're spending awake in bed, which means maybe going to bed later, maybe waking up earlier and making sure that if at any point

you are frustrated and awake in bed, get out of bed, do something enjoyable and relaxing and go back to bed when you feel sleepy. Not only so you can increase your sleep drive and help make your sleep more efficient, but also so you can divorce that association that bed is where we stay awake and worry about things, and renew the association that bed is where we sleep. So I need to do this. And my question is, do I need an expert? Do I need an expert in CBTI cognitive behavioral therapy for insomnia? Is that expert different from a sleep doctor? Where do I start with all of this?

So for this, you will want a provider who is trained in CBTI, cognitive behavioral therapy for insomnia. And that's the ideal way to do it. It's like training with a physical trainer who can actually tell you exactly what to do at exactly what times. If you're seeing a specialist for this, they will be able to tell you exactly

what time you should go to bed on this day. And then based on your results from that week, they will tell you exactly what time to go to bed and wake up the following day. The problem is not everybody's going to have that option. And there is data to show that self-help CBTI methods are also very effective. So there are apps that can help you do this.

Some are more expensive, some are not. The more expensive ones are more robust. But you can also use a book. And mine is only one of many. I'm not saying you have to go out and buy my book, but my book does detail. And I wrote that guide with the help of two different behavioral sleep specialists. And it will take you through exactly how to do this step by step. And exactly what to take into consideration. So you can try to tailor it to your needs, you know, if you

have trouble falling asleep at night, then maybe you want to start by making your bedtime later. If you wake up prematurely in the morning, then maybe you want to start by making your bedtime later. If you wake up prematurely in the morning, then maybe you want to start by making your bedtime earlier. So you're kind of working with what your body already wants to do, and then you expand from there, sort of meeting you where you are. And so it depends on the options available to you, I think. Ideally, yes, go to behavioralsleep.org, track down a behavioral sleep specialist from that site or any sleep center or sleep clinic you can find, ask them if they're experienced treating insomnia, ask them if they're trained in CBTI, and go from there. If not, explore apps, explore books,

and other self-help measures because they can be effective if you stick with it, and if you feel like you have the discipline to do it at home, you can also do it at home. I did it at home. You did it at home. Sort of accidentally, but yes, I did it myself. When I was sort of on this journey, we had decided since I was the anchor for the overnight news show, and obviously a lot of our viewers also suffer from sleep problems, that we would document my journey for the show. And so the original intention was I was going to get screened

for sleep apnea and anything else the doctor wanted to do. I basically just went in and said, put me through sleep boot camp, whatever you want to do I will do. And we will show, you know, sort of how the process works. And so he sent me home with an ad home sleep apnea test and another test that is supposed to analyze your sleep architecture.

And that very day, good morning America, asked me to come on and do stand-by anchor duty, which meant now I had to go back into work at 11.30 in the morning, which for me was smack in the middle of the night. And anytime this happened to me, it completely threw me off, because it was really difficult for me to get my body on a day-time sleep schedule. And so anytime I differed from that, it felt like for me at least it took me weeks to get back to the measly three or four hours I was getting anyway. And so since this happened just as I was doing these tests, the sleep apnea test came back negative, but the other test was basically inconclusive, because I wasn't getting enough consolidated sleep

to even register on the sleep cycle analysis. So under normal circumstances, Dr. Wright then and there would have sent me to a CBTI specialist. But because we were documenting this, I wanted to show the full process. And so he said, you know what, just wait, get yourself back to your normal four hours or whatever it is that you normally get. And then we'll do that test again. We'll show the result of that test.

And then we'll recommend you for CBTI. And in the process of trying to get myself back to that three or four hours of sleep, so I could then to the test and continue on, I started reading about all these CBTI techniques and just trying them. And my goal was just get back to those, my normal four hours of sleep, so I can move on and finish shooting the story

and side note fix my problems. And what ended up happening was I actually fixed the problems. And so when he three weeks later went back and did the test on me, I was getting six and a half hours of high quality sleep. And he basically was like, congratulations. You fixed your insomnia. So when I set out on this, I was not intending on doing it by myself. This was not meant to be a DIY mission, but that's what it ended up turning into. Well, it's heartening to hear though,

because while it'd be nice if we could work directly with an expert in CBTI, but it is also possible to use a book like yours to do it at home. So I find that story empowering. Yeah, and I do want to clarify. It's not like reading one guide out of my book is not going to be the equivalent of getting actual cognitive behavioral therapy because there are other elements to it,

but some of the main techniques, for example, sleep restriction, sleep compression, that you can do on your own. And in your case, it may be enough. In other cases, you may need other elements of CBTI that can only be done by a professional therapist. that can only be done by a professional therapist. After the break, Diane weighs in on reading in bed, mindfulness and sleep, and the top sleep myths. That's right after this. Let me ask a few other questions about this moment that I think will sound familiar to many people

of getting in bed and just thrashing around. What's the conventional wisdom about reading in bed? Because I do a lot of that and my wife says I'm a dummy for doing that. Is she right? No, and there's some debate in the sleep medicine community about this because some feel very strict nothing in bed other than sleep. After talking to a lot of different clinicians about this and based on my own experience

and now my understanding of the mechanics of it all, I'm more of the mindset as are many of the doctors that I spoke to that it's really about not wanting to be anxious in bed. So if reading in bed makes you feel relaxed and you feel like that helps you to unwind and isn't something that's revving you up in any way, then I think that's a good thing.

And if it helps you to sort of take the temperature down and it helps you to unwind and it helps you to get your mind off of your worries about sleep, then absolutely do it. I think anything that actually helps your sleep is a go for me. It's just more if you are laying in bed scrolling through Instagram, let's say, or whatever your vice may be, and you're doing something that sort of sucks you down that rabbit hole

where now you lose track of time, you don't even tell when you're sleepy. And the next thing you know, it's two hours past your bedtime. You only realize that that moment you have to go to the bathroom because you've been ignoring all of your bodily signs. That's what you want to avoid. That thing where you completely lose track of time and get totally sucked in. But if you're enjoying reading a book, or listening to a podcast, or listening to an audiobook, or whatever it is, that helps you to relax at night, and you feel like that actually helps you also to recognize your sleepy cues, and go to bed when you feel sleepy. I'm all for it. And meditations, a big one too.

I was just going to ask you about that. What do the data show about the relationship between sleep and meditation? I'll just say, listeners may have heard me say this before. I always find it interesting that, for example, on the 10% happier app, sleep is among the most popular, if not the most popular, section of the app. And yet, you know, the word Buddha means awake. This technology was not designed to help you sleep. So what are the data show?

So I think the most interesting point I found about this came from Dr. Jason Ng, who's one of the leading experts on mindfulness and sleep. And his advice is, I'm a huge advocate of meditation and mindfulness for sleep, but my patients are always surprised that I tell them they're not gonna meditate at night. I want them to meditate during the day.

And the logic behind that makes sense when you explain it. And the way that I explain it is, if you were learning to play the piano, you wouldn't do it for the very first time, blindfolded in front of a stadium full of people, right? You would do it at a time that felt pretty relaxed where you could mess up and feel okay about it and eventually you build up to when you're ready to play in front of an audience. What we often do when we have sleep problems is because we have this

arousal going on where you lay down in bed and you feel like your thoughts are going a mile a minute, We hear about meditation. This is what happened to me, right? So I heard about meditation and heard that meditation helps to quiet the mind. And to me, I just thought, well, oh, yeah, boom, that's what I need. So I'm going to download a meditation app and I'm going to turn it on and I'm going to get in bed and I'm going to follow what the narrator says. And I'm going to be like, neo, and I'm going to stop my thoughts like slow motion bullets

and I'm going to go Neo, and I'm gonna stop my thoughts like slow motion bullets, and I'm gonna go to bed, no problem. Always, always very temperate expectations on my end. And then, of course, what ends up happening is the narrator's telling me to focus on the breath, and that works for about five seconds. And then all of a sudden, I start thinking about how my calf is itchy, or I start thinking about how I forgot

to buy those sneakers I really wanted to get. And for me, every time my mind started to wander in all these different directions, I would then kind of reprimand myself because I felt like I wasn't doing a good job at meditating. And because I was not doing a good job at meditating, that meant I was also not going to sleep, because the meditation was going to make me sleep. And we just set ourselves up for failure when we do this. And you actually helped shed light on this for me when you told me that that's not really the point of meditation.

And it was then listening to your podcast that explained every time you get distracted and you notice that you're distracted, that's a win. Because the whole point of meditation is to get distracted over and over again, and notice that distraction. And listening to both your advice to me in person, and then to your guidance on 10% happier, that helped me to realize, oh, okay, so this is normal. I'm supposed to get distracted. That's all part of the game.

And so I think there's a few lessons to be learned here. One is just that recognition of when you're meditating, you're not supposed to have zero thoughts. Your mind is not actually supposed to be quiet. I think that's a huge breakthrough for people who are trying to meditate, but it's also something we should be aware of with sleep, because we have the same misconceptions when it comes to sleep. Those of us who have trouble sleeping think, I can't sleep because I can't shut my brain off. I can't tell you how many time those words came out of my mouth But it's a misconception that everybody else who sleeps well

Does so by turning their brain off at night your brain is very active all the time including when you are sleeping So it's not a matter of turning your brain off It's just a matter of lowering your arousal so you're not so upset and getting stressed out about those thoughts. So I think if you can get to a healthy relationship with meditation that helps you develop that relationship, we're, oh, okay, I'm having these thoughts, but these thoughts are okay. I'm a huge proponent of meditation. But I think for a lot of people, it may not be the best place to start and at the very least maybe follow the advice of Dr. Ong and do it at a time of day when you're naturally already pretty calm. Because not only does that make the meditation itself easier and you start to

develop that skill, but again, that mental autopilot feature starts to kick in. And you may get to a point where as soon as you turn on your meditation app, your brain starts to associate that with relaxation because you're generally relaxed when you do this. And now, as you starts to associate that with relaxation because you're generally relaxed when you do this. And now, as you start to develop that skill and reinforce that relationship, it eventually becomes a tool that may be on a random stressful night, you can use your meditation to calm you down again and bring you back to that place where you don't feel like you're getting governed around by your emotions in your words.

But I think it's important to temper those expectations. And also to realize that different things are relaxing to different people and are stimulating to different people. So for some people, as you say, Buddha means awake. For some people meditating is actually something that makes them feel energized.

In which case, it's still a great practice. But maybe that's something better reserved for daytime instead of the thing you're trying to use to unwind at night. Let's talk about the third disorder that was dogging you when you were having your sleep problems. You used the words restless legs syndrome. I get very, very restless at night, physically, not psychologically. I don't know if that's restless legs syndrome.

What is RLS and how do we treat it? So RLS is a condition that makes you feel a discomfort, usually in your legs, but it can be in other limbs as well. And the best way I can describe it is it's almost like when you get an ice cream headache, like imagine having a mild ice cream headache, but in your shin. And the only thing that sort of feels like alleviates it is if you move your shin a little bit. And so for people who have it, you will generally feel like you have to keep moving your legs, you feel a bit fidgety.

More and more as the day goes on. So more around night, it'll happen more around night time. And more when you are sitting for a long period of time or laying for a long period of time. And for some people, for the exact reason that you just described, it can be a big problem with sleep because you go to lay down for bed and you just can't quite get comfortable. And so now you're moving your legs around. And for some people, they may not even realize that that is keeping them awake. And so it makes it hard to fall asleep and rest the slags in your hands.

One of the many, many sleep disorders that often coexist within something because when you're doing that song and dance of not being able to fall asleep because your legs aren't comfortable, now you get in your head and you start to get worried and you start to feel like, why can't I fall asleep? And then that sort of fuels the whole thought process that ends up turning into insomnia.

For me, I find my rest of sex syndrome actually doesn't interfere with my sleep, so I've never treated it. And I don't plan to, unless I feel like it becomes a problem. For my mother though, it's a huge problem. And the way we figured this whole puzzle out was she read the first draft of my book. She read the first chapter, which details a bunch of different sort of common sleep disorders in very simple ways so everyone can understand. And she had the exact light bulb moment

that I was hoping to give to readers, where she read this description and said, hey, wait, I have that. And my mother has always been someone who identifies as an insomnia accurately, someone who, you know, has sleep problems, but she's never complained to me about her legs. So I said, well, okay, tell me more. So she describes to me what sounded like textbook symptoms of Ressa's leg syndrome. And I asked her, I said, did you ever tell your doctor about this? And she said, yeah, twice, I went to my doctor. They scanned me for blood clots in my legs. And when they didn't find any blood clots,

they sent her home with a diagnosis of your leg is fine. Of course, Ressus Leg Syndrome is not something that's gonna show up in a scan for blood clots, which is part of why I wrote this chapter, why I started the book where I did, because I want someone like my mother who goes in and describes these symptoms and gets told, then, now your leg is fine,

to push a little harder and say, well, what about rest of the leg syndrome? Because I'm matching these other symptoms too. And that might make the difference between your PCP sending you home or your PCP then referring you to a neurologist or a sleep specialist who can diagnose you with rest of the leg syndrome and then treat you

if you need it. But treatment for rest of the leg syndrome ranges from just kind of doing all the same things you would do to alleviate insomnia because lowering your arousal levels can really help with the restlessness that fuels the restless list in your limbs. So I feel much less fidgety and restless

with my limbs now than I did when I was having all those sleep complications that I was having. But also they found great results with magnesium. In certain cases, magnesium can really help with restless leg and in certain cases, iron can really help with restless leg. So the answer may be quite simple, but it does involve knowing what it is that you're dealing with, so you can make sure you're doing the right solutions.

Because if someone has RLS and they're just trying a bunch of solutions for circadian rhythm, let's say, and they've got the bright light lamp and they've got their meal times correct and they've got the lavender oil on their pillow. They're going to say, well, none of this stuff is working. And the reason none of this stuff is working is because those tools aren't meant to address your specific problem. My psychiatrist recommended magnesium for me and it's been very helpful. You've referenced food timing.

Can you say more about what that is? Yeah, so I think we often hear, you know, breakfast is the most important meal of the day, that holds true for sleep, especially when it comes to people who struggle with circadian rhythm issues. And this is based on research that showed when you deprive animals of food. Once you reintroduce the food, their body clocks start to adjust to when food is available to them. So if you take a rodent, for example, which are naturally nocturnal animals, and you suddenly make food available to them only during the day, their body clocks will change so that they now sleep at night and are awake during the day. So they are programmed to be awake when food is

available to them. So there is a working theory. It's never been tested in humans yet, but anecdotally, a lot of people swear by it. That intermittent fasting helps to reset the body clock. The idea is if you intermittent fast, let's say before you have to start an overnight shift or before you get on a flight to travel, that kind of a thing, and you fast for a certain period of time,

and then you eat breakfast on the time zone of the place you're traveling to, or before you start your overnight shift, you are now telling your body it's morning. And that will help to shift your clock faster than dealing with the week long of Jack Lag, it'll take before your body naturally adjusts. And so for me, this manifested on a much more basic level

where I started realizing that when you were sleep deprived, you tend to crave a lot of sugar, a lot of fatty foods, a lot of junk food for lack of a better term. And you tend to be more hungry because the hormones that regulate when you feel satiated and when you feel hungry, they get thrown completely out of whack when you're sleep deprived. And so it's really hard to lose weight when you're sleep deprived for that reason. And so I was often waking up in the middle of the day, which for me was the middle of the night, and I was hungry because that's when my body's

naturally programmed to eat. And I also wanted comfort because I felt like crap, because I just woke up after three hours of sleep and I felt terrible. So I would seek comfort and food. And I would often eat whatever was the easiest thing for me to shove in my face, which was very rarely something healthy. And so rather than try to go on some really ambitious

intermittent fasting plan, because I love food, and that's not going to be an easy solution for me, I decided to just start small. And I just sort of told myself, okay, even if all of the science on this isn't completely established, it does make sense that me eating in the all of the science on this isn't completely established, it does make sense that me eating in the middle of the time that I'm supposed to be sleeping is not relaying the right message to my body. And so I started first by scaling back if I woke up and I needed a quote-unquote midnight snack

instead of eating some big meal. I found something that I thought would not trigger my acid reflux. Something I would be friendly in that respect. And something that was a light snack easy to prepare but would still feel kind of comforting to me. And so I found for me, plain oatmeal with a little bit of salt and a little bit of honey

or a little bit of apple sauce to sweeten it, did the trick. It was warm, it made me feel comfortable. I liked it, it didn't trigger my acid reflux and it was still a fairly light snack that my body could process pretty easily. And then I started revamping the before bed issue as well because what you often will hear is if you suffer from acid reflux then you should make sure you have at least two or three or four hours between your last meal and when you go to bed. But what a lot of people miss in that conversation

is that sleep deprivation can cause acid reflux. And so I found myself in this cycle of having really bad acid reflux, and I had a treated with all types of different medications, nothing really seemed to help. And so eventually I started scaling back my meals more and more and having a larger and larger gap between my last meal and my bedtime. And I found that that would just make me sleep worse,

and then I felt even worse with acid reflux, and so I scaled back my meals even more. It turns out that for some people, it's really difficult to sleep on an empty stomach and I'm one of those people. So I kind of threw all of that out the window and started from square one and did the opposite. We're instead of trying to have this huge gap.

Oh, I don't eat four hours before bed. I started eating a sleep-friendly snack, toast oatmeal, something light with a little bit of complex carbohydrates. And I would eat that somewhere within two hours an hour of bed. And it helped me so much. And what I know now is that carbohydrates themselves can actually help our sleep.

Because we all know how trip-to-fan makes you feel a little bit drowsy. You think of Thanksgiving when you have the turkey and you go into the food coma, but trip to fan actually can't reach the brain without the help of insulin. And insulin is triggered by carbohydrates in our body. Trip to fan is this tiny amino acid

in the middle of this really crowded space, almost like it's in a traffic jam and it just can't quite get through. And when we have some carbohydrates, the insulin that happens, that insulin spike in our blood kind of parts these other amino acids out of the way and allows the trip to fans to get to the brain. We're can turn into serotonin, which makes us feel good.

And so the key is here, despite the fact that a lot of people may think, oh, well, in order to lose weight or be fit or whatever, I need to eat protein all day. And if I am going to have carbs, I'll have it at the beginning of the day so I can burn off those calories. If you have trouble sleeping, you might actually consider doing the opposite. Eat protein earlier in the day, which helps us store up drift of van in the body. And then you have complex carbohydrates at the end of the day. Well, we have a few minutes left. Is there something I should have asked, but fail to ask?

I think sleep myths can be a good aspect to address. And there are so many, but I think a few big ones. One, the thought that everybody needs eight hours of sleep is completely not true. The average, according to the National Sleep Foundation survey, which is where everybody gets these numbers from. The average for most adults is somewhere between seven and nine hours, but that same survey points out

that anywhere from five to 11 hours may be appropriate for some. And I think that's a really important point because we all know what happens if we don't get enough sleep. We hear about it all the time. But no one ever talks about the opposite end of that coin, which is if you are a six-hour person and you try to force yourself to get eight hours, all that time you spend awake and bed trying to force yourself to get that sleep is going to give you insomnia.

The other aspect of it is there are a lot of people who think they are getting that recommended eight hours of sleep because they go to bed every night at X time and they wake up in the morning and as far as they're concerned, they slept through the night. And what they don't realize is they have sleep apnea or PLMD or any other number of what I call secret sleep disorders that are disrupting their sleep throughout the night. And so that's why I think it's really about checking in with yourself, not about the hours that you're getting on your fitness tracker or that you're seeing on your clock. If you feel like you need an app all day, if you're dozing off during moments of stillness,

even during the day when you feel like you should feel awake, then that's a sign that something's wrong. And you want to get that checked out. And on the flip side, if you feel fine all day, if you feel like your energy levels are pretty good, then you're probably getting enough sleep, even if it's not the quote-unquote recommended eight hours. I'm glad you brought up the sleep myths. Thank you for doing that. Before we go, can you just plug your book in any other resources that you've put out into

the world for people who want more. Yes. So the book is called the Sleep Fix. You can find more information at sleepfixbook.com. My social media handles are at Diane R. Masato on Facebook, on Twitter, on Instagram, and I am the Diane Masato on TikTok, which I just joined. But I particularly on Instagram, I put out a lot of sleep information. I, for example, just got recommended a sleep screener that's still in the works by a few sleep

scientists, but is the kind of site where you go in, you answer a few questions, and it will actually spit out what your symptoms indicate you may be suffering from. And so resources like that, I think are so helpful to help make sure people are addressing the right problems. That's the kind of thing that I kind of keep people up on on social media because I really just want to help people as much as possible and help steer people in the right direction. Because especially after the pandemic,

there are a lot more sleep problems out there than there used to be. And I think people really need more resources than what's available to them right now. Really appreciate it. You're helping me, I think you're helping a lot of people. So bravo. Thank you.

Thank you. Thanks for having me. And I hope it's helpful. Thanks again to Diane. Quick notes to say that if you are a parent and you want a deep dive into how to get enough sleep from that angle, our colleagues over on the Child Proof Podcast posted a whole episode on that and I will put a whole episode on that. And I will put a link to that in the show notes.

This show is made by Gabrielle Zuckerman, DJ Cashmere, Justin Davies, Samuel Johns, Kim Baikama, Maria Wartelle, and Jen Poient. And we get our audio engineering from the good folks over at Ultraviolet audio. We'll see you on Wednesday for another brand new episode. The second part of this week's exploration of sleep. And as a reminder, it's all part of our May mental health awareness series.

We've got an excellent sleep scientist coming up on Wednesday to build on everything we just learned from Diane. So her name is Dr. Sarah Mednik. So we'll see you on Wednesday for that. [♪ OUTRO MUSIC PLAYING [♪ Hey, hey hey prime members. You can listen to 10% happier early and add free on Amazon Music. Download the Amazon Music app today, or you can listen early and add free with Wondery

Plus in Apple Podcasts. Before you go, do us a solid and tell us all about yourself by completing a short survey at Wondery.com slash survey.