The Dr. Hyman Show - Eliminate Toxins, Reduce Stress, And Exercise Properly For Better Sleep: Part III Of Dr. Hyman's Sleep Master Class

Episode Date: November 8, 2021

This episode is sponsored by Cozy Earth and Athletic Greens. Toxic exposures on top of our stressed out and sedentary lifestyles can all wreak havoc on our ability to get quality sleep. However, there is so much we can do to reduce our toxic exposures, enhance our detoxification pathways, reframe how we view and handle stress, and move our bodies to help find a nice, deep slumber. In part III of Dr. Hyman’s Sleep Master Class, Dr. Hyman is joined by Dr. Mark Burhenne, Dr. Mary Pardee, Dr. Judy Hinojosa, Dr. Afrouz Demeri, and Mike Mutzel to discuss the impact of toxins, stress, and exercise on sleep. If you’d like to watch the whole series, you can sign up for free at www.drhyman.com/sleep. Mark Burhenne, DDS is a bestselling author and a family and sleep medicine dentist who focuses on patient-centered and preventative dental healthcare. He is the creator and author of AsktheDentist.com, a website dedicated to exploring the mouth-body connection for better overall health.   Dr. Mary Pardee is a Naturopathic Medical Doctor, Certified Functional Medicine Doctor, and founder of modrn med who specializes in integrative gastroenterology and hormone balancing in Los Angeles, California.   Dr. Judy Hinojosa is a licensed Naturopathic Medical Doctor and the lead physician and founder of Vitality Wellness Clinic. Dr. Judy has received higher level postgraduate education in Environmental Medicine, Intravenous Nutritional Therapies, Natural Hormone Balancing, Ozone Therapy, Lyme Disease and Mycotoxin Illness, and has completed in-depth training in Energy Based Medicine.   Dr. Afrouz Demeri is a licensed board-certified Naturopathic Medical Doctor specializing in integrative, Functional Medicine for women. Dr. Afrouz finds the root cause for hormonal imbalances, thyroid disorders, stress, weight or digestive issues, fatigue, depression, and anxiety.   Mike Mutzel earned his B.S. in Biology from Western Washington University, completed his M.S. in Clinical Nutrition from the University of Bridgeport, and is a graduate of the Institute for Functional Medicine’s (IFM) Applying Functional Medicine in Clinical Practice (AFMCP).   This episode is sponsored by Cozy Earth and Athletic Greens. Nice bedding can feel like a big investment, so Cozy Earth makes it super easy to try out their products with a 30-day free trial and 10-year warranty. Plus, right now they are offering 40% off. Just go to cozyearth.com use the code HYMANPODCAST at checkout.   Right now, Athletic Greens is offering my listeners 10 free travel packs of AG1 when you make your first purchase. Just go to athleticgreens.com/hyman to take advantage of this great offer.

Coming up on this episode of The Doctor's Pharmacy. If you're in go mode all day long, no wonder it's hard to calm down at night. I promise you that if you prioritize relaxation and you tap into yin energy for at least a few hours each day, your body and your mind and your sleep will thank you. Hey everyone, it's Dr. Mark. Now, we all know there's a direct link between the way we grow and process our food and how that impacts our health. But what about the other agricultural commodities we rely on? Well, conventionally grown cotton is one we need to think about. It's often sprayed with a slew of toxic chemicals, including the pervasive glyphosate, which is so dangerous that I've developed an entire podcast episode

and actually a few to it. And these chemicals can persist on our clothing. Cotton also requires huge amounts of water and fertilizers and contributes to the pressing issue of soil degradation. So it's not a very environmentally friendly sound option. Now, to avoid all these issues, I try to buy sustainable non-toxic clothing as much as possible. Bamboo is actually a great alternative to cotton. As it grows rapidly, it needs very little water or chemical inputs, and as an added bonus, it sequesters a large amount of carbon dioxide, absorbing five times more carbon dioxide and producing 35% more oxygen than trees. My favorite bamboo fabric is from Cozy Earth.

They make the softest, ethically sourced bamboo pajamas and loungewear I've ever worn. Now, these make a perfect gift to any of your friends or family. I love mine so much. I never want to take them off. Another reason I love bamboo fabric is that it's temperature regulating. So the Cozy Earth pajamas are great for helping you get a solid night's sleep without feeling too hot or cold. Right now, you can try out Cozy Earth's bamboo pajamas and loungewear for 40% off.

Their highest discount ever offer. Just go to CozyEarth.com and use the code HymanPodcast. That's Cozy Earth, C-O-Z-Y-E-A-R-T-H.com with the code HymanPodcast. All their products are covered with a 10-year warranty, but I know you love them as much as I do. So many of my patients wait until they're sick to finally take care of their health. I've even had doctors as patients, well, many actually, who just wait for their problems to get worse and worse and receive a diagnosis of disease before taking any kind of action.

This is not the path to health. We can live longer, healthier, happier lives if we just prevent imbalances in our bodies in the first place. And nutrition is a key part of this. Many of us don't get the optimal amounts of key nutrients through diet alone, even with a whole foods diet. And then when you add in all the stressors we're up against, like work demands, toxins, lack of sleep, we're even more likely to have a nutrient deficiency. So one of the things I use every day to optimize my intake of vitamins,

minerals, phytonutrients, pre and probiotics is AG1 from Athletic Greens. It's a comprehensive superfood powder with a special blend of high quality whole food ingredients that work together to fill the nutritional gaps in your diet. It's specifically designed to support energy and focus, aid with gut health and digestion, and support a healthy immune system, which we all need right now. I've made AG1 part of my daily ritual because I feel better knowing I have a little extra nutritional insurance to complement my healthy diet. It also gives me a nice energy boost without feeling overstimulated. I like to think of it as a huge leafy green salad shrunk down into a simple glass of water I could take anywhere. Right now, you can get 10 free travel pracks of AG1 when you make your first purchase.

Just go to athleticgreens.com forward slash hyman. That's A-T-H-L-E-T-I-C-G-R-E-E-N-S dot com slash hyman. Now let's get back to this week's episode of the doctor's pharmacy. Hi, this is Lauren Fee and one of the producers of the doctor's pharmacy podcast. Today we are featuring part three of Dr. Hyman's sleep masterclass. You'll hear from Dr. Mark Bruhena, Dr. Mary Pardee, Dr. Judy Nahosa, Dr. Fruz Dameri and Mike Mutzel about the impact that toxins, stress and exercise have on sleep. If you'd like to watch the whole series, you can sign up for free at drhyman.com forward

slash sleep. We hope you enjoy this episode and tune in next Monday for part four. When I got sick a few years ago, my sleep really suffered. I was tired all the time, but I couldn't get a good night's sleep. Turns out that I had toxic black mold in my house, which led to a host of issues, including a really bad cough that I couldn't kick. I can't tell you how much better I slept when I removed myself from the environment and I used the principles of functional medicine to heal my body and my brain and my sleep. I hear this story often from my patients. They come into their house and then they feel super sluggish and tired and they wake up feeling groggy. It turns out toxins lurking in your home can interfere with getting quality sleep. Now I know that talking about toxins can be scary. It seems like every return we're being bombarded with environmental toxins that we can't escape. But I don't want you to feel helpless and hopeless when it comes to this subject because we can't live in a bubble

nor should we, but there are things you can do to minimize your exposure to toxins and improve your body's ability to get rid of toxins all while improving your sleep. In this lesson, we're going to talk about toxins. We're also going to discuss our immune health, which is intricately linked to our sleep. Bad sleep habits are going to weaken our immune system, and you guessed it, getting better sleep can strengthen our immune system. Immune dysregulation is something I see almost daily with my patients. A runaway immune system can cause systemic inflammation that if left unchecked can cause heart disease, cancer, diabetes, dementia, autoimmune disease, and lots more. If you're inflamed, you're probably not sleeping well

because when your body's inflamed, so is your brain. So let's dive into these topics, starting with the discussion on toxins. Environmental toxins are some of the worst aggravators that really can disrupt one's sleep. We are now exposed to so many toxins in our environment. Toxins are coming from our air, so air quality is very important for us to understand when we go to bed at night, but not also in our bedroom or our home, but also outside air. So quality of air is one. The second source of exposure is the food. The foods that we consume can have high toxin levels. Also, the water we drink can be full of toxins and products that we use in our personal care. So toxins are absorbed through our skin.

So those are the four ways that toxins can enter our system. And toxins can really disrupt one's sleep. When it comes to sleep, I want to talk to patients about what is their sleep environment like. A lot of people actually don't fall asleep well because they're living in a toxic environment. And one of the most toxic items one can have in one's home is actually a mattress. Is a mattress from anything that you're exposed to could be the most potential danger for one's health if you get a conventional mattress. A mattress takes seven years to off-gas. So it off-gases while you sleep.

And while you're sleeping, your body will get warmer. You can sweat at night. You're warming up the mattress to release more toxins. And mattresses have a lot of what are called VOC, volatile organic compounds. These are solvents, anything that off gases. So they have a lot of formaldehyde. They have flame retardants. They have toxins, benzenes that have been used to create the safety of the mattress.

But all night you're sleeping in a pool of toxins. And this is the same for your pillow and the sheets that you use, your comforter. If you're using regular sheets that are not organic cotton or organically made, you're going to have a lot of herbicides, pesticides being released at night. But your mattress is probably the biggest item that if one could make a change to have better sleep, would be to get an organic mattress or if your mattress is older than seven years old then don't change the mattress but getting a new mattress and it takes a long time for it to off gas i had a case of a patient that came to see me

and this patient had moved into a 35 year old female stephanie she had moved into a 35-year-old female, Stephanie, she had moved into a new home. And she had gone through a lot of new construction. There was new carpet, new paint. There was new furniture. Everything was new in her home. And by the time she came to see me, she said that after moving into this house, within five months, she started not to sleep as well. She was having difficulties not falling asleep. And she was waking up very tired. And she was waking up with migraines and headaches. She had a lot of brain fog in the morning.

She would describe it as she said that she felt like she was waking up drunk. She said, I felt like I had a bottle of wine last night. And I'm waking up through the night. She even described having some flashes of heat. So first she said, am I going through menopause? What is happening in my body? Because I'm waking up very hot. I'm sweating.

I'm waking up anxious. But I can't fall back to sleep easily. And in the morning, she felt like she was drugged. So I'm taking her history. I did what is called an environmental history to understand what had changed in her environment. I also ran her hormones and surprisingly her hormones were fine. It wasn't a lack of hormones that was causing her to wake up. So on understanding her history that it was so connected to having moved into a new house, she also had gotten a

new car. So she had a new car, she had a new mattress, she had a new home, and she had carpet in her house, fresh paint, new furniture. And I decided to run with her an environmental toxin panel that measures one's levels of solvents, measures chemicals, pesticides, herbicides, any chemicals one could get exposed to through breathing, again, drinking, eating, or touching your skin. And I also run with her genetic marker to check to see if her glutathione pathways were working correctly. And glutathione, I like to call it the boss of detox, is a really important nutrient to help us metabolize toxins, to bind toxins. And I wanted to know what her genetic mutation was, or if there was one. And I also measured her glutathione levels to know

where are we at with this patient. And the reports came back, and her levels of benzene, which are the solvents, were 10 times higher the upper limit. So she didn't really have the pesticides, no chlorines, but the solvents. So benzenes were very high for her, the volatile organic compounds. And in assessing her history, we knew that she had gotten a new car, a new mattress, carpet, new paint, which all are constantly releasing the volatile organic compounds, which are the chemicals that are used to make all these materials. But they take years to off-gas. And she also had a new car. A car takes on average about 18 months to off-gas. So she was moving through the day in a car that was full of toxins. And at night, she was coming and sleeping

in a bedroom that was full of toxins. And the night, she was coming and sleeping in a bedroom that was full of toxins. And the carpet was also off gassing. So her levels were very high. And her glutathione levels were also very depleted. She should have been around 1500 and she was around 500. So her liver was very empty of the essential nutrient to detox. And he was waking her up at night because the liver was going to cleanse, but it didn't have enough support. So we made the connection of how she was missing a lot of glutathione from her body. And when we ran the genetic marker for her glutathione gene, she actually had an absentee on what is called a GSTM1. She was missing that gene. So first, she's missing the gene. Second, she has low glutathione that she's depleted because of the toxins.

And now she's constantly exposed to these toxins, and her body, her liver could not clear those out. So it was waking her up at night. And the solvents cross also the blood-brain barrier. So solvents go into the brain. The solvents are being associated with depression, with fatigue, brain fog. Very high solvent levels can show up almost as dementia for patients. And the feeling of she felt like she was drunk, she was drunk on solvents. So the first thing I had her do is get

an organic mattress. And she right away changed her mattress um i also because her case was so extreme um i also had her remove the carpet from her bedroom and put uh wood or um so she removed the carpet and she got a filter an air filtration system to put in her um bedroom since she had also new furniture and new paint i had her get, I like the brand IQ Air. There's many brands, but it was a HEPA filter. And she was, I had her run it throughout the whole day and at night, just running on a setting of one. So a low setting, so it wasn't loud. So she, I also had her open windows to get fresh air in.

And I had her, some of her pieces of furniture that she had, I had her put it outside in the sun. In Arizona, we have sun all the time. So the sun also helps off gas and pull the chemicals off the furniture quicker. And she also off gas her car. So she went back to using her old car. And there's something called cooking, a method of releasing solvents out of new furniture, new cars. So I had her cook her car.

So in essence, over the summer, she just parked it outside and let the heat close the windows and let the heat rise. Heat pulls toxins out of furniture or of mattresses, of cars, of any material. It moves it quicker out of the material, so it off gases rather quicker. And she cooked her car for three months to let all the solvents out. And once a week, she will just open the doors to let it out, close it again. So after doing this for about four months, we were able to supplement her with glutathione. So she took liposomal glutathione every day and was doing also sauna.

I had her do sauna to pull the solvents. When we sweat, we're able to move a lot of solvents out of the body, a lot of toxins, but I had her take some charcoal afterwards to bind what was coming out of her so it wouldn't recirculate through her body. And so she was doing a lot of sauna, a lot of charcoal, a lot of chlorella.

She changed what she was doing in her environment. I lot of charcoal a lot of chlorella she changed what she was doing in her environment i gave her some intravenous glutathione levels to raise those levels and i also advise her to add a lot of foods that can help increase glutathione levels so she did a lot of cruciferous vegetables so your broccoli your cauliflower brussels sprout cabbage she also increased avocado consumption as asparagus, and all the allium family, leeks, garlic, onions. And the combination of all those foods helped her body make more glutathione. She also took some fiber. So flaxseed is a great binder and up her intake of vegetables to just get a lot of fiber in her body. So I increased her body's ability to bind

what was coming out as she was doing sauna three times a week. And the sauna was helping her sweat out a lot of these toxins. And then as we were raising glutathione, she was cleansing her liver, binding what was coming out, but she had to remove what was the aggravator. Otherwise, we couldn't cleanse her body. If you're living in toxins, you can't really detox. You're just moving the equation in the same direction. So after doing this for a few months, we retested her solvent levels and her solvents had gone down to about 80%. And she had significantly reduced the amount. The glutathione levels came up. Of course, her genes are not going to change once you know what they are.

But what was interesting is that her case changed so drastically. She was no longer having insomnia. She was sleeping through the night. And she was not waking up with the feeling of feeling drunk. Her headaches went away. Migraines went away. She didn't take any hormones. She didn't take any other supplements.

She changed her environment. She also changed her sheets and her pillow. She bought everything organic and got in a habit of also opening windows in her bedroom over the weekend just to get fresh air. And it's important for patients to know that air quality, your indoor air can be 10 times more polluted than outdoor air. We have industrial pollution outside, but we have wind and sun to move it. Indoors, you're just trapping all the toxins and the body's just

taking all this off-gassing. So having a filtration system, it almost acts like a liver, a backup liver in your bedroom that's taking everything out so it doesn't hit your body. But it was a very drastic shift on her to see how just changing what was going on in her surrounding and supporting her body, she was able to regain her sleep back and also improve her brain function, her energy, her mood the next day. Next, I want to talk about a source of toxicity that you might not be thinking about that much. I'm talking about EMFs or electromagnetic

frequencies. They're everywhere. Have you ever thought about the electronics that are plugged in your house all the time, especially in your bedroom? Making the switch to lowering the amount of EMFs we are exposed to can be life-changing when it comes to our sleep. Let's hear from our experts. A story I like to tell often to my patients is the story of this young woman who, in her early teens, was having a really tough time in so many areas. Was unhappy, wasn't thriving in school despite her wonderful abilities. Her parents were having issues with her.

It was a difficult time for her. And there was no sign of any kind of sleep apnea. I looked and we checked and we got the sleep studies. And she passed all her sleep studies with flying colors. So what do you do with a patient like that? And that may be you. I mean, people will have tested you. Your doctors, you may have complained about not having slept well.

And what is the reason for that? So my message would be, don't give up. Just because you have passed a true PSG, not a home study, but a very good sleep study, doesn't mean your sleep is not being interrupted. This young woman was sleeping, her head was next to the back of the main electrical box in the home. And so the panel opened on the other side, but her head was right at the level of the main panel for all the electrical conduits and wires going into this house. And it was an older house, so it didn't have as much shielding.

It was not up to date. It wasn't grounded. I went into her home because I was very curious at this point what was going on. I looked for dark curtains and blackout curtains and allergens and carpeting that was old. And she had a great sleep environment, but she was always tired. I took my EMF measurement device, not knowing that the junction box was on the other side. And as I walked over to that part of the room, this device, which is a very simple device, you can get it on Amazon, they're $10 to $20, just lit up. And her head was sleeping next to this huge source of EMFs every single night. Within a week, a week and a half of having moved the bed to the opposite side of the room,

a lot of her issues were going away. And the first thing she reported was, I don't remember. After the time I went to sleep, I don't remember anything. And when I woke up in the morning, I had no idea how long I had slept. I thought it had been five or 10 minutes. She was finally getting deep sleep just by moving her bed. So I use that story with my patients, especially the ones that do well on a sleep study that have been tested, but they still are tired during the day. Keep looking. There's got to be a reason. There are many other reasons why you may not be sleeping well.

EMFs and radiation and technology. So our cell phones, the Bluetooth, the towers, all this has been shown to affect the pineal gland. And we talked about melatonin, but that is where it's made. That's where the signaling comes for our circadian rhythm. It comes from that pineal gland, and it is affected by what's around you. So one of the best things to do, I say have a docking station. We have one when we come in in the kitchen, everything stays there at night, nothing makes it to your room. The bed is just for sex and sleep. It is not for a place for you to do any kind of work. No cell phones, no laptops, you know, really keeping all that away. And if it's in you or on you, it should be on airplane mode and completely off because that will affect how

much melatonin is released and it will affect the rest of your that that circadian rhythm. There are a lot of gadgets out there that I'll get into that people wear, you know, the watches that track your sleep. I'm wearing the Oura ring, which will track your sleep and tell you the kind of quality of sleep that you're getting, not just the hours. Please make sure they're all on airplane mode or you're not actually adding more harm by measuring your sleep, but then getting all this Bluetooth and, you know, radiation that's going to actually disrupt your sleep.

So most of these things you can, like the Oura Ring, I'll put it on airplane mode and I'll go to sleep. And then when you're awake, you can put it back on, but stay away, you know, don't be right around it, you need, you need some distance so that you don't pick that up. And I'm seeing this and because I help so many couples have babies that moms and dads, especially moms, when they're pregnant, their entire time, the cell phone is on the belly, and they're holding it. And that's absolutely going to affect the baby and the future child, and their sleep, you know, or these baby monitors that are on and giving off EMFs. And then the coil in the bedding of the baby and their sleep. So I learned a lot about this when my kids weren't sleeping. And the sleep hygiene that has to go into children is very different for us. But if we're not aware of it and don't understand that that coil is a metal detector, and it's going to amplify the EMF that's given off by that baby monitor or anything else that might be in that space or that room or the electricity or the magnetic field even.

So I had all this stuff measured and I was blown away, you know, so I had to change the bedding because we had spring coils. And you know, building biologists can come to your house and measure these things and tell you. And it's amazing how much of people's fatigue and insomnia is affected by what's around them. because these affect the sodium, the chloride channels in our body. And one of the medications that, you know, is prescribed for sleep is Xanax, which is given for anxiety, which affects GABA. And GABA is affecting your chloride levels and the chloride channels in the body.

And we know that these EMFs, that's what they're also affecting. So it's amazing how all this is linked. and we're just so oblivious to it. And if I could go to everyone's home and really clean out how much dirty electricity and how much all this stuff is affecting your energy and your ability to completely let go and have a deeper sleep, I would. I know we are living off phones and computers, but try to minimize whatever you can do. So be conscious on getting maybe a protection screen on your phone to block some EMF. Change the lighting on your phone. It's very important that we are not exposed to a lot of blue light, which the blue light is stimulating. The blue light blocks the production of melatonin. So we're not going to make enough melatonin if we are constantly exposed to blue light. Sunlight helps us produce melatonin. One of the techniques and tips I tell my patients is put your

phone on night shift. And I actually put my phone on night shift starting at noon. I don't wait until night. If I'm looking at my phone, I want that red light. So when I'm looking at my screen, I'm not looking at the blue light. So there's many devices that you can, apps that you can download, or if it's a computer, you can also download a software to install so the lights change and you're not constantly emitting to the blue light. I know patients sometimes can wear glasses as well. So having glasses to wear at night that block the blue light is also helpful. So a lot of my patients don't like wearing the glasses.

Sometimes they find them uncomfortable. So at least getting a blockage on your phone and minimizing your exposure throughout the day. As we said, if you're in a car, put your cell phone on airplane mode and be conscious, be constantly conscious of why do we need to be stuck and attached to our

phone all the time. Create really a practice of having boundaries around our phone. Our phones have become quite addictive and all of us experience that. It's a constant gratification and something to hold on to. It's our new form of smoking. So being very conscious and clear how to create boundaries around your phone. When do you check your email? When do you check your texts? How available are you? Before we had cell phones, we were not this available.

So really blocking that lighting, that blue light and EMFs are two ways that we can restore the natural rhythm within our body. So being conscious of that. Many of the companies that make these blue light blocking glasses, they make them for children. And here's what's unique that a lot of parents should understand is children are much more susceptible to the negative health effects and

the consequences of evening blue light exposure than us as adults. It has to do with how their eye is shaped and structured. And so several sleep lab studies throughout the world have conducted research and they found that even just like 45 minutes of exposure to an iPad for a kid is before bed. They need like three or four hours of separation between exposure of that light before they go to bed because the melatonin production goes down significantly compared to an adult. For example, you or I could be on our iPad and then stop at 9 p.m., right? We could be on it for 20 minutes, 20, 30 minutes, and go to bed at 10. It would impact our melatonin, but not that much. Maybe it would cut it in half, right? For children, if they did that same thing, it would have like a 100% reduction. There's been a few

studies that have come out in 2018 to show this. And so the point that I'm trying to convey here as parents with children that have devices, that have tech, that watch TV or have their phones and iPads, blue light blocking glasses are very important in addition to creating those boundaries around the tech. Now I can understand trying to police this. If you have a teenager, it could be quite challenging. So maybe you could just make a rule in the house, look, if you're gonna be on your phone at night, you know, in your bedroom or whatever,

please use these blue light blockers because again, the shape of the eye, it's not totally developed and can't mitigate that harmful blue light exposure. So yeah, I mean, three years ago, it was weird to wear blue light blocking glasses when you're out in public. But now it's like we had to go to the mall the other day, the Apple store, and there's tons of light from all these things.

And we just walked in there. My daughter had them on, my wife, myself. And it's like wearing your seatbelt when you're driving. It feels weird or foreign. You know, I'm sure when seatbelts, you know, in the 1970s was weird when people actually started clicking them on because they've driven without seatbelts forever. But, you know, people used to smoke in airlines, right? I mean, it was like common. Everyone would get secondhand smoke.

And now we know that, and again, I'm not against tech or light, but it's the timing of it. It's just bad. It can be deleterious at night. And so mitigating that with filters on the devices or the blue light blocking glasses, especially for children, can be super helpful. Now let's talk about immunity. Chronic inflammation and poor immune health can lead to depression, insomnia, and lots more. Our immune system relies on good quality sleep. Let's hear more about this from our experts. Immune cells, the immune system at night goes to regenerate itself. It goes through a cleansing mechanism and we create a more healthy immune soldiers, immune cells during the deep state of sleep. So when someone is ill or they have illness,

a cold or flu, or even like a chronic condition like Lyme disease or chronic fatigue syndrome, fibromyalgia, you want to try to get the deep sleep, but it's often lost for a lot of patients. And one of the worst aggravators for the deep sleep state is actually alcohol. So patients that consume alcohol, especially in the evening, are going to have lower deep state levels. And they have actually done research showing how consuming alcohol two hours closer to bedtime is going to impact your ability to go into the deep state of sleep and also impact REM. Both of these really important phases are going to get disrupted by alcohol consumption.

And the other rest of the night, about 60% to 65% of the rest of the evening, we actually spend on what's called light sleep. And the light sleep, the body's healing, is resting, regenerating, but it's not engaged. The brain doesn't engage the same way that it engages through deep sleep, through REM sleep. Through light sleep, this is where the detox pathways become the most active. Our lymphatic system, so let's talk about the lymphatic system. Our lymphatic system is one of our main mechanisms to remove waste out of the body. Think of it as in the fluid form, we have channels, we have organs that are part of the

lymphatic system. So the tonsils, the thymus, the spleen are all our glands that help us clean out the immune system at night. And the lymphatics is this waste dumping mechanism that allows for this fluid to move. And our lymphatic system is the most active at night. It's actually 60% more active than in the daytime. So as the body goes to sleep, the immune system goes to work. And patients that have chronic conditions, we see a lot of Epstein-Barr virus. Now, it's very common to see that. So chronic mono, we're seeing a lot of Lyme disease. A lot of patients with autoimmune disease, they're exposing throughout the whole day

to viruses, parasites, any kind of infection, including toxins. We'll talk a little more about toxins, but toxins also are being flushed out in the lymphatic system. So the lymph, it's a fluid that carries a combination of immune cells, toxins, all the waste, metabolic waste that the body's created through the whole day. And during light sleep, the body is flushing all, this mechanism goes to work. So this pumping mechanism turns on. And this is really important that this also, to understand that this also happens in the brain. There's something called the glymphatic system. And it wasn't until four or five years ago that research showed that we have actually a lymphatic system in the brain.

We all only thought that it was part of our body. But as we can see that we build toxic waste through just metabolic processes, the process of just speaking or digesting food or breathing creates a lot of metabolic waste in the body. That metabolic waste has to be removed at night mostly, but the brain also creates metabolic waste. It wasn't until recently that we realized that the conversation between neurons, the conversation between the cells in the brain, the creation of neurotransmitters,

the processing of memories, all of that creates a lot of metabolic brain waste. And that also has to be removed at night. And the glymphatic system wakes up at night. It works the most actively. So again, without proper sleep, you're not cleansing that. There is something called beta amyloid that is a protein that is often associated with patients that have dementia and Alzheimer's.

So patients that have dementia and Alzheimer's have the highest levels of beta amyloid, and the glymphatic system at night is removing beta amyloid, is in charge of removing that. So again, this goes to show how lack of the proper sleep causes an accumulation of this waste material throughout the body. The immune system, actually the cytokines, kind of the soldiers, are made and produced when we sleep. So anyone who has an autoimmune disease or gets sick often or has anything to do with wanting to protect their immune system, especially during the fall or the winter when it's flu season, you want to increase sleep. And isn't that amazing that that's a time where winter and fall, our nights are longer, it gets cooler out

more wide so that you sleep more. So the brain, if you look at the four seasons, and when we get sick more, and why certain viruses grow in certain times, sleep absolutely is more essential during the time where it's darker. And that's because it's been shown that when we have an infection, different things happen during sleep, we actually wake up more. And there's research showing it's to actually help you induce a fever to fight the infection. There's we're finding that things happen in the brain on the lymphatic level during an infection that doesn't happen when we don't have an infection. So one of the things I always say is during the fall in the winter, I try to actually get more sleep to help your immune

system. So it's not just about getting that flu shot. It's about you know, taking your vitamin C and zinc and elderberries and really getting more sleep. Sleep is essential for the immune system, especially if you already have an immune disorder, an autoimmune disease, or you just want to protect and know that you might have a predisposition because of your family history. So here are my main takeaways from today's lesson. Number one, we learned that one of the most toxic items in your house can be our mattress. If you're considering purchasing a new mattress, try one that is organic. Now, if you have a mattress that's more than seven years old, it's probably off-gassed all the toxins, so it's safe

to keep. Number two, if possible, purchase an air filter for your bedroom or sleep with the windows open. This is going to help improve the air quality in your room. Now, as we heard, indoor air quality can be 10 times more polluted than outdoor air. There are some really excellent air filters out there. My favorite one is called Air Doctor, which is pretty affordable and removes nearly 100% of the particle pollution, along with the vast majority of toxic ozone and volatile organic compounds. I also like IQ Air and there are a few other great ones on the market. Number three, minimize your exposure to food that contains toxins. The best way to do this is to stick to organic whenever

you can. Now I know it can get expensive so I like to follow the Dirty Dozen and the Clean 15 list created by the Environmental Working Group at EWG.org. This is a list of 12 foods that should always be purchased organic because they contain the most pesticides, and 15 foods that are usually safe to buy when they're conventionally grown because they don't contain that much pesticides. Number four, support your natural detoxification systems by eating foods that boost your glutathione levels. That's the body's main detoxifier. Things like the cruciferous vegetables, broccoli, cauliflower, brussels sprouts, cabbage. If you suspect you have toxins in your home like mold, bring someone in to inspect your house. If you catch the problem early, it could be an easy fix. Now, sometimes it might be as easy as fixing a leak under the sink. Sometimes it's as bad as having to gut your whole house like I had to do. Also, make sure you're

drinking clean, filtered water. Toxins like microbes, pesticides, plastic, yes, prescription meds, heavy metals, chlorine, fluoride, and other things are poisoning our water supply. So invest in a good water filter. Next, make your bedroom or the area near your bed a safe space. Avoid junk light from phones and TVs. I like to turn off all Wi-Fi at night. You don't need Wi-Fi when you're sleeping. Just unplug it from the wall. Also, wear blue light blocking glasses and turn your phone to night shift mode in the evening. Now, these are just a few simple rules for reducing your toxic exposure to improve your sleep.

Now, when it comes to our immune health, it's important to incorporate all the principles that we've discussed in this course such as avoiding refined sugars and processed carbohydrates and minimizing our exposure to toxins. We also need to boost our detoxification systems, we need to eat a diet rich in polyphenols, we need to get sunlight and time outdoors, and we need to figure out ways to reduce and manage our stress. And remember, sleep is how we boost our immune system and it's when our bodies do most of our detoxification. So just prioritizing sleep alone is a great step in the right direction. We all know what it feels like to miss out on a night of quality sleep and wake up the next day feeling cranky. Maybe we're short-tempered

or find it hard to tap into kindness or compassion. Maybe we feel stressed and unable to cope with our daily tasks. When I wasn't sleeping well, I had major brain fog and I couldn't even remember my patient's names. When we miss out on quality sleep, our brain suffers the most. In my practice, I see a lot of ADHD. I'm not really trained to detect it, but it's not difficult to see a kid, typically a young man that comes in and is bouncing around, bouncing off the chairs. I had one of my patients jump out the window in my dental operatory. He came back. He was just out by the car. I mean, it's not hard to see that there is a lot of hyperactivity going on and there's focus issues and all that. And then to see a sleep disorder alongside this should be of no surprise. The data is out now

that at least 50% of the time, there's probably a misdiagnosis of ADHD, and it's actually a sleep disorder. And then on the other hand, the two usually go together is the sleep disorder, the cause of the serotonin issues and synapsing issues in the brain that is causing or predisposing the child to an ADHD diagnosis. So I usually warn the parents that you know if there's any hint of ADHD if you have a diagnosis and there's a diagnosis or a sleep disorder it's related and it's one in the same and both have to be dealt with at the same time. We know that America is the number one prescriber of prescription stimulants in the entire world. Rates of ADHD are continually increasing for both adults and children. The reason behind this is it's the thought that we

need more stimulation to the brain to actually focus and have energy levels. But I want to start to question this idea because is it really more stimulation that we need or are there other things that are gonna help us focus more? You see, we're inundated with stimulation all day long. We've got billboards to look at, we have commercials to watch, we've got Instagram DMs to respond to,

we have emails coming in constantly. So is it really more stimulation that we need or is there something else? And I'm questioning, I think that there's something else. I think that it's actually a lack of mindfulness and meditation that we're striving for that would help us get that focus. So I want to break and talk about a case and we'll talk about this guy named Ralph. And so Ralph is a 47 year old male and Ralph has had issues focusing. so he's on Adderall. Adderall is a prescription stimulant that can help with ADHD.

He's on about 40 milligrams per day in divided doses and he takes his last dose at 3 p.m. Now Adderall's half-life is 19 to 14 hours. This means that almost half of it is still in your system after nine or 14 hours, which is incredible. And so if he's taking his last dose at 3 p.m., it's still going to be into his system past midnight, even towards 5 a.m. Ralph tries to go to bed at 10 p.m., but he can't fall asleep, so he uses trazodone, which is a

prescription sleep medication. Other things like Ambien are similar. So he uses Adderall in the morning to wake him up because he's groggy from using Trazodone at night to fall asleep and then he needs Trazodone at night to fall asleep because he's stimulated from the Adderall that's still circulating in his system at night. And you can see how this ping pong effect can continue years later. Ralph also has an elevated heart rate. His heart rate's like 110. We need a heart rate of 80 or less to be optimal for health. He's got elevated blood pressure, likely due to the stimulant use as well. Ralph is a perfect example of what we see in society.

We're striving for stimulation, using uppers to get us up in the morning and downers to make us fall asleep at night. But this ping pong- like effect is going to continue year and year after until we find the answer as to why we can't fall asleep in the first place. We need to start asking the question of why can't you fall asleep? What's keeping you up at night? Are you worried about finances? Are you stuck in a scarcity mindset where you never think that there's enough? Are your relationships not in line with your values, and those are keeping you up at night?

Or do you have a dysregulated circadian rhythm where cortisol is still too high at night? All of these things are questions that we need to ask. And on the flip side, why don't you want to get out of bed in the morning? Are you not excited about your job? Is your career not in line with your values? Are you just not passionate about what you're doing? Or are you not getting enough sunlight exposure

during the day that's affecting your circadian rhythm? Whether it's physiological or emotional or mental, these are all the questions that we really need to dig into. We need to start asking the harder questions, get to the meat of the issue so that we can solve these problems at their root and not put band-aids on them. It wasn't until recently that we realized that the conversation between neurons, the conversation between the cells in the brain,

the creation of neurotransmitters, the processing of memories, all of that creates a lot of metabolic brain waste. And that also has to be removed at night. And the glymphatic system wakes up at night. It works the most actively. So again, without proper sleep, you're not cleansing that. There is something called beta amyloid that is a protein that is often associated with patients that have dementia and Alzheimer's. So patients that have dementia and Alzheimer's have the highest levels of beta amyloid.

And the glymphatic system at night is removing beta amyloid, is in charge of removing that. So again, this goes to show how lack of the proper sleep causes an accumulation of this waste material throughout the body. I like to focus on the basics, the root cause

stuff. There's no magic pill. There's no magic silver bullet for this. There's no supplement that we can supplement ourselves out of deep sleep. There's no shortcut. Sleep is that important. It's one third of our life. Get used to it. Don't think of it as a waste of time. I used to think of it as a waste of time. I used to think of it as a waste of time. I used to be able to go to bed at 2 a.m. and wake up at 5.30, 6 o'clock the next morning, and I felt great, or at least I thought I did. And then it caught up with me. And I just increased my chance of getting Alzheimer's or heart disease, you know, by factors of 3 to 10.

I mean, it's huge. I want to touch briefly on neurotransmitters, which we also discussed in episode three. These are the messenger molecules of our brains and our nervous system. Just like our hormones, they're involved in nearly every function of our body. The brain chemicals or neurotransmitters send messages throughout the body to every cell, organ, and tissue, helping you do everything from move your arm to feel happy or sad. So the most important neurotransmitter for sleep, I'd say is actually GABA. And GABA helps you relax. So GABA is a neurotransmitter that most people can take in a supplement. It's not supposed to cross the blood brain barrier. It's a large a large molecule. But I do find that it does.

We have leaky guts. We have leaky brains. We have leaky sinuses. Unfortunately, our society is so leaky that it is safer to take in a supplement form if you need to. But obviously, you need to ask yourself or have your doctor assess, why are my GABA levels low? But GABA is an important one, and that's how a lot of the benzodiazepines, the Valiums, the Klonopins, the Xanax, they work through GABA. Other neurotransmitters that we have are GABA and glycine and L-theanine. So these neurotransmitters are called inhibitory versus excitatory. So we have two kinds,

the ones that stimulate you, they wake you up, such as dopamine, touring, and then we have the ones that calm you down to allow you to rest and sleep. Similar to what we talk about with the parasympathetic and the sympathetic nervous system, we have neurotransmitters that allow us to be sharp, alert, focused, and we have neurotransmitters that allow us to calm and relax at night. So GABA is probably one of the most important neurotransmitters. GABA is a natural, we call it as a natural Xanax, is the relaxer for the body. And GABA is also produced in the evening.

GABA, the neurotransmitter GABA is also made by the bacteria, by your friendly bacteria in your gut. So if someone doesn't have a healthy gut or a healthy microbiome, they're not going to make enough GABA in their body. And lack of GABA leads to a lot of anxiety for patients. So neurotransmitters, also L-theanine is another one that calms the brain and calms one's cortisol level. So L-theanine is used to reduce cortisol and calm all that stress in the brain. So L-theanine and GABA are some very important neurotransmitters that if someone is low on, they're going to experience a lot of anxiety and not be able to cope with stress. So serotonin is very connected for depression support and L-theanine and GABA for anxiety.

So those are the neurotransmitters that I always want to make sure my patients have proper levels in order to support pathways of sleep. And again, when we don't sleep, we don't regenerate those neurotransmitters. So it's, again, it's the cycle. The lack of them causes you not to be able to fall asleep, but not sleeping also depletes the body from it. So it's a lot of times when we have a broken cycle of sleep, we do have to supplement with

GABA, with L-theanine, with 5-HTP or melatonin to allow the brain to reset and calm at night until the body starts to make it on their own. Now, I want to take a moment to talk about stress. Chronic stress has become an epidemic in our society where faster is better, and we attempt to pack more obligations into our ever-expanding schedules. And when we're stressed,

we often put sleep on the back burner. When you're stressed, your adrenal glands release hormones like adrenaline and cortisol, which we already talked about, that flood your system, raising your heart rate, increasing your blood pressure, and making your blood more likely to clot. It also damages your brain's memory center. It increases belly fat, and it generally wreaks havoc on your body and your ability to get quality sleep. I'm here to tell you that late nights

and burning the midnight oil at the cost of your health is not a badge of honor. In fact, in the long run, this lifestyle will only slow you down and make you less sharp, less focused, less energized, and less happy. In my practice, I often see patients who are so stressed that they can't sleep and that's really unfortunate. When it comes to this

challenge, a personalized approach is always best. But there are things that you can do today to minimize your stress. Now one of the best ways to enhance our sleep, to manage our stress, to optimize our brain health, and our overall health is, drumroll please, exercise. You know you can't exercise your way out of a bad diet and bad sleep habits, but exercise is an essential tool for getting and staying healthy. In fact, as our experts will discuss, people who are fit actually sleep better. The American Association of Sleep Disorders has actually come out and said

that exercise is an effective way to treat sleep. Why does exercise actually affect sleep and how does it? Exercise has been shown to increase low-wave sleep. This is your deep restorative sleep phase. Exercise also decreases sleep onset, so it takes you less time to fall asleep. And lastly, exercise can just increase sleep duration, so you can sleep longer. Now I want to ask you, why do you think exercise actually helps with these things? In order to answer that question, we have to understand why

we fall asleep in the first place. So sleep onset is thought to be triggered by a decrease in core body temperature. This is our ability to thermoregulate or change our body temperatures. And exercise has a key responsibility in thermoregulation. So when we exercise, say we're exercising at 70% of our maximum capacity or 70% of our VO2 max. If we do that for about 15 to 20 minutes, we're going to increase our body temperature by two degrees Celsius. So this increase in body temperature causes vasodilation, meaning that all of the arteries veins, they dilate and they shunt blood flow to the surface of your skin. This is also why you just look flushed when you're exercising is because all the blood is rushing to the surface in order to cool off our core body temperature, which is essential. You don't want to overheat. This cool off though in core body temperature may be what

is helping us sleep at night because it's that decrease in core body temperature that we need for sleep onset. So that's one factor why exercise might actually help us sleep, but there's a bunch of other ones too. So just increasing caloric expenditure, meaning that you're using energy up more so during the day when you're exercising, so you're just more tired at night. Makes sense. The other one is that exercise is going to increase your sleep drive. So again, that sleep drive is that buildup of adenosine, which is a byproduct of the glucose or the blood sugar metabolism. So it makes us sleepier at night. So increasing sleep drive is one of the mechanisms where exercise is really promoting that sleepiness towards the end of the

day. Other things are going to be that exercise is anxiolytic, meaning that it decreases anxiety levels. And we know that anxiety is one of the key factors in insomnia. So that might be why it helps you feel more calm at night, making sleep onset a little bit easier. Now, it might not be the actual exercise that's improving your sleep, but the result of the exercise that's improving your sleep. So fitness level is now being tied to your ability to sleep and have really good sleep quality.

I want to take, for example, one study that I looked at. So this study found athletes who were no longer exercising because they were injured. So they were out of commission for a little bit, but they were still really fit, right? And what they found is that these fit subjects who were no longer exercising still had superior sleep quality compared to their non-fit counterparts. And I find this fascinating because now we're realizing that it's not just the exercise, but the results of the exercise. So it starts to ask the question, when somebody can't sleep or they have poor sleep quality,

should we be saying, are you fit enough to sleep? And this is something that we haven't talked about in medicine or in health in general, but it's one thing that I think we need to start changing the mindset around, that you actually need to have a fitness level to have really good sleep quality at night. With exercise, consistency is king. So exercising one day will likely not have any effect on your sleep at that night. But exercise over a prolonged period of time is likely to really help improve sleep quality. When it comes to exercise though,

consistency is king. So if you exercise just once and then you expect to have better sleep that night, unfortunately that usually doesn't happen. So this is over weeks or years where you get the effects of exercise on improved sleep quality. Now, one study looked at how this can influence your sleep, and they looked at an eight-week study at first at putting people into a fitness regimen. After eight weeks did not improve their sleep quality. But after 16 weeks of exercising, they found improvements in sleep duration, sleep quality, and shortened time to actually fall asleep. So again, we need to make sure that we're giving it a good shot. Three days of exercise per week for several weeks before you're actually making any judgments on whether it's helping

your sleep is really, really important. There's also too much of a good thing. So when it comes to exercise, I have a lot of athletes in my practice and I see this all the time. They think more is better and that's not the case when it comes to sleep optimization. So too much exercise can actually be detrimental to your sleep. It's believed that over two hours of high intensity exercise can decrease sleep quality. One study looked at female swimmers. These were athletes and what they found is during their highest training volume times, they had decreased sleep quality and increased sleep movements, meaning that they were moving more during their sleep and more disturbed during their sleep.

Similarly, there's been a bunch of studies on marathon runners and they see decreases in the total volume of REM sleep after that marathon. So while exercise is super important for sleep and consistency is even more important, we need to make sure we're not overdoing it. Moderation is key. So the moral of the story with exercise is that consistency is super important. We need to give it a good shot over a prolonged period of time and we need to not overdo it. So more is not always better, but moderation is really what we should be striving for. So we know that exercise is important for sleep, but what kind of exercise should we be doing? There's a few types of exercises and I want to focus on aerobic versus

resistance training. So aerobic training is that endurance training. It's going out for a long run, it's going for a swim, a bike ride, all of these things that get your heart rate up for a prolonged period of time. Resistance training is more like strength training. You're lifting weights, you're increasing your heart rate quickly, but then you're taking a break between sets. And both of these have phenomenal effects on health overall, so it's not that one is better than the other, but it looks like most of the research is on aerobic training for sleep optimization. So if you're having trouble sleeping, then this is where you might want to focus your attention. Aerobic athletes have been shown to have increased duration of slow-wave sleep. It also takes them less time to fall asleep, and they have more sleep quality.

So these are the patterns that we see with exercise in general, right? One study looked at resistance training, though, and what they found is that when they put elderly patients through a resistance training program over 10 weeks, they had them exercise and lift weights three times per week for one hour, and they found that they had a self-reported improvement in sleep quality. This just means that the participants said that they slept better, which is valid. That's actually what we're going for is that people feel like they're sleeping better. Now, does this mean that we should only be focusing on aerobic training and not resistance training? Absolutely not. We need the benefits for both of them. But if sleep is really detrimental to your health and it's the one thing that you're

working on, then I would really tell you to try to focus on aerobic training versus resistance training in the beginning. And then you can add the resistance training in once you feel comfortable with the aerobic training. The best way to start to focus on aerobic training if you've never done it before would be to start with a walk three times per week. Once you feel comfortable with a walk, then increase to a slow jog. Once you feel comfortable with a walk, then increase to a slow jog. Once you feel comfortable with a jog, now you're running. So you really want to titrate up to your comfort level and to your training level. The last thing you want to do is jump into a high intensity workout where you get injured and then you can't work out for another 16 to 20 weeks because that's going to

be more detrimental to your sleep and your overall health than anything. So start slow, start low, and increase as your comfort level progresses. We've been talking about when we eat and the importance of that. And when we exercise is very important as well. And I'm of the belief that earlier in the day is best for exercise. Now, I'll just provide a little context and caveat. Exercise when you can. But if you're doing very intense interval-based exercise, Tabata, high-intensity interval training, where you're revving up your heart rate through

the intensity, say CrossFit, for example, even Orange Theory, the earlier in the day that you do that, the better. Because, you know, look, I mean, if you look at the physiology of exercise, we're raising adrenaline, a stress hormone. We're raising noradrenaline, a stress hormone, and cortisol. Again, these are beneficial hormones in the context stress hormone. We're raising noradrenaline, a stress hormone, and cortisol. Again, these are beneficial hormones in the context of exercise. They're counterproductive to fostering deep restorative sleep. So I'm not anti-exercise at all. It's just being smart about when you exercise. And I've personally found with clients, if they exercise late in the evening, it does compromise their sleep. They tend to want to have some food after they exercise, maybe some protein. They're kind of wired. And so earlier in the day, just like with food, can be better.

And there's another advantage from a circadian rhythm standpoint of when we exercise and pushing it earlier in the day, because from a circadian biological perspective, our mitochondria, which is where we oxidize and burn a lot of our fat for fuel, are amplified from a circadian rhythm standpoint earlier in the day. Cortisol is elevated earlier in the day. And cortisol actually, I know it has kind of a mixed reputation amongst integrative doctors and practitioners, but cortisol really actually helps us pull fat from our adipose tissue and utilize that for fuel. And cortisol is going to be highest earlier in the morning. So, you know, I advise people and coach them and encourage them to just, again, make exercise

a routine first thing in the morning. You're going to drive that stimulation of the adrenal glands, which is what you want. It's not all day long. It's just temporary. It's transient. Transient stress is adaptive. It's beneficial. Chronic stress, chronic elevations of these wakefulness hormones

and stress hormones is maladaptive. And so short-term high-intensity interval training in the morning can be beneficial, again, for digestion, for gut health, for creating an appetite for food so that you're eating earlier in the day. And another benefit of early time restricted feeding is by that time you've had one or two meals, you're not really hungry for dinner. You're like, I'm good. I've had enough food. And again, the importance of those early meals is they influence the peripheral clocks. Unlike light, which influences the central clock, meal timing and exercise can influence

the peripheral clocks, which is great. So that's one of the benefits, I think, of early morning exercise. And the last benefit is most people are not having food right before they go to the gym because they've woken up, they don't have time to make breakfast and so forth. And so you're exercising in a low state and that causes you to deplete glycogen, which is stored glucose. It causes your body to preferentially burn more fat for fuel. There's been some controlled feeding studies and controlled exercise studies by a gentleman. I can't remember his first name, Akiyama in Japan.

And what he found is people that exercise fasted in the morning oxidize more fat during the day compared to people that exercise fed in the afternoon. So again, exercise when you can make it a habit consistently. But if you're trying to really optimize things for longevity, for health purposes, there could be some added benefit to doing your exercise in a fasted state in the morning. And as we've been talking about, that creates this pattern, this system. And it also creates a little bit of pressure so that you can tell yourself like, hey, I have to get off Netflix and Instagram at 10 p.m. because I have a workout in the morning I need to prep for. So it helps to foster that sleep pressure and hold yourself accountable. And especially if we

exercise with other people that I really recommend clients and everyone to do this. Exercise shouldn't be this isolated event that we do by ourselves. The more people that we can get involved with when we train, whether that's a coach, an accountability partner, your spouse, your friend, like, hey, we're meeting at the gym at 6 a.m., like, let's go. That's going to hold you accountable. And so you'll be less tempted to have that third glass of wine before bed or less tempted to watch that next episode of the Netflix series that you're into. And it'll force you to go to bed. So we got to take advantage of every little strategy that we

can because there's a lot of things going against us in this world, right? There's amazing television shows, Netflix and YouTube videos that we could be watching, audiobooks we could be reading, Kindles and all that. And so if we can piggyback off all these little tricks, I think it can help us get more deep sleep. So let's put this all that. And so if we can piggyback off all these little tricks, I think it can help us get more deep sleep. So let's put this all together. Here are some action steps from today's lesson. Number one, move your body. You should be incorporating some form of movement every single day. Ideally, you want to exercise in the morning or the afternoon and not before bed or after dinner.

But for most people, I recommend working out before dinner. Some people can't do it before two, which is optimal, but at least if it's before dinner, that's okay. Incorporate a mixture of resistance training, which is like strength training, and cardio. And one of my favorite is HIIT or high intensity interval training. High intensity interval training involves working at the very top end of our capacity for 30 to 60 seconds, and then recovering for three minutes by walking or a slow jog, and then returning to very high intensity

for another 45, 60 seconds. And don't let the short time fool you. You can see significant fitness gains very quickly because you're pushing yourself to your limit. You can do it fitness gains very quickly because you're pushing yourself to your limit. You can do it walking, running, biking, jumping rope, dancing, or even swimming. Just focus on getting your intensity up to a nine on a one to 10 scale during these intense intervals, and then allowing your system to recover as much as possible during the rest cycles. And prepare to work up a sweat. The New York Times has a great seven-minute workout

app which incorporates HIIT training. Also find something that you love to do every day and do it every day. I love to play outside. I like tennis, skiing, horseback riding, gardening. I have to spend time outside every day and as we learned it's important not only for our well-being mentally but for our circadian rhythm. Spending time outside is also a great way to boost our immune system, which we also know is important for sleep. So what do you like to do outside? Can you move your indoor workout outdoors a few times a week? Sometimes spending more time outside is as simple as going for a 15-minute walk in the morning and then in the evening. Next, make relaxation a part of your daily routine. Unfortunately,

we've come to see active relaxation as self-indulgent when in fact it's a necessary component of staying healthy. We know that your sleep is not just about how you end the day, but how you start the day. I like to do a 20-minute meditation in the morning and a quick breathing exercise at night. I like to do a 20 minute meditation in the morning and a quick breathing exercise at night. I often meditate in the afternoon as well, 20 minutes, and it seems like it's a waste of time, but actually it helps me focus, sleep better, and be better. Now, if you need some guidance, there are tons of apps out there like Calm or Headspace that you can use to guide you through different types of meditations. Here's two quick breathing exercises from our expert, Dr. Judy Hinojosa, that you could do just before bed. I'm going to teach you two

breathing techniques that I like to have my patients do. And again, you can do this throughout the day. It's not just for sleep. If you do them throughout the day, you're prepping your body to go from the fight, flight, freeze to rest. So you're getting from the yin and yang the yin being the calming space so the first one is called um it is often both practices are practiced in yoga and meditation practices so the first one is called four seven eight breathing technique and the four seven eight breathing technique is a form of breath that involves, I'm going to walk you through it, involves a couple steps. It's pretty easy. So what you're doing is you're going to breathe. Before you start taking the breath in, you're going to empty out what's already there.

So the whole point of this breath is to activate the diaphragm. The diaphragm is the location right here. It's an organ that lives right on top of the intestinal tract. And when we're breathing, when we're doing deep belly breathing, we're moving the diaphragm. We're expanding the diaphragm. So doing belly breathing, when we say belly breathing is an expansion of the diaphragm, a type of breath that doesn't just sit on the chest. If we just do chest breathing, we're not activating the diaphragm. And the diaphragm is important to activate because it stimulates the vagus nerve.

So if we don't stimulate that vagus nerve, the adrenals are going to feel stressed. So think of it as the vagus nerve massaging your adrenals. So every time you do this type of breath, you're massaging the adrenals so they can calm and relax. So you're having a little bit of an internal massage. So the vagus nerve wants to be stimulated when we do belly breath, which is the diaphragm. But so the 4-7-8 breathing is what you start with is you're going to first take all the air out and you're going to breathe out through your mouth. And by breathing out through your mouth, you're going to force out through your mouth and by breathing out through your mouth you're going to force that air you're activating the diaphragm so i'll show you the first breath so you're going to take all the breath out so you put the pressure and you're

breathing out all the air is out once all the air is out you're going to breathe in and as we do this i advise my patients to close their eyes. Of course, be sitting somewhere comfortable. Don't be doing this when you're driving. Close your eyes. And then when you breathe, count to four. And as you're breathing, I want my patients to envision the breath coming right in between their eyes. So as you take a deep breath, you're going to count to four. And the breath goes up right into here. You count to four and then you hold it for seven. So you're going to hold seven seconds.

And as you're breathing in, try to put the tip of the tongue on top of the roof of your mouth. So as you take the breath in, count to four seconds, and you hold it for seven. And by doing that pause, by holding for seven, you're bringing that oxygen to the brain, you're exogenating the brain. And then you're going to breathe the air out. And you're going to breathe down on eight, but you're going to breathe it out through your mouth. So then we're going to actively diaphragm. So you're bringing the air. And by doing the longer breath out, so you're going to actually slow down your nervous system. So the quick breath in, holding of the breath and breath out allows your diaphragm to be expanded. But the slow breath out when we have longer exhales calms down our central nervous system. That's really important. If patients don't do the four, seven, eight, just the simple act of breathing out slowly and steady and control calms down our nervous system.

But through this breath, I'll run you through it now. So it's four seconds. And then you hold it for seven. And then you breathe it out through your mouth. And you count to eight. But you want to breathe it out and get all that air out. And when you're breathing in, expand your abdomen at the same time. So you want to breathe in with expansion of the abdomen and breathing out through your mouth. And all you need to do is four cycles of that.

So get in a very comfortable space, no tight clothing, where you can really expand that abdomen and the diaphragm. But by doing this breath, you can do this twice a day for four cycles. If you're under a lot of stress, you can do it. But before bedtime, definitely do an hour before bedtime, 30 minutes before bedtime. But do it somewhere in the day as well. So your body gets that resetting and that messenger of clean air, fresh breath to activate the vagus nerve and slow down the central nervous system. If patients can't, if they wake up in the middle of the night,

instead of doing the 4-7-8, I have them just breathe in and breathe out by always the breath out, count it twice. So you can do a 4, 8. So breathing four seconds and slowly let it out on eight seconds. And in the middle of the night, if the body just is awake, the brain is awake, just reminding ourselves. I like to tell my patients, remind that this is a perfect opportunity to breathe. This is a perfect opportunity to meditate. This is when your body is awake at night. Just bring the breath in. Bring the breath. And as you do the breath, four in, eight out, it will calm your central nervous system.

And you can count as you're counting and counting out. Your mind will disengage on the thinking. It's going to focus solely. Your attention is going to go. All the awareness is on the breath. You're watching the breath. You're watching the breath out and you're counting. And the mind is no longer engaged because when we wake up in the middle of the night,

we're anxious, we're thinking, the mind can't stop. And this is a very simple technique. If I wake up in the middle of the night and I can't fall back to sleep, I'll just remind myself this is a perfect opportunity for me to breathe. I'm just going to do this breath and with no expectation or attachment, tell yourself, I'll just breathe for as long as I need to. It's great for my nervous system. It's great for my vagus nerve. It's great for my brain. I'm just going to breathe right now. And within a minute or two, you'll probably be falling asleep already.

It's taking the expectation and the stress off, I can't sleep. So the 478 is a great breath technique. The other one is the alternating of the nostrils breath. The alternating of the nostrils is also a very simple technique where, again, you do it it for you can do it for two minutes but you're bringing air in through one nostril so you cover one nostril as you bring out and then you let the air out so you can use the right what is easier to do use the right thumb to cover the right nostril layer air comes in and you can count to six seconds and then layer goes out through the other nostril. So you're just literally covering back and forth the nostrils. And if you do maybe a round of 10, you're bringing air up in the brain is really good to activate the oxygen into the brain,

which allow what it does by doing the taking turns on the right and left. It allows for both hemispheres of the brain to become in balance. And when the hemispheres are in balance, the brain is easier to go into rest at night. So it's a great breath that you can do throughout the day. This is something you don't have to close your eyes. I will do it maybe in between patients. I try to practice doing that type of breath to calm my central nervous system. And that's the importance of doing something throughout the day so it's easier to fall asleep at night. So the alternating breath is very easy to do. Just bring the breath in, bring one in, one nostril out, both parts of the brain will be activated.

Another way to relax before bed is to take time to connect with people in your home. My wife and I like to play backgammon. We like to chat and catch up, just hang out and chill together or read a book. Sometimes when it's nice out, we go for a long walk around the city or around our house in the country. And one of my favorite ways to relax is with an Epsom salt bath before bed. That really helps you sleep. And if you put some lavender drops in it, it lowers your cortisol and helps you sleep even more. Remember, yang energy in Chinese medicine is all about doing, doing, doing.

It's all about activity and focus. Most of us spend too much time in the yang energy. And we need more time in yin energy, which is soft and relaxed. If you're in go mode all day long, no wonder it's hard to calm down at night. I promise you that if you prioritize relaxation and you tap into yin energy for at least a few hours each day, your body and your mind and your sleep will thank you. For me, I'm always trying to understand. I take so much time to not just ask about sleep, sleep, sleep, sleep. I want to know you. I want to know who is this person that cannot fall asleep. Because falling asleep has a lot to do with letting go of control. You literally have to become unconscious. You literally have to let go of everything in your life, your kids, your plans, your job, your money issues, whatever is going on in your life. For seven hours, five hours, 10 hours, you have to completely let go. So control might be an issue that I might address with some patients, you know, how,

how good are they at letting go of the past or literally letting go of things and wanting to be in control. But looking at myself, I remember when I had this incident when someone broke up with me. My heart was broken. I was shattered into pieces. I literally remember feeling like I was all over the room. I was in bed but couldn't fall asleep. I couldn't get out of my bed, low motivation. I actually lost all my appetite, lost weight.

And when I went later back into India for a yoga training retreat, one of the mentors there, you know, I remember having asking them if they had something to help me sleep. And he was a beautiful spiritual guru. I think he was almost 100 years old, you know, doing headstands every day. And he said, don't suppress the pain. There's a reason why you're not sleeping. You have to stay up and actually feel what your mind is going through. And I thought, oh my God, what's this guy saying? He obviously hasn't had insomnia and doesn't know how hard it is and how bad it is. But honestly, it's probably the best advice I got with sleep because it was still at my beginning stages of the grief you know and I was unable to sleep and I knew why because before then I

slept okay it wasn't like as a kid I had a sleeping disorder and so often I encourage this in individuals I say sometimes people wake up at 2 or 3 and I remember Wayne Dyer saying that's when he wrote all his books you know sometimes it's not what we think it is, you know, and there's even research showing people who had a negative outlook on insomnia, thinking that if they don't fall asleep, or they wake up, that they're more predisposed to disease, they actually got more sick than the people who were okay with themselves waking up at three, going into another room, reading something,

getting sleepy, coming back into bed. And so I think it's important to remember that don't objectify and attach to this disorder. If you've been diagnosed with insomnia, or everything I said right now kind of freaked you out and go and you're like, Oh my god, I have all those things. Okay, great. Put that aside. Go back to you, you know, you, you know what you feel. And it's often from a mental, emotional, spiritual disharmony that is making you not able to do something that's so natural. It is the most natural. It's just like breathing, right? So if you can't do it, there's a reason for it. So address that, you know So if you can't do it, there's a reason for it. So address that, you know, and you can start with cognitive behavioral therapy. You can start with even

finding a counselor or meditation or spiritual or someone who can help you understand you better and not band-aiding it because we already know in medicine that those don't even work, you know, and they have so many other side effects. So I highly encourage people to care enough about themselves to not start themselves on that bandwagon of the Zolpidem and the Ambien and the Xanax and all these medications. Because I see 20 years later, some of these people, I cannot help them. They cannot come off some of these things because it has messed up their brain. And now I have five other things that I have to fix.

And so I always encourage, see this in your kids. If you're starting to see they have anxiety, they have depression, or, you know, I asked my daughter who can't fall asleep what it feels like because she's learning about the word anxious. And I always say, I'm six years old. I don't understand what that word is. What do you feel? And she'll say, I feel this inside, you know, and I feel like we forget to use sensations. And so I've helped her with magnesium, you know, but just getting this to come out through art and music and getting her climbing, getting her to use this energy. And

we'll say it like how much of this is happening right now, you know, but I'm teaching her to be in tune with what she truly feels on an energetic sensation level. Instead of I have anxiety, I have a mood disorder, I have depression. What does that mean? What do you actually have? You might have sadness, you might have anger, you might have rage inside, you might feel betrayed, you might feel something. And you can't let go of that you're upset about it. And that's making your cortisol and melatonin and serotonin and all these fancy things that we say doctors go up and down. But if no one's helping you address that, and we are even just looking at, you know, all these root causes, but that is the root cause, and it often is, then we're missing the whole picture. And we're just using, you know, these supplements and herbs to help you. But I encourage you to look at that and

say, you know what, there is pain here, and I want to address it. I want to see me not being able to sleep. If it is coming from that, that I want to go through it so that I can come out of it. And I can't tell you, yes, I didn't sleep for those nights and it was painful. But I have now experienced insomnia on a whole other level. I'm glad and I can help other people from it. But I also understood on a spiritual level when I am not able to express an emotion and I hold it in, it goes somewhere. It affects something.

It comes up as a symptom. And as a doctor, I encourage patients to feel free and give themselves permission to feel their pain, to feel what they're feeling and the cause of not being able to let go at night. Because nighttime is the most vulnerable time. So you will feel whatever you've been holding in and trying to not show to the rest of the world. That is a time where your body is like, okay, we can't hide it anymore because now we've got to let go and we are not letting go. So yeah, looking at perfectionism,

tendencies for OCD. I mean, all these words I don't like to use, but a lot of my patients will resonate, you know, that they like things a certain way, that they worry about their kids health, they worry about certain things, they worry about their lab numbers, they want to get their microbiome tested, they want to get everything tested. So sometimes they'll come in with a binder of lab tests done with previous doctors. I already know this patient doesn't get good sleep just from that alone, right? Because it has to do with control. Like what is health to you? And what does it mean if you do find something wrong? Well, it's because you want to fix it. And in life, probably something happened to them that they couldn't fix.

They were out of control. And now they're compensating in the daytime. And guess what? In the nighttime, we'll remind them. The yin in them will remind them. The time where they get their period, which is your most yin time, will remind them of their true emotions. And I hate when we keep labeling people with

PMS and mood disorder, it's hormonal. No, sometimes you are supposed to be fatigued during the first day when you're bleeding. You're supposed to feel something during ovulation. You're supposed to have a shift. Being female is amazing because we have this report card every month that reminds us of how we did last month and these emotions you know back in iran there are homes that my grandparents that is made out of clay and it's true it was tradition that women would go into these areas only when they had their period so that they could be around that energy and really go in, go inward, go yin at nighttime. And they would just sleep, they would oversleep to restore their body so that then they can get ready, you know, ready for ovulation to conceive. And so it's

amazing how sleep was used very differently than like the sort of mechanical way that we use it, they slept more during their periods. And that is normal. And that's healthy. Whereas now people come to me, they're like, I'm so tired, you know, I have my period, and I'm going to the gym. And, and I'm like, but you're not listening to your body. There's a reason you're tired, you know, your your uterus is like working so much right now getting rid of all this blood and you're pumping that blood to the periphery and trying to exercise. And then you're exhausted, you know, so you might need more sleep during the first couple of days of your period of the day before. It should never be to the point where you're a whole other person, you know, so sometimes there is true PMDD, which

is the PMS is very severe, and sometimes it's from progesterone deficiency. And they'll say, I have insomnia the week before my period. I don't sleep well. I'm restless. I'm tired. So that's different. But being more emotional around your cycle, there's nothing wrong with that. That's actually a great time for you to go in.

And same at nighttime. It's a great time to journal, it's a great time to be still with your mind. So I encourage that sort of five minute in the morning to, you know, make yourself the ritual of having a tea or coffee or whatever it is. It's not about the thing you're drinking. It's the ritual, being aware of your breath, your diaphragm. So remember I said during sleep, the only muscle that is awake and working is your diaphragm and your eyes during that rapid eye movement. And how many of us don't even know how to breathe?

Our diaphragm is stuck. Literally, I'll palpate here and it's like everyone's like, ow, ow. And it's because it's got the fascia there is so tight. We are not using that diaphragm to breathe like a baby, like in and out, in and out. And it's because it's got the fascia there is so tight. We are not using that diaphragm to breathe like a baby, like in and out, in and out. So at nighttime, during the daytime, in the middle of the day, those are times you want to prep for sleep. If you've got sleep issues, start with your morning. Get a puppy, get a dog so it forces you to take them for a walk and get that sunlight in your eye.

If you don't have sunlight and it's gray, you might get an artificial light that actually stimulates light. So your sleep is all to do with the light that you get throughout the day. Try to take a break throughout the day to check in with your diaphragm and your breathing. Check in at nighttime with your breathing, checking at nighttime with your breathing, have an unwind hour before bedtime where, you know, you are using something to relax you and help you fall asleep, but that will also help you stay asleep. Thanks for joining us in this lesson. In our next lesson, I'm going to share my favorite supplements, tools, and gadgets to enhance your sleep. I'll see you there.

Hey everybody, it's Dr. Hyman. Thanks for tuning into The Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introducing you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter and in it, I share my favorite stuff from foods to supplements to gadgets to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health and I'd love you to sign up for the weekly newsletter.

I'll only send it to you once a week on Fridays. Nothing else, I promise. And all you have to do is go to drhyman.com forward slash pics to sign up. That's drhyman.com forward slash pics, P-I-C-K-S, and sign up for the newsletter, and I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger longer. Hi, everyone. I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. and better and live younger, longer. advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and

search their find a practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner and can help you make changes, especially when it comes to your health.