The Dr. Hyman Show - Why You Crave Carbs When You're Tired And How To Improve Sleep

Episode Date: January 15, 2024

View the Show Notes For This Episode Get Free Weekly Health Tips from Dr. Hyman Sign Up for Dr. Hyman’s Weekly Longevity Journal Get Ad-free Episodes & Dr. Hyman+ Audio Exclusives In today’s episode, I talk with Shawn Stevenson, Dr. Todd LePine, Dr. Andrew Huberman, and Dr. Cindy Geyer about the value of sleep and the basics of sleep hygiene. Shawn Stevenson is the author of the international bestselling book Sleep Smarter and creator of The Model Health Show, featured as the #1 health podcast in the U.S. with millions of downloads each year. A graduate of the University of Missouri–St. Louis, Shawn studied business, biology, and nutritional science, and went on to found Advanced Integrative Health Alliance, a company that provides wellness services for individuals and organizations worldwide. Dr. Todd LePine graduated from Dartmouth Medical School and is Board Certified in Internal Medicine, specializing in Integrative Functional Medicine. He is an Institute for Functional Medicine Certified Practitioner. Prior to joining The UltraWellness Center, he worked as a physician at Canyon Ranch in Lenox, MA, for 10 years. Dr. LePine’s focus at The UltraWellness Center is to help his patients achieve optimal health and vitality by restoring the natural balance to both the mind and the body. Dr. Andrew Huberman is a McKnight Foundation and Pew Foundation Fellow and was awarded the Cogan Award in 2017, which is given to the scientist making the largest discoveries in the study of vision. His lab’s most recent work focuses on the influence of vision and respiration on human performance and brain states such as fear and courage. Work from the Huberman Laboratory at Stanford University School of Medicine has been published in top journals including Nature, Science, and Cell and has been featured in TIME, BBC, Scientific American, Discover, and other top media outlets. Dr. Cindy Geyer received her Bachelor of Science and her Doctor of Medicine degrees, with honors, from the Ohio State University. She completed residency in internal medicine at Strong Memorial Hospital in Rochester, N.Y. and is triple board certified in internal medicine, integrative medicine, and lifestyle medicine. She joined The UltraWellness Center in 2021 after practicing and serving as the medical director at Canyon Ranch for 23 years. This episode is brought to you by Rupa Health, AG1, and Sweetgreen. Streamline your lab orders with Rupa Health. Access more than 3,000 specialty lab tests and register for a FREE live demo at RupaHealth.com. Head to DrinkAG1.com/Hyman and get 10 FREE travel packs and a FREE Welcome Kit with your first order. Check out your nearest Sweetgreen or go to Sweetgreen.com to learn more.

Coming up on this week's episode of The Doctor's Pharmacy, sleep may be the fundamental foundation of health and disease prevention and even weight control. Hey everyone, it's Dr. Mark. Now I know there are a ton of functional medicine practitioners who listen to this podcast and I want to ask you a question. Are you tired of wasting valuable time on complex lab ordering procedures? If so, I got fantastic news for you. Rupa Health has revolutionized the process for ordering labs and in just just a few clicks, you can access over 3000 tests from over 35 companies, all in one convenient portal. Plus Rupa Health ensures that you pay only one invoice for all your tests, making everything simpler and more efficient. No more juggling multiple invoices or

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Hi, this is Lauren, one of the producers of The Doctor's Pharmacy podcast. Sleep is one of our most basic human needs, yet millions of Americans suffer from insomnia or get insufficient sleep. Thankfully, there are many ways to get your own sleep hygiene on track, which will improve every aspect of your health. In today's episode, we feature five conversations from the doctor's pharmacy about how sleep affects all the systems in your body and strategies to improve overall sleep quality. To start, Dr. Hyman speaks about the basics of sleep hygiene. He then speaks with Shawn Stevenson about sleep cycles and how to improve your sleep, with Dr. Todd Lepine about how blue light suppresses melatonin, with Dr. Andrew Huberman about the importance of honoring circadian rhythm, and finally with Dr.

Cindy Geyer about practical tips to improve your sleep environment. Let's jump in. So we know that poor sleep makes us less productive. It makes us tired, hard to focus. Basically, having sleep deprivation is basically equivalent to being drunk in terms of your performance. You know, I read a study once where there were snipers who were excellent shots and that they had eight hours sleep. They were like 100 percent accurate. If they had seven hours sleep, they were like 95 percent accurate. If they had six hours sleep, they were like 95% accurate. If they had six hours sleep, they were like 70% accurate. And if they were like less than six hours sleep, they were basically like 50%. It's like almost a hit and miss. So not good. Even when you're an expert in something,

you can't function when you're tired. So next to sort of nutrition exercise, and maybe even before it's somewhat argue sleep, maybe the fundamental foundation of health and disease prevention and even weight control. So why is it so important? How does sleep dysfunction lead to changes? Well, there's a very important hormone called cortisol, which is your stress hormone. And it helps when it's imbalanced to go up in the morning to get you energetic and focused and do the things you need to do for the day. And at night, it's imbalanced to go up in the morning to get you energetic and focused and do the things you need to do for the day and at night it's supposed to go down and you're supposed to calm down and relax now a lot of people have an inversion where their cortisol is low in the morning they can't get out of bed and at night they're tired and wired sound familiar i bet you

some big experience that i certainly have at different moments in my life when you get down in bed you're exhausted but you can't fall asleep because you're just wired that's to do with your adrenal glands and they they're designed to keep things in balance to regulate your weight to moderate your stress response to control blood sugar regulate inflammation and regulate sleep and wake cycles so when we're constantly in a state of stress where we're actually often struggling with sleep because of the way in which it affects our sleep. So when you're thinking about it, when your cortisol is high, you're running from a tiger, you're in danger, you don't want to be sleeping, you want to be alert.

And that's the problem. So if your cortisol levels are balanced and they're high in the morning and then low at night, and your blood sugar stays even, we'll talk about why that's important. Because fluctuations in blood sugar often will cause midnight or middle of the night awakening. But when your cortisol and your body stress response are balanced, then your pineal gland produces something called melatonin that pulses really strong in the afternoon and the evening, which gets you ready for sleep and lets your cortisol drop off. And then you can feel calm and go to sleep at night and feel sleepy. And if you're healthy and balanced

in your circadian rhythms and your cortisol melatonin cycles, you'll be fine. But if your cortisol is high in the afternoon or high in the evening, you might feel tired and wired. You want to sleep, but you can't. Or you might fall asleep because you're really tired. And then you wake up in the middle of the night, like between one and four. And that happens when you sort of go, go, go, go, go, do your email, you're working, working, working and busy. And then you go to bed and you fall asleep because you're exhausted. But you end up waking up because your body is still in a stress state.

There's still high levels of cortisol. So how does stress affect your sleep-wake cycles? Well, it works in a lot of different ways. Psychological stress can be a big factor, right? Worries about family, work, money, physical stresses, lack of exercise is a stress, believe it or not, too much screen time, junk food, toxic lifestyles, hormonal imbalances, environmental toxins, all these drive increased inflammation, increased brain inflammation, and also increased cortisol. Because by the way, do you know this? That when you eat sugar or starch, your body responds by jerking up the adrenaline and cortisol levels. So literally eating sugar is a stressful experience to your body.

Even if you're getting pleasure and you don't think it's stressful and you're meditating while you're eating sugar, you're still going to have high cortisol and high adrenaline. So what are the things that are the two most common things that are screwing up your sleep wake cycles? It's probably blood sugar imbalances and spikes and crashes in blood sugar and chronic stress. So what should you do to optimize nutrition so you can regulate your stress hormones through food and lifestyle? And how do you deal with actually regulating sleep throughout the whole night and get high quality sleep? So first thing is our bodies, whether we

like it or not, are biological organisms and they run in circadian rhythms and they need to be balanced. So you have to live in rhythm. I experienced the dangers of not being in rhythm when I worked in the emergency room. I would sometimes work a seven in the morning till five at night shift. Then I'd work at two in the afternoon till the two in the morning shift. Then I'd work at 11 o'clock at night to a seven in the morning shift. Then I'd work at two in the afternoon until the two in the morning shift. Then I'd work at 11 o'clock at night to a seven in the morning shift. Then I'd work an eight in the morning to an eight in the morning shift, 24 hour shift.

I was all over the place. And my whole system became dysregulated. And ultimately it led to chronic fatigue syndrome and a bunch of other stuff. My system just kind of collapsed because I was pushing through all these circadian rhythms, which have to be in balance for you to be healthy. And whether we like it or not, we tend to be in balance for you to be healthy.

And whether we like it or not, we tend to do a lot better from our health perspective if we go to bed at the same time, if we wake at the same time, if we eat at the same time. Our bodies are designed like that. So you wanna make sure that you actually don't eat before bed because that's the worst thing you can do.

But you need to make sure you're having meals during a regular time space. So don't eat three bed because that's the worst thing you can do, but you need to make sure you're having meals during a regular time space. So don't eat three hours before bed. Don't eat a heavy meal before bed because I guarantee you that'll screw up your sleep. Also carbohydrates. I think if you want to actually eat some starchy things like sweet potatoes or some more starchy foods and you can handle it metabolically, make sure you do it at night because the serotonin levels go up and it helps with sleep when you have your carbohydrates. But still don't eat white flour, sugar, all that processed food. Also, not eating enough is stressful. If your body's not getting enough food, it's also considered a stress.

Now, you can do time-restricted eating and you can sort of narrow the window in which you eat for longevity purposes and so on. But you also want to make sure you're getting enough food and not actually starving because that will increase cortisol and you'll wake in the middle of the night. Now, if you want to lose weight, you can use what I think is probably the most effective treatment I've ever found, which is the 10-day detox diet. It helped people lose 120, 130, 200 pounds. It's like a gastric bypass without the pain of surgery, vomiting, and malnutrition. Another thing you can do is get stuff out of your head. Write your worries down at night. So get a little piece of paper or journal or maybe in your phone. write down all your worries, what you have to do,

your days should be organized for the next day. Free up your mind so you can actually let go of things and go into a deep, restful sleep. Next, you can try a number of supplements and things that I found very helpful. Magnesium is super important. It's the relaxation mineral. It helps regulate the stress response, helps to regulate cortisol cortisol helps relax your muscles i recommend two to four hundred even more of magnesium glycinate before bed glycine also helps with sleep so you can use glycine and you can use that to help relax the nervous system and your and your muscles uh next try some melatonin mellow out with a little melatonin you can use half to up to two to three milligrams of melatonin at night, and that can often help you reset your circadian rhythms, particularly with travel.

Also, ashwagandha is an Ayurvedic herb that can be really powerful for resetting cortisol. I use a product called Cortisol Manager, which helps at night to reduce the stress response and improve sleep quality. Also, make sure, as I said, to get in rhythm, you know, where you can sleep at the same time. Try to go to sleep before 10. That's the best sleep you can have is before midnight, believe it or not. So get in bed by 10, try to be asleep shortly thereafter, 11 at the latest, try to wake up at the same time every day. Also make your bedroom completely sleep supportive. For example, make sure you have eye shades or blackout shades on your windows

or eye shades on your eyes, earplugs if it's noisy. Make sure you really take care of creating a carefully controlled environment. Next is caffeine. Some is tolerated okay and metabolize it, others don't. So I encourage you to sort of maybe stop after breakfast, coffee, don't have coffee throughout the day. That's particularly important.

If you're still struggling, I would probably just stop coffee and caffeine altogether. Alcohol definitely screws up sleep. So if you want to sleep well and you're not sleeping well, quit alcohol, just get off it. It can interrupt sleep and creates poor sleep quality. Also sunlight is basically great medicine. You know what I mean?

Sunlight, I'm going to go to sleep. No, but 20 minutes of sunlight in the morning without sunglasses on, outdoors, not behind a window, has a big effect on your circadian rhythm. So we are photobiomodulating organisms. The light affects us. It regulates our biology. And it's important to make sure you have a good 20 minutes of light exposure in the morning. Sleep is a very strange phenomenon. We don't even have a definition for what it really is,

but with science, we can see, we know when we're sleeping because there's a change in your brain waves. Deep sleep and light sleep and REM sleep. Exactly. We go from just a normal waking state right now, we're in beta and get into some gamma as well. And then we transition to alpha, theta, and the deep delta sleep. And so all of those sleep cycles are correlated with different processes, hormones, release, neurotransmitters in the body. And our key, it's not necessarily how many hours of sleep you get. It's really the quality of those hours because you can sleep for eight or nine hours and wake up feeling like a trash, you know, like a dumpster juice or whatever. And I don't know where that even came from, but you can feel terrible because you're not actually getting efficient sleep

cycles. And so that's what I focus on is how can we ensure that we're getting quality sleep? And for a lot of people, they can potentially sleep six hours and sleep better than folks that are getting nine. Yeah. And the truth is we've sleeping about two hours less than we did a hundred years ago per night. And that is interesting stat. And also the quality of sleep is terrible. And tens of millions of Americans have sleep problems. And it's something that we don't really deal with very well in medicine. We say, Oh, take Ambien or take Ativan or take Xanax or whatever. And those have serious consequences and they reduce the quality of your life. They increase mortality.

They increase the likelihood of cognitive impairment and cognitive dysfunction, dementia. I mean, these are real issues where people are dependent on these pills. So how do we get from our sleep deprived and disrupted sleep culture, what's causing it to fixing it? That's such a great question.

You know, today more than ever, there's a epidemic for sure with sleep deprivation. Hmm. That's such a great question. You know, today more than ever, there is, there's a epidemic for sure with sleep deprivation and we're seeing this show its face in so many different areas. I think the first step is actually understanding the value of sleep. And so for example, you know, real talk, nobody's waking up in the morning, like, you know what, I want to look terrible today. You know, to look good and if we understood just how much our sleep quality and affected our body composition I think it would start to push that conversation forward so there was a really cool study I was done so

sleep and weight are connected oh my goodness University of Chicago did a really fascinating study so they took folks and they put them on a calorie-restricted diet which is what I was taught to do in a university setting, which doesn't necessarily work, by the way. Exactly. But they put them on this calorie-restricted diet. And during one phase of the study, they allowed them to get eight and a half hours of sleep, so sufficient sleep. Another phase of the study, same people, same exact diet. They're not cutting any more calories.

They're not exercising more or less and now they sleep deprive them so now they're getting five and a half hours of sleep they take three hours away at the end of the study they compiled all the data and they found that when folks were getting a sufficient amount of sleep they lost 55 percent more body fat just from sleeping yeah right and i didn't say weight they lost lost actual fat mass. Not muscle. Which is crazy. I'm not saying you're doing eight days a week CrossFit. You're just sleeping better. And the question for me is immediately, oh my goodness, how?

How is that happening? And so it's during sleep that we release, this is crazy, melatonin. This super glorified sleep hormone, which it really isn't that it's kind of a regulator of your circadian rhythms period but it actually is a really profound fat burning hormone as well so the journal of pineal research found that melatonin that's that gland in your head that releases melatonin it's like pineal gland correct which that's not the only place so we'll get back to that in a moment it's like your third eye gland basically so the pineal gland and it responds to

light and you know all the artificial light and the fact it suppresses it it has to have darkness right so the journal pineal research found that melatonin increases your mobilization of something called brown adipose tissue or brown fat and this is a type of fat that actually burns fat. That increases your metabolism. Yes. And the reason it's brown versus the white adipose tissue is kind of the stuff we think about when we're trying to get rid of fat. Brown adipose tissue is brown because it's so dense in mitochondria, right?

These kind of energy power plants. I know you've talked about many times on the show, but it's such a metabolically active tissue. And so if you're not getting adequate sleep, you're not producing that hormone, nor you get your greatest secretion of human growth hormone during sleep. And this is the most, it's also known as the youth hormone in a way. It's the repair hormone. Kids have so much HGH. This is why they have so much energy. It's muscle sparing. And also it's a big component of you healing and recovering. And so you're missing out on that. And cortisol, that's another one. So if you're sleep deprived,

one of the very first things we see is an increase in your cortisol levels. That's the stress hormone. Exactly. Exactly. And cortisol has this interesting ability to literally break down the muscle that you're working so hard to build. It's terrible. Gluconeogenesis, a process called gluconeoneogenesis break down your valuable muscle tissue and turn it into fuel because it's this stressed hyper alert cautious dangerous state your body thinks you're in because you're sleep deprived and i can go on and on i'll show them share one more stuff for the i always

say stress is is is bad because when you have high cortisol it does everything you don't want right it shrinks your memory center your your brain, causes Alzheimer's. It causes you to lose muscle and gain fat. It causes your sex hormones to get screwy. It has so many horrible effects. And it's not worth getting stressed about stuff. Yeah. It doesn't matter.

You know, like stuff, there's stuff that does matter that you have to worry about. But the truth is most of the things we react to and stress about are just our beliefs or thoughts. They're not really real, right? Yeah, that's it. And I even focused on that as well because a lot of folks have what we call clinically just a lot of inner chatter. Hey, everyone. Dr. Mark here. One of the big problems with our food system is that most Americans are getting their vegetables in the form of french fries and ketchup.

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It's great food and I love that it's better for the planet and better for our health. We could use more Sweetgreens in the world. So check out Urinary Sweetgreen or go to sweetgreen.com and use the code MARK5 to get $5 off your first order after signing up. And now let's get back to this week's episode of The Doctor's Pharmacy. You know, the brain is a very vocal and kind of noisy organ, you know? And so the great thing is a lot of our needs are met, especially if people are listening to this right now. It's like the crazy ant that lives in your head, you know? Right.

Right. But we have so many things covered in our lives that our ancestors didn't have to worry about. But the human mind is so expansive, so we can manufacture things to worry about. And that worry can push us. And I often tell people, you know, when people come into my clinic, that you can overeat your way fat you can under exercise your way fat or under move your way fat you can under sleep your way fat and you can also overstress your way fat for sure it has a huge component for our overall health and our body composition too so but i was going to share stanford university yeah they found that just one night of sleep deprivation has a dramatic effect on suppressing leptin.

Yeah. Right? And that's that kind of glorified hunger hormone. To make people fall. I mean, I'm sorry, satiation hormone. And ghrelin on the other side has this uptick. And that's that hunger hormone. Right?

So just one night. And it makes you crave a ton of carbs. I want to ask you this. I was going to say, I know you've been up late before but I don't know if it's me or if anybody else listening have you ever been up at like 2 o'clock in the evening maybe at a party maybe just kicking back watching TV

and you're like you know what I really want a salad right now nope if that's ever happened please inform me I don't get a craving for broccoli I want salty sweet sweet, crunchy. Carbs. Yes. Yes.

Because your brain is literally starving for glucose. Just one night of sleep deprivation, we're seeing about a 14% reduction in glucose reaching your brain. Yeah. I know it's true. I remember working many nights in the emergency room, delivering babies, being up all night. And the next day, all you want to do is eat carbs and sugar. I'd go to McDonald's and get the apple turnovers and the french fries like the middle of the night it was the only thing

was open in the hospital so between it was only closed between two in the morning and six in the morning otherwise it was open 20 hours a day it was the only thing open in the hospital can you leave it and i would go you know be sleep deprived and stay up all night and i i totally craved carbs wow and you did that work on that food and now what you're made of now and the work that you're doing is just like exponential like you see that i thought about this the other day we're putting folks in space on vending machine consciousness right astronaut just imagine if we can get people on really healthy real food and what we can create as humanity it's exciting so what's exciting about

your book about sleep is that you you break it down you talk about 21 strategies that are very specific to actually fix your sleep yeah because i'm sure many people listening maybe even half or more have sleep issues whether it's not enough sleep whether it's disrupted sleep whether it's poor quality sleep or the more serious things like sleepnea, people often don't know they have it. So can you walk us through some of the key strategies and what really matters? Sure. So I've been really working to press this into public awareness for about five years now. And this was because seeing people in my office coming in and they're struggling with their blood sugar, for example. And we had about right around 75% success rate with, you know, getting folks off, you know, lisinopril and metformins and all this and working along with their doctors. Those are blood sugar and

blood pressure pills, right? Yeah. And here's the thing, that 25% of folks who weren't getting those results, ironically, that would really bother me. And I know you've probably felt the same thing. Oh, yeah. Yeah. Ironically, kind of keep me up at night. It's that 20%. What are you missing? And so it took about five years in practice, maybe a little longer before I had the audacity to ask, how was your sleep? And what people would tell me blew my mind. I couldn't believe they're even sitting there. And this is another thing that we know is that folks don't really want to change too much to get the result they want. And I knew knew that and so I just dug into the research and I wanted to find

Clinically proven strategies that people don't have to turn their world upside down And once I implemented those with the patients I was working with It's the like the floodgates would come off. The weight would finally come off. Their blood pressure would finally come down Their symptoms of depression would start to dissolve and And I was just like, this is really something special. I need to tell more people about this. And so eventually it's compiled into these 21 strategies. And for me, again, some of these things are going to be a reminder for folks today, but I want to talk about something that a lot of folks still don't have a big awareness of. And this is the fact that your gut and the health of your microbiome

has a huge impact on your sleep quality so your poop and sleep are connected what a concept in a way okay let's dig into that one don't do the two together no that's you know that's gonna blow people's mind and even my mind tell us how the microbiome and your gut affects your sleep and what you can do about it absolutely so let's start with a basic component. And I know, again, these are going to be things people have heard about before probably on your show. But let's start with serotonin. Okay. So it's pretty well known.

And by the way, there's more serotonin in your gut than there is in your brain. Exactly. Upwards of 80% to 90% of your body's serotonin is actually located in your gut, produced by your enterochromaffin cells, by the way. Those are special cells in your gut produced by your enterochromaffin cells by the way all right so those are those are special cells in your intestinal lining yes now i'm just translating all the big words see i like that we're like flipping places because i would do this for you so here's what's so interesting is that serotonin we talked about melatonin being important for our sleep in our circadian rhythm serotonin is a precursor or a seed to make melatonin.

So already right off the bat, your gut environment, these cells in your gut are helping to make this compound that's related to your sleep quality. And with melatonin, it's what I want to liken it to. It's like that manual gear shifter for you to go through your sleep cycles properly and to actually get recovered. You need melatonin to be produced. And we'll come back to that. So that's number one, serotonin. And you can't just take melatonin? I'll answer that in a moment. That's tricky. So, well, I'll just tell you. So I looked around because some of our colleagues would feel that, and this was just a theory, that if you take supplemental melatonin, it's going to reduce

your body's ability to produce it itself and that's actually i couldn't find that anywhere there was no evidence of that what i did find was taking supplemental melatonin taking too much or too frequently can down regulate receptor sites for melatonin uh-huh so your body can still produce it but the receptor sites that actually do something with the melatonin. So your body can still produce it, but the receptor sites that actually do something with the melatonin can get downregulated. So the key is there, but the lock isn't. Yeah. So we do need to be mindful of that and we can come back and talk about that. But here's the biggest, probably aha moment, hopefully of this episode is that it's not just serotonin that's producing the gut. And so check this out. And I just came across this.

I'm going to share this with you today this was in the world journal of gastroenterology listen to this they found that there's upwards of 400 times more melatonin in your gut what than in your brain because you talked earlier about the pineal gland that's what i was taught in school it's produced by pineal gland in the story this study found that you can actually have a pinealectomy, which is a removal of your pineal gland, which I don't recommend, by the way. Don't do that. It's like a frontal lobotomy. Go there.

And you don't actually lose those levels of melatonin that's located in your gut. So you're a gut brain and a brain brain. Exactly. And that's something really important to understand, too. Your gut is really, it's often referred to as a second brain. We can And that's something really important to understand too. Your gut is really, it's often referred to as a second brain. We can call it the enteric nervous system. There's like 30 neurotransmitters just like your brain.

It's like a mass of nerve tissue. 60% of your immune system and most of the genes in your body. Vegas nerve as well. Yeah. That Vegas nerve. So UCLA researchers found that the Vegas nerve, which we thought was just kind of like the brain communicating more, telling the gut what to do.

90% of the communication from those nerve fibers from the vagus nerve to the brain is your belly, your gut telling your brain what to do in many ways. Totally nuts. The other thing people should know is that when you're stressed, not only is your cortisol high and you lead to more fat accumulation, it stores belly fat, but it actually blocks your cells' ability to burn calories. Because the nerves, the vagus nerve, help you metabolize your food, which is the relaxation nerve. It also has the effect of decreasing absorption of nutrients. So not only are you not absorbing, but your metabolism just slows down, which is amazing. It's just because of the nervous connection between your stress nerves and your relaxation nerves

and all your gut function. So profound. But this is just getting out of that isolation thinking. This is what I was taught in school as well. It's like- Well, that's functional medicine. The body's a system. Yes, everything is interconnected and it's just beautiful symphony if everything's working well so uh caltech researchers to kind of get to how does

this all connect they discovered that and this was just i mean it's been around for years but this is more of a recent like okay meta-analysis now we know that certain bacteria in the gut communicate with cells that produce these sleep-related hormones and neurotransmitters. So your gut cascade, your microbiome has a huge impact on your sleep quality. And so now the question is, what do we do about it? How do we protect or support our microbiome? And that's one of the things that's going to help to improve your sleep quality. So let's just go through a couple the the biggest thing in my opinion is avoiding things that mess it up all right so one of those would be eating processed foods so that crazy amount of sugar

has a tendency to feed pathogenic opportunity bacteria right so that's one thing avoiding haphazard use of antibiotics they have a, but we shouldn't be using antibiotics every time you get the sniffles. And that's literally what, when I was a kid, just give them some antibiotics, right? We would even, like if my mom had some antibiotics, you know, just totally negligent. Yeah. Give them whatever's in the cupboard. Also, pesticides, herbicides, rodenticides. The metals.

Yeah. These things, side literally means toenticides. Heavy metals. Yeah. These things, side literally means to kill, by the way. Yeah. But these have a pretty, because they're meant to kill small things, guess what your microbiome is made of, you know? And so- And how many millions and millions of people are taking acid blockers, which also terribly disrupt your gut microbiome.

Yeah. We're looking at that the wrong way as well. And so just avoiding those things, but also what I want people to do is support their microbiome by, and this should be just Captain Obvious at this point, and me working at a university for so long as a strength and conditioning coach

before I did my clinical work, I work with people from all over the world and I would ask them about their fermented foods and every culture had something yeah right so whether it was like some kind of kefir or like yeah pickled whatever right and so making sure they were getting us at least you know every couple of days get a serving in of some fermented food or beverage gotta eat the kimchi yeah I got a jar in my fridge I love kimchi and my my mother-in-law makes it for me and she's from kenya so they had like uh fermented

um a fermented like kind of similar to kombucha like she knew about this like 20 years ago and i'm like what is this weird stuff she's growing yeah yeah in the kitchen it's freaking me out she had grass like first time i came to visit and they were growing grass you know like it was wheat grass but i was like hey why's your mom got grass in here she's like did she get it i didn't know so anyways um we got a grass i didn't know but that is a big component here is like shifting gears and having a more targeted perspective about supporting that gut microbiome but also and this is a really cool takeaway for everybody today is making sure we're getting in servings of what I call good sleep nutrients every day. Yeah. What is that? Because eating first sleep, nobody really talks about that.

So what does that look like? The first one I'd share, and this one is from the Public Library of Science. And so they found that vitamin C, which we know about vitamin C, we tend to associate it with the immune system, right? It's a powerful antioxidant. found that folks in their in this particular study that were deficient vitamin c had a tendency towards waking up more frequently and getting vitamin c levels elevated reverse their symptoms all right so that's just one example so iron is the other one if you have a little fair is another one yeah that's oh my goodness that's huge and especially more so for women yeah it tends to be and another one this was published in the journal sleep all right this is the big journal and what they found was um calcium right

so this goes back to that story that i was told about calcium it is important for sure but folks who are deficient in calcium had uh more interrupted sleep patterns as well and so by getting those calcium levels up but how do we go about that i'll just pass it over to you yeah rather than drinking like homogenized glowing dark you know like from a mutant cow like what other sources of calcium uh calcium do we have oh my god you know it's it's when you look at the on calcium, it actually isn't as great as we thought for bones, but the best absorbability and use is actually from greens, like arugula and greens that we can have, dark green leafy vegetables.

Also, there's some great sources like tahini, which is basically ground sesame seeds. Also, different things people might like, I like, which is sardines with the bones in them and salmon with the bones in them, like canned salmon. Those are really great to eat because they have a lot of great absorbable calcium. Exactly. Calcium is kind of like an end product from this biological transmutation. So bones have a great source of it, but- People say, well, you need milk. I'm like, well, where do you think a cow gets their calcium from and has strong bones? Have you ever seen a cow bone? They eat grass.

Or they should eat grass anyway. This is a really fascinating process. It's kind of like a biological transmutation of sorts where certain things come together to create bone, right? So like you need silica. You need- Boron. Boron, right? Vitamin K2, yeah.

All of these things come together to make this magic happen. So, and by the way, I want to give some sources with vitamin C. Obviously, we know about citrus um fruits like strawberries uh sweet peppers but there are these quote superfoods as well like camu camu berry this might be the highest botanical source of vitamin c uh super tart tangy fruit it's like a amazonian thing uh amla berry acerola cherry those are super super high sources of vitamin c another one and this was this is the last one i'll share there's a whole list in sleep smarter so this was a study conducted by university of oxford found that omega-3s can help folks to get deeper more restful sleep all right so it helps with those modulating

those rhythms which makes sense because it has to do with your brain yeah right your brain has these gates you know you have the blood-brain barrier but the gate allows in certain vips yeah and it's only like 30 things right and one of those is a mega although you can have a leaky brain and then you get more trouble oh my goodness you know about the leaky brain this is like you're already you're getting into some territory here this is super fascinating stuff right leaky gut leaky brain who knew yeah right who knew so exciting and also there's some um researchers just came across that the brain kind of has its own nerve um immune system in a way yeah it does it has its own lymphatic system which is like to clean the brain every night and guess how you do that sleeping yep it's 10 times more active yeah i mean we know if you if you don't sleep you're

a much higher risk of alzheimer's because you can't clear out the garbage and your brain gets toxic yeah it's fascinating that's run by the glymphatic system yeah so that's like a little shout out to the glial cells that help to run it the body is just incredible so eat plenty of good good sleep nutrients every day. Magnesium though? Oh, that was the last one actually. Okay. I was like, that's the first one I go to with my patients. This is the big one.

I was saving the best for last. I first learned about the benefits of magnesium probably from you. Okay. And this was again, like you've been talking about this for like 15 years. Yeah, I'm getting old. And I was like, holy crap, because it's responsible for so many biochemical processes. Oh my God, 300 enzymes and yeah. And so what that means for people, it's just like, so magnesium is responsible for these,

well, now we know like over 325 processes. What that means is there are 325 things your body can't do or can't do properly when you're deficient on it. Yeah. And by the way, magnesium deficiency affects 48% of Americans. And it's caused by stress. Chronic magnesium deficiency. It's caused by stress.

It's caused by coffee, alcohol, and not having enough in our diet, which comes from mostly plant foods, beans and greens, nuts and seeds. Yeah, absolutely. And this is one of the things that we can do something about but like you said it's a it's kind of like an anti-stress mineral yeah and so just the amount of stress that we're exposed even even today even our environment is stressful it's different you know we're indoors a lot more processed air and we're not getting access to sunlight like just our reality is more stressful but then put on top of that our work demands

relationship demands how would you know if you're magnesium deficient? You can get a test done, but I really always- By the way, most of the tests are very inaccurate. Red cell magnesium is better, but it's mostly symptomatic. And actually, the way we really have to diagnose it is called a magnesium load test, where you give people a high dose of IV magnesium, and then you collect the urine for 24 hours. And if nothing comes out, it means their body sucked it all up. And if it all comes out, it means they have enough. So I think, you know, magnesium testing is tricky.

So you got to go by the symptoms. Exactly. Exactly. That's the thing. And what I was going to say is I always err on the side of how do you look, feel, and perform, you know. And in my practice, there were only a couple supplements i would recommend magnesium was generally and maybe for 80 of the people that came in because it there's such a tendency for people to be deficient in it and so but here's the issue so food first

obviously anything green is going to be a good source of magnesium uh so just keep that in mind kale collard mustard greens but outside of, supplementation can be tricky because we have this bowel tolerance. So even if you take a little bit more than your gut can handle at that moment, and you might need to really get your magnesium levels up, you're going to activate what we call clinically disaster pants, which means potentially pooping in your sleep. The whole thing, this goes full circle. milk of magnesia right magnesium citrus what they give people before they have colonoscopies to clean out their bowels right it works so and there's different forms and some are going to be better for different people but what i i don't know if

you've done this or looked into this but like topical magnesium yeah you can use topical magnesium yeah that's what i do even brought some with me when I travel, you know, keep it in my, um, in my bag and I love it. I think it's fantastic. It's important. And people can, you know, overlook symptoms that are all caused by magnesium deficiency, right? Sleeplessness, insomnia, anxiety, palpitations, muscle cramps, menstrual cramps, seizures, arrhythmias, palpitations. All those things are caused by magnesium deficiency. And it's interesting, in medicine, we don't really think about it, but it's used as a, quote, drug in the worst cases because drugs don't work.

For example, preterm labor. Someone comes in having a baby too early, you give them intravenous magnesium. Someone comes in and they're having high blood pressure and seizures in pregnancy, they give them intravenous magnesium. Someone comes in and they're having high blood pressure and seizures in pregnancy, they give them intravenous magnesium. People have cardiac arrhythmias where their heart is beating crazy beats in the emergency room and none of the drugs work, you give them magnesium. It's pretty interesting and it's something we use all the time in medicine. We don't think about it in this way, but it is probably one of the most powerful things for sleep for people. Absolutely. And Oz told me that he would use it for open

heart surgeries, you know, to keep that heart going. That's, it's profound. It's really profound. So, and it's sort of the relaxation mineral instead of antidote to stress. So besides the nutrients, the processed food, all this stuff we're eating, what are the other key tips that people need to know if they're not sleeping? And what are the other causes of sleep issues? Because you mentioned the gut microbiome being a cause, right? So you can take all this stuff and eat the right diet, but if you don't know what the cause is, like, so tell us about what the causes are that are common. And then what are the other key strategies to actually help people sleep? That's such a good question. One of the biggest causes that I would see is having a upside down cortisol level or abnormal cortisol rhythm.

So folks are having their cortisol too low in the morning, making it very difficult to get out of bed. And then it's too high at night. And so they're just like up. And so this cortisol rhythm, and by the way, so cortisol has definitely gotten a pretty bad name and rightfully so, but it's not all bad. You actually need cortisol to like make thyroid hormone. It's just if it's produced at the wrong time in the wrong amounts, then it could be a problem. And so to help folks to reset that cortisol rhythm, what we call a cortisol reset, this is super low hanging fruit and anybody can do this.

This is so cool. And I've seen so much good success with this. Appalachian- Hanging on the edge of my seat here. So Appalachian State University did a study and they went to find out, would the timing of your exercise affect your sleep quality yeah and so they took test subjects and they had them train exclusively at 7 a.m for one phase train exclusively at 1 p.m in the afternoon and then train exclusively at 7 p.m for the final phase of the study

they compiled all the data and they found that morning exercisers, first of all, they tend to spend more time in the deepest, most anabolic Delta stage of sleep by exercising in the morning. They found that they had a tendency to sleep longer. They had more efficient sleep cycles overall. And here's something cool. They also found that the morning exercisers on average had about a 25% greater drop in their blood pressure at night, which is kind of correlated with that deactivation of that sympathetic fight or flight. And 1 o'clock wasn't good? 1 p.m. it was negligible in the change, and they did see some benefit with the 7 p.m., ironically,

which you've got to be careful with that because that might get your body temperature too high, your cortisol can get elevated. But I even have a children's book that I read to my son when he was little, and they take the kid through a bedtime ritual with the characters. One of their rituals, like old-timer type things, is doing exercise before bed, right? Like tire yourself out, I guess, is the approach that you might think.

And there's a difference between getting great high-quality sleep and passing out from exhaustion, right? Because then people are tired and wired, and they fall asleep, and then they wake up because their cortisol is so high. Exactly, exactly. And so what we want to do and how does it work out in the morning it gets that cortisol rhythm it gets that cortisol elevated in the morning to kind of put it back on track because it should be elevated if it's a normal rhythm somewhere around at its peak maybe 8 to 10 a.m and gradually drop as the day goes on and so but the question is well you know maybe i can't, I have whatever in the morning, you know, kids work, whatever. I work on the afternoon,

just five minutes, four minutes. You can do Tabata, right? 20 seconds of exercise, 10 seconds of rest, set your phone timer. Incredible. First of all, you're going to get some fat burning benefits, right? And that post exercise oxygen consumption, right? You're going to be burning more calories, but also it's going to help with your sleep quality at night. And so that's one of the big low-hanging fruits is just to get in at least five minutes of exercise in the morning. Amazing. That's pretty cool. So fix your gut, exercise in the morning, take the right supplements. What are the big things people can do? Now, this one is a little bit more common knowledge now now but the question

really is what are we doing about it and this is our issue with our tech right this is like the most pervasive thing we're dealing with right now and harvard researchers have confirmed that the blue light spectrum coming from your iphone from your desktop from your they found that at night this does in fact suppress melatonin production and elevate your cortisol not during the day during the day there's no impact fine but at night and here's what they found and this is just an approximation every hour you're on your device at night you suppress melatonin for about 30 minutes wow so you might be up on your device or watching tv for three hours and you go

to bed because you're just physiologically exhausted or just like, I really should get to bed. You're not even producing adequate melatonin to take you through your sleep cycle for almost two hours into sleep. And so again, this is why we're waking up tired and we're not really getting high quality sleep is because we're destroying this process of producing melatonin. Artificial light at nighttime, I think is a big, it's sort of the elephant in the room. And for people that have had sleep problems, one of the easy things that you can do that can help to fix that is to have a blue blocking lights glasses at night. Yeah.

I actually have them. I do too. Absolutely. So when you look at the- You look goofy, but you sleep good. Right. Exactly. Yeah. I actually have them. I do too. Absolutely. So when you look at the... You look goofy, but you sleep good. Right. Exactly. Yeah. And it's actually in the medical literature. And these LED lights have a very high blue spectrum. And blue light is the type of thing that sort of wakes your body up and it suppresses melatonin. So melatonin, which we can measure, we can measure that easily

in patients, is the hormone of darkness. So one of the times when I'm seeing patients, not only do I measure their sex hormones, their adrenal hormones, but I also measure their sleep hormone, which is their melatonin. Like at night, maybe. Yeah, at night. So you actually, you can check it in the morning and you can also check metabolites of melatonin. And your melatonin levels tell you whether or not you're getting enough darkness so you can take melatonin um and as you get older our bodies produce less melatonin but the thing that you can do to boost your melatonin is not expose yourself to light at night and whether it's candles back to candles back to candles yeah exactly blue blocker glasses yeah yeah candles

actually work quite well yeah they do but uh the But the LEDs on screens and all lights now, there are no more incandescent light bulbs. So what about the sort of night setting on the computer iPad? Does that just go garbage? It doesn't cut the mustard. It's not as good. But what if you wear the glasses when you use the screens? Yeah, and you'll know they work

because when you wear the real ones that really cut out 99.9% of the blue light, you can see the screens. Yeah. And you'll know they work because when you wear the real ones that really cut out 99.9% of the blue light, you can see. I did the other night. I was tired, but I put my glass on and my blue glasses I got from True Dark. And you can go to truedark.com

and you put the glass on and I watched my movie on my computer in bed and I was like, normally I kind of mess with my sleep a little bit, but it was like, fine. I guess I had a great deep sleep. And I'm like, wow, this is really amazing. Yeah. I mean, whatever you're going to do with computer, whatever, it's not going to look normal, but you will sleep a lot better. And I do that myself. And I actually, this is where it, where it really hit me about the, the effect of light is I was york city uh one weekend and i was giving a lecture

and it was you know it was a friday night and i was lecturing the next day and uh i'm walking down you know just what are you doing in new york you walk down broadway so i'm walking down broadway it's about 10 o'clock at night i did it for about a couple hours it was like 11 12 o'clock oh yeah and you know the lights on broadway it Broadway, I could not sleep that night. Yeah. And that's where it really hit me as like, oh my God,

this is, I mean, this was obviously real, real bright LED lights, but it was phenomenal. I just could not fall asleep. Wow. Could not stay asleep. That's incredible.

And that sort of got me down that path of really understanding. Light. So light is a big problem. Light pollution. Light pollution. Yeah.

Exactly. I mean, there was a book I read years ago called Lights Out, which describes the advent of chronic disease and obesity with a light bulb. Yes. And how that affects our sleep-wake cycles, how it affects our circadian rhythms, how it affects our hormones,

how it affects our metabolism, which is something we normally don't think about. Exactly. Especially in traditional medicine. We never learned about light. Exactly. But now, you know We never learned about light. Exactly. But now, you know, there's, I mean. And one of the best things that you can do,

and I try to do this as often as I can, is early in the morning exposing yourself to light. So darkness tells you to go to sleep. Light tells your body to wake up. And exposing your eyes without, actually even without glasses to the sun i'm really a sun worshiper now i mean it's sort of you know you know sun gazing uh it is very very powerful for you're blind but you sleep yeah right yeah you're blind but you sleep fine exactly

but exposure to light shortly after you get up is one of the things that helps to synchronize and set your circadian rhythm. Every morning, my wife and I, we get up and we take the cats for a walk around the yard. Yes, our cats go for a walk. They're well-trained Burmese cats. And we literally walk around and get the sunlight and spend 20 minutes out there

just walking around the yard. And it's just so nice to get that sunlight in the morning. Exactly, yeah. And you want to do it relatively early, within about 20-30 minutes of getting up and exposing yourself to the sunlight is very, very helpful for synchronizing your body clocks. So that's

one reason that people are having so many sleep issues. And what are other reasons people have sleep issues, other than the light pollution? Sometimes it can be medications, medication side effects. Some of the people are taking these stimulants. So, so I'm tired. So here, your doctor gives you Ritalin or Adderall,

and then that is a stimulant and it's sort of keeping you up, um, excess amounts, uh, overuse of caffeine, uh, or having caffeine too late in the day. Um, you know, some people are very caffeine sensitive and, you know, they can't have any kind of tea or coffee. Yeah. Most people in general, I'm going to say that, you know, if you have one kind of tea or coffee yeah most people in general i'm going to say that you know if you have one or two cups of green tea coffee and it's early in the day it's not going to affect your sleep the half life of coffee is about six hours so in six hours half of it's out and then another six hours a quarter of it definitely nothing afternoon exactly exactly nothing afternoon exactly and most people it's not going to affect them. And alcohol is a big sleep disorder.

Oh, alcohol is a big one. In fact, I was telling you about a case. So I had a patient who was eating late at night. And that's another one. That's another one, right? Another one. And that actually, I think, also affects sleep also. Because when you're sleeping, you don't want to be digesting.

You really want to be in a fasting state. One, it's going to interrupt your sleep. And two, it's going to make you fat. Yeah, exactly. Storing it instead of metabolizing. That's how sumos, right? The sumo diet. That's how sumos get fat. They eat and go to sleep. That's right. That was actually a chapter in my book. One of my first books, Ultra Metabolism, was called the Sumo Wrestler Diet. Right, because the sumos have a recipe for knowing how to put weight on, right. You eat and go to sleep. So, and it was a, it was a simple patient came into me and they were eating late at night. It was like eight, anywhere between eight to 10 o'clock at night. And they were having a couple of glasses of wine, you know, which, you know, that sounds okay. Well,

it was a combination of eating late at night and those two glasses of wine or alcoholic drinks and very commonly especially as you get older maybe after 45 50 you'll get what's called rebound insomnia so the alcohol sort of mint relaxes you whatever but when it wears off the brain wakes up and I started to experience this myself when I started turning 45 50 and so I'm very aware of it. So any patient... So you drink wine in the morning. I drink wine in the morning, exactly. Happy hours at noon.

So no coffee or wine after lunch. Yeah. So one of the things that you do with patients is, you know, get them aware of their circadian rhythm or their sleep-wake cycle, the importance of light in the morning, darkness at night, and then also get them off for maybe two months, get them off of all alcohol and all caffeine and sort of see where their baseline is. And then it's for them to decide how much and how often and when to have those things,

which a good cup of coffee is pleasurable, a glass of wine is pleasurable, but too much too late is not a good thing. Yeah, and there, a glass of wine is pleasurable, but too much, too late is not a good thing. Yeah. And there are other things that are sort of off the chart a little that people don't think about, but I had severe mercury poisoning and that really interrupted my sleep. So insomnia can be related to heavy metals and toxins, for example.

It can be related to thyroid problems. People have low grade, low thyroid function. That can be a sleep disruptor. Hormonal issues. Obviously, menopause is another one. Yeah, menopause is huge. Even like blood sugar issues. People who are diabetic or pre-diabetic, they can get hypoglycemia in the middle of the night.

They wake some up, they get night sweats and hot flashes. So there's a lot of reasons people have sleep issues that are biological that you can fix. And even nutritional factors, low magnesium and other factors can be really a big issue. Exactly, yeah. And it's interesting you say that because there are some people who will have a very big cortisol response at nighttime.

So cortisol is the adrenal hormone, sort of your get-up-and-go hormone. We're supposed to have cortisol rising as we wake up. And there's a test that we do called the cortisol awakening response. So how much does your cortisol rise as you get up? Well, there are some people that will have problems with cortisol secretion at nighttime when it should be really, really low. And that's another thing that I think is the important thing that interrupts people's sleep is excess amount of

cortisol stress hormone at nighttime. You don't want to be watching scary things and stimulating things and get your adrenaline up before you go to bed. And I think, you know, often we live a sleep disruptive lifestyle, right? So we eat late, we drink, we have lots of lights, we engage in stimulating activities before bed, 24-7 news, email before bed. We don't do things to wind down. Just having a simple sleep hygiene routine. You know, I'm really religious about this, but at least an hour, maybe even two hours before you turn everything off, maybe I take a hot bath with epsom salt i put lavender drops in there because lavender actually reduces cortisol levels to lavender essential oils i've made my room completely black i have a blackout shade even have eye shades earplugs

if you need them if you live in a noisy area yeah uh i use it when i travel blue bocker glasses so there's a lot of a lot of ways to structure your environment so that it's really, it makes sure the temperature's right. Yeah. There's another clinical case. I had this older gentleman who had a whole bunch of different kinds of problems and had probably a little bit of early Parkinson's, mild sort of slowing down. He's in his late 70s. And he, on his own, found out that when he turned the thermostat down

from 70 degrees to 64 degrees, he slept so much better. Yeah. And again, that's the other thing. What happens to animals at nighttime? They're actually out in nature. And guess what? We're animals too. That's true.

We're actually designed to be out in nature. Yeah. And that lowering of the temperature also, I think, is very, very good for inducing sleep. And I actually think, this is my own sort of theory, is that when you take the warm bath and then you go to bed in a colder environment, that shift of the temperature differential helps. Once you really appreciate how vital sleep is and how great life can be if you're getting good sleep and how terrible it is for our health, both immediate and long-term, if you're not, I think then it creates its own set sleep anxiety. And so one of the things that I've been very active- I've had that for sure. Yeah. Where you think, to be fair, the body and brain are resilient. If you don't get a good

night's sleep every once in a while, it's fine. You can manage that. Certainly new parents do just fine over time, although it's challenging, but there are a few things that really help with sleep. So in terms of, and there are a lot of causes of insomnia and things. So all the, so they're the basics like avoiding caffeine in the afternoon, if you're caffeine sensitive, et cetera. But one of them is to start to understand that this state of sleep is not something that you should be able to drop into unless you do a couple of other things properly. And based on the research done in part by my lab, but mainly a guy out at the National Institutes of mental health named samur hatar he's the director of their chronobiology unit he's done these beautiful studies

showing that light exposure early in the day getting bright light exposure ideally from sunlight within an hour ideally within 30 minutes of waking up is vitally important for getting sleep later that night and the reason is is it basically once every 24 hours, you're going to have a spike in cortisol. It's non-negotiable. It's built into your genome. It's going to happen. So do people like Arizona sleep better than people in Seattle? Well, they do actually. And a lot of, a lot of people in Seattle need light, light boxes. Cause if you're living in an area where you can't get sunlight first thing in the day, feel free to flip on artificial lights.

But you want, basically the rule is you want as much bright, ideally natural, but if you can't get natural, artificial light would be fine, early in the day. And what that does is it basically times this cortisol spike to wake you up. That spike in cortisol isn't to stress you out, it's to wake you up. And then it sets a timer on your melatonin release. So 14 to 16 hours after your bright light exposure, you're going to get a pulse of melatonin, which is the hormone, of course,

that promotes sleepiness and puts you to sleep, independent of any supplementation of melatonin. Light inhibits melatonin through a direct pathway, through the eyes to the brainstem, and then up to the pineal it's a well-established pathway so the the number one thing is get bright light exposure to your eyes so no sunglasses eyeglasses or contacts are fine early in the day how long well depends on how bright so anywhere from two minutes to ten minutes ideally you're not looking at your phone

during that time ideally it's sunlight but if you wake up before you know flip on a bunch of artificial lights and then get outside once the sunlight is outside taking a walk you're not looking at the sun you're not looking directly into the sun you don't want to burn your retinas out indirect exposure is fine but there's a class of neurons called the melanopsin ganglion cells that reset your circadian clock and time things nicely they time the cortisol that time the melin. So that's the number one thing for, I wouldn't just say for sleep, but also for optimizing levels of alertness throughout the day.

The other thing is that you really want to avoid bright light between the hours of 11 p.m. to 4 a.m. If you're on a standard schedule, shift workers is totally different. The reason is Sammer's lab and a guy named David Burson at Brown University have shown that bright artificial light of any color, blue blockers or no, if there's bright artificial light, it activates a pathway in the brain involving this brain structure called the habenula. When I was an undergraduate, actually someone asked in neuroanatomy, what's the habenula do? No one knew. The habenula is involved actually in generating our feelings of disappointment.

It suppresses dopamine release for several days afterward. Now, if you have to go to the bathroom or you have to pull an emergency trip to the supermarket or something in the middle of the night, you don't have to worry about crushing your dopamine long term. It's a chronic thing. But you really want to dim the lights in the evening starting at about 10 p.m and so you're saying those blue blocker things that doesn't work well the the blue blockers will work but if the lights are bright enough it doesn't matter what wavelength they are and this i is because these melanopsin cells these neurons in the eye they do respond best to blue light but they're very broad spectrum the wavelengths that

they will respond to you can shine bright red light on one of these cells and it will signal to the brain time to wake up amazing so it's really key to just dim things down and i always say blue blockers are terrific but you don't want to wear them during the morning and early part of the day because blue light is the optimal stimulus for this wake-up signal so we took the blue blocker thing is great in principle, but people kind of took it too far. So bright light when you want to be awake and alert and dim light when you want to be asleep. So like, so how many hours before that? Cause you know, people are up on the, on their TVs and their screens and computers and phones. And yeah, so the subtle things that people can do are to start dimming the lights

in the evening right about the time the sun goes down is when you want to say oh the sun is going down outside and if it's overcast it's getting dark well that's the time to dim the lights in your home the other thing is because of the where these neurons are situated in the eye overhead lights will activate this wake-up signal much more readily than lights down low so the scandinavians have it right. In the evening, you want desk lamps. Most people aren't going to have floor lighting in their house. Desk lamps in early in the day and throughout the day, that's when you would want overhead lights. So those two things are going to be very beneficial. A lot of bright light, overhead

light throughout the day, ideally from sunlight. and then in the evening avoid bright lights of any color any kind between 11 p.m and 4 a.m don't get neurotic about it but many people find that just making these changes you don't have to like be off from like six o'clock at night no no no no and there's there's actually a the third uh tool which is also grounded in really nice work a paper published in scientific report shows that if you get some sunlight in your eyes in the evening, right about the time of sunset, and if you can't get it from the actual sunset, just go outside. You don't have to see the sun setting. You just need the light, the ambient light, the outdoor light in the morning is sufficient. There's so many photons out there. Even on a cloudy day, you'd be amazed. In the evening, if you see or get outside and get some sunlight or you get some light in your eyes,

that has an effect of lowering the sensitivity of the retina, of the neural part of the eye, and provides you a kind of insurance. It offsets a little bit of the late night bright light exposure. I call it sort of your Netflix inoculation. It kind of protects you against some of the ill effects. Now, if someone's schedule is really messed up, I mean, they're not sleeping. They're really screwed up. There's a study out of the University of Colorado that showed that this is a little extreme, but going camping for two days, reset these melatonin and cortisol rhythms for two weeks.

It's pretty incredible. It's pretty incredible. It's really incredible. I noticed when I go camping or I go out in the wilderness or far away from technology, I just sleep way better. We had a storm in my house last summer and we got power out for four or five days. And we just had candles at night and it was unbelievable. I loved it. And it felt so good to not have all that bright light at night and it was unbelievable. I loved it. And it felt so good to not have all that bright light at night and to go to

sleep and sleep better and deeper. Yeah. You really reset. And you mentioned, I'm glad you mentioned candlelight candlelight in the evening is fine. Actually not to turn people into geeky scientists, but there's a great app. I have no relationship to it.

It's, but it's completely free. It's called a light meter and you can run this experiment. You can download the app. You go outside on an overcast day in Boston in January and press the little button on light meter in the morning and it'll show you that even though you don't see the sun, it looks like dense cloud cover. It'll be something like 5,000 lux of light.

You'll go inside, you'll point the thing at a really bright artificial light and it'll say 300 lux. 00,002,003 00,002,003 00,002,003 00,002,003 00,002,003 00,002,003

00,002,003 00,002,003 00,002,003 00,002,003 00,002,003 00,002,003 00,002,003 00,002,003

00,002,003 00,002,003 00,002,003 00,002,003 00,002,003 00,002,003 00,002,003 00,002,003 00,002,003 00,002,003 to turn on every light in the house and it won't reset. Ah, but the clock and your eye get more sensitive as the day progresses. So you have to control it at both ends.

And candlelight is fine. Dim light in the evening is fine. But throughout the day, you really want to try and get some bright light exposure. And for many people whose schedules are just really screwed up, anchoring to these two or three things of bright light exposure

and avoiding bright light in the evening hours between 11 p.m and 4 a.m often not always can really reset people's ability and once you're sleeping well everything else gets better so that was kind of the the first question you had the other one is that um i'd be remiss if i didn't mention there are things that people can take i'm sure you're familiar with with several of these as well obviously well we have a doctor right here so talk to a doctor obviously i'm not a physician i don't uh i'm a professor but um so don't prescribe anything but the three things that have have made a tremendous difference you don't prescribe i profess i don't prescribe that's right that's what you usually say uh profess lots of things um the three things that I've certainly benefited from,

and I know a number of other people have, and for which there's really good research, are apigenin, A-P-I-G-E-N-I-N, which is, it's very inexpensive. It's chamomile extract. And it basically turns on a chloride channel mechanism in the brain. It turns off thinking. It's kind of the equivalent of an alcoholic drink. It just turns off thinking. You could still drive on this stuff, but it makes people drowsy. Do you drink chamomile tea or you have to take a concentrated?

Some people get that benefit from chamomile tea. Other people like the apigenin. And the other ones are the magnesium. And magnesium threonate and biglycinate in particular, threonate spelled T-H-R-E-O-N-A-T-E, and biglycinate, I won't spell out, but it's sort of just as it sounds. Those cross the blood brain barrier more readily because you're ingesting this obviously into the gut, and then that magnesium needs to get into the brain. And basically the magnesium seems to act as a precursor to GABA, the inhibitory neurotransmitter.

And so for people who have a hard time turning off their thoughts, that can be very beneficial. So there's the kind of light, which is a kind of ancient mechanism about regulating alertness and getting into sleep. And then there's the modern thing, which is supplements. And there's something sort of in between worth mentioning, which is there's a great tool that was developed by my colleague, who's our associate chair of psychiatry at Stanford. His name is David Spiegel. He's

actually a clinical hypnotist. He's done a lot of work on pain management and even breast cancer outcomes from hypnosis. And he's developed a free app that's on Apple and on Android called Reveri, R-E-V-E-R-I. It's a 15 minute hypnosis that you do in waking, which trains the brain to sleep better. And I think that a lot of people hear hypnosis and get a little bit freaked out, but there are a lot of clinical data showing that this can help people to learn to turn off their thoughts and to relax and go to sleep. And there's some other nice hypnosis scripts in there as well. It's David's voice and he kind of walks you through it. So those are, aside from the supplements, the light and the hypnosis are free resources that I think

most everyone could benefit from. If I wake up in the middle of the night, oftentimes I will do one of these hypnosis scripts. And just one other thing about sleep, a lot of people wake up in the middle of the night oftentimes I will do one of these hypnosis scripts and just one other thing about sleep a lot of people wake up at 3 or 4 a.m. and can't fall back asleep okay I never understood why that was and then I talked to the folks in the sleep lab at Stanford and I talked to the chronic here's probably the reason yeah there's an asymmetry in this seesaw that we all equipped with internally which is that we can all push on and stay awake more easily than we can just force ourselves to sleep right that's true right right at some point we fall asleep but if you're waking up at 3 or 4 a.m unless you're drinking too many

fluids and that's the reason why chances are you are running out of melatonin at that point it's the levels of melatonin in your blood are, are dropping. And what it means is you stayed up too late and you probably are one of these people that should be going to bed at eight 30 and waking up about three 30 or 4. I am. And people don't like that answer because they think,

no, but I want to be the person that goes to bed at 11. And you know, there are ways to shift your circadian rhythm that we could talk about but try and go to bed one hour earlier and chances are you will wake up feeling better at 3 or 4 a.m now it's not exactly a solution but if you're in an argument with your spouse or something about going to bed at you know at one hour or the next you know you can leverage biology or cite this discussion. Wow.

So we really have this sleep epidemic problem. And people are struggling with figuring out how to deal with it. And your lab and you have worked really a lot on how do we navigate the landscape of sleep. Because as we're having this conversation, whatever I ask you, you keep coming back to sleep, which is fascinating to me as a foundation. And we always think diet's the foundation, exercise foundation, meditation. But sleep is sort of that neglected fourth leg of the table. Well, and it's the thing that we've been encouraged to push through. And I mean, there are some elements, I mean, that we could get down into the fine science of it.

You know, we sleep in 90- minute cycles, ultradian cycles. Better to wake up after six hours than seven, right? For most people, for sake of alertness. So waking up at the end of one of these 90 minute cycles, you're going to feel more alert

than you would say if you slept into, seven hours would mean you weren't complete through your last ultradian cycle. But sleeping at 7.30 would be even better if you can, you know, so getting the right amount of sleep is it, it's a process that you want to master on average, right? You know, the one occasional all nighter, you'll be okay. You drank coffee too late. You'll be fine. But on average,

you want to be sleeping. Most people it's going to be anywhere from five to eight hours a night naps in the afternoon seem to be okay. five to eight hours a night. Naps in the afternoon seem to be okay. The hypnosis script and the other things will really help people get centered around this. I think that the idea of breaking up one's sleep, there were these crazy sleep cycles that were promoted, not to be confused with Huberman. They called it the Uberman schedule. I just want to be very clear, not Huberman schedule there there was a study that came out recently that showed that it's incredibly detrimental to all sorts of inflammatory cytokine markers oh no to try and sleep two hours wake up sleep two hours wake up sleep

around the clock there people they found they could compress their total sleep time this was a kind of a Silicon Valley thing, like trying to master one, you know, you just can't conquer. You do have these human bodies you've got to actually. Yeah, you can't conquer that. But I think sleep is vitally important. First and foremost, we have to recognize that sleep, you know, you and I trained in an era where sleep deprivation or how little sleep you could get by on was a badge of honor.

Yeah. So we need to shift that internal dialogue that we all have that, oh, if I'm sleeping, I'm wasting my time and I'm not getting my stuff done. So first, honor the importance of sleep for your overall health and well-being and even your ability to stick to your intentions around choosing healthy foods and sticking to your exercise plan. Then create a sanctuary that's really conducive for rest and relaxation. Dark, quiet, cool, ideally electronics out of the bedroom

or turned off if you can. Getting rid of all of the light exposures, even your chargers that have that little light. Yeah, like those lights, like those red, green lights on different devices. I'm like, that drives me crazy. I had a patient who told me she traveled around with black electrical tape whenever she went to a hotel and she would put it over all the little light sources in the hotel room.

I travel with eye shades because you never know where you're going to be. So those two, quiet, calming. And I think this idea that you go, go, go, go, go, go, hop in bed and turn it off like a switch, That doesn't work either. So building in a transition to rest and relaxation. If you can do an hour, that's great. And getting off the devices, not watching TV, maybe reading a book or journaling or doing something, taking a bath, stretching in the tub. I mean, there's all kinds of wonderful ways to ease into rest and relaxation. The hot Epsom salt bath and lavender drops because

the lavender lowers your cortisol the magnesium relaxes you and the sulfur and the epsom salt helps you detox that's my favorite as well and then you go to your cool bedroom and you do your legs up the wall yoga restorative yoga position and bingo you've got your transition to rest and relaxation so powerful and and alcohol obviously is yeah that And alcohol, obviously, is a good practice for people. Yeah, that's a tough one. That's a tough one. So the rough analogy is this. It's funny, when they asked partners of people with insomnia, how many of them were suggesting

that they have a drink to go to sleep? It was about a third of them. So people think alcohol is going to help you sleep and it might make you fall asleep. But then as it clears out of your system, there's an arousal that can exacerbate hypoglycemia. It makes you wake up. It's going to make sleep apnea worse. If you're a woman in midlife, oh boy, it's a bladder irritant. It's a hot flash trigger.

So it's really affecting sleep in a lot of ways. The rough equivalent is there's about an hour of sedation followed by an hour of arousal. Yeah. So if you had a glass of wine at six and you go to bed at 10, it's probably not going to impact your sleep as much as if you have two glasses at eight or like your late dinner last night, if you had a glass or two of wine. I had a beer. Yeah. That has another impact on your sleep.

I just noticed it. Actually, I had an aura ring for a while and I was tracking my sleep. And I noticed whenever I drank, my sleep pattern was so disrupted. Cogging sleep, the depth of sleep, the amount of REM sleep, deep sleep, snoring, all that. It's really interesting. And then caffeine also is another big one, right? Yeah, absolutely. And we're all different in terms of our caffeine metabolism ability. Some people are really fast metabolizers. I happen to be one of those. But if you're a slow metabolizer, half of your cup of coffee from noon could still be in your system at 9 o'clock at night. And most of the time, we're not thinking back to that new cup of coffee.

With food, it's really about quality, quantity, and timing of food. It's all three. Um, yet another area that's impacted with the health of the gut microbiome is sleep. And data is suggesting that people who eat a wide variety of colorful fruits and vegetables tend to have better sleep quality, whereas a highly processed standard American diet is associated with more sleep disruptions and less deep sleep. So quality matters. We already touched a little bit on the timing of eating. So eating your calories earlier in the day also helps re-regulate

those circadian rhythms. So the clocks in the brain and the clocks in the body that are ideally going to be working in sync with each other, they're influenced by light, by movement, and by food. So when we line all those things up during the day, it's going to help us get the rest that we need at night. So important. This is such good information. Thanks for listening today. If you love this podcast, please share it with your friends and family. Leave a comment on your own best practices on how you upgrade your health and subscribe wherever you get your podcasts.

And follow me on all social media channels at DrMarkHyman. And we'll see you next time on The Doctor's Pharmacy. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic and Function Health, where I'm the chief medical officer. This podcast represents my opinions and my guests' opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only. It's not a substitute for professional care by a doctor or other qualified medical professional.

This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner now. 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 is trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.