The Rich Roll Podcast - Neuroscientist Matthew Walker On Why Sleep Is Your Superpower

Episode Date: May 10, 2021

Why do we sleep? What exactly happens when we sleep and why is it so important? What are the implications of sleep deprivation? And what can we do to improve our sleep hygiene? Answering these questions is the life’s work Dr. Matthew Walker. Longtime listeners know that I am obsessed with sleep and the critical role it plays in every facet of health. This infatuation is driven in no small part by the incredible work of today’s guest, one of the world’s leading neuroscientists and researchers in the field of sleep science. Matriculating at Nottingham University where he studied neuroscience, Matthew earned his Ph.D. in neurophysiology from the Medical Research Council in London, subsequently became a Professor of Psychiatry at Harvard Medical School, and is currently a Professor of Neuroscience and Psychology at the University of California, Berkeley, where he serves as the founder and director of the Center for Human Sleep Science. In addition, Matthew hosts a MasterClass on the science of better sleep. His TED Talk, ‘Sleep is your superpower’ has over 20 million views. And his international smash bestselling book Why We Sleep—a must-read for anyone and everyone looking to live and feel better—provides the framework for today’s mind-blowing, slumber-focused primer. To put it rather bluntly, this conversation covers everything you need and ever wanted to know about sleep, including: why do we sleep? what happens to our bodies and minds when we sleep why is sleep so important? what happens when we don’t get enough? what is the deal with dreams, sleepwalking & sleep paralysis? what are the various stages of sleep (REM, deep, etc.)? what can we do to prioritize and improve our sleep?  In addition, Dr. Walker answers the questions like: how do caffeine and alcohol affect sleep? Why do our sleep patterns change across a lifetime? What is the relationship between sleep, immunity, weight gain, and mood? And most critical: how do we resolve the global sleep-loss epidemic? All told, this is an utterly fascinating masterclass on why you must rethink your relationship with sleep and the profound short and long-term impacts sleep has on every facet of our lives from learning to mood, productivity, energy, hormone regulation, longevity, and even susceptibility to cancer and other diseases. FULL BLOG & SHOW NOTES: bit.ly/richroll600 YouTube: bit.ly/matthewwalker600 I urge all of you to absorb this conversation in its entirety. Whip out your pen and paper—this is essential, potentially life-altering listening for every human. And simply put, it’s everything I hoped it would be. Peace + Plants, Rich

Firstly, it's during sleep and particularly during deep sleep where the body will be stimulated to produce many more of those critical immune factors. Even better, sleep will actually increase the sensitivity and the receptivity of your body to those increased immune factors. So you wake up the next morning as a more robust immune individual. Sleep will restock the weaponry in your immune arsenal. You know, starting with this recommended sweet spot of between seven to nine hours a night, going in the downward direction, there's a very simple truth, which is that the shorter your sleep, the shorter your life. Short sleep predicts all-cause mortality. Sleep is the single most effective thing that we can do

each day to reset the health of our brain and our body. I'm Matt Walker, and this is The Rich Roll Podcast. The Rich Roll Podcast. Hey, everybody, welcome to the podcast. Good to be here, glad to have you. So longtime listeners probably know this well, but if you're new, suffice it to say that I am obsessed with sleep and the critical role that sleep plays in every single facet of health. Well, this infatuation of mine is driven in no small part by the incredible work of today's guest, one of the world's leading researchers in the field of sleep science, Matthew Walker. sleep science, Matthew Walker. Matthew is a former professor of psychiatry at Harvard Medical School and a current professor of neuroscience and psychology at UC Berkeley, where he also serves

as founder and director of the Center for Human Sleep Science. His book, Why We Sleep, is an international bestseller. It's an incredible read that has had a profound impact on me personally. And I say this without any hyperbole, a must for anyone and everyone looking to live and feel better. Matthew is somebody I've wanted to have on the show for a very long time. And today he absolutely crushes it. A few more things to mention before we dive in, but first. We're brought to you today by recovery.com. I've been in recovery for a long time. It's not hyperbolic to say that I owe everything good in my life to sobriety. And it all began with treatment and experience that I had that quite literally saved my life. And in the many years since, I've in turn helped many suffering addicts and their loved ones

find treatment. And with that, I know all too well just how confusing and how overwhelming and how challenging it can be to find the right place and the right level of care, especially because unfortunately, not all treatment resources adhere to ethical practices. It's a real problem, a problem I'm now happy and proud to share has been solved by the people at recovery.com who created an online support portal designed to guide, to support, and empower you

to find the ideal level of care tailored to your personal needs. They've partnered with the best global behavioral health providers Thank you. Navigating their site is simple. Search by insurance coverage, location, treatment type, you name it. Plus, you can read reviews from former patients to help you decide. Whether you're a busy exec, a parent of a struggling teen, or battling addiction yourself, I feel you. I empathize with you. I really do. And they have treatment options for you.

Life in recovery is wonderful and recovery.com is your partner in starting that journey. When you or a loved one need help, go to recovery.com and take the first step towards recovery. To find the best treatment option for you or a loved one, again, go to recovery.com. We're brought to you today by recovery.com. I've been in recovery for a long time. It's not hyperbolic to say that I owe everything good in my life to sobriety. And it all began with treatment and experience that I had that quite literally saved my life. And in

the many years since, I've in turn helped many suffering addicts and their loved ones find treatment. And with that, I know all too well just how confusing and how overwhelming and how challenging it can be to find the right place and the right level of care, especially because unfortunately, not all treatment resources adhere to ethical practices. It's a real problem. A problem I'm now happy and proud to share has been solved by the people Thank you. personal needs. They've partnered with the best global behavioral health providers to cover the full spectrum of behavioral health disorders, including substance use disorders, depression, anxiety, eating disorders, gambling addictions, and more. Navigating their site is simple. Search by insurance coverage, location, treatment type, you name it. Plus, you can read reviews

from former patients to help you decide. Whether you're a busy exec, a parent of a struggling teen, or battling addiction yourself, I feel you. I empathize with you. I really do. And they have treatment options for you. Life in recovery is wonderful, and recovery.com is your partner in starting that journey. When you or a loved one need help, go to recovery.com and take the first step towards recovery. To find the best treatment option for you or a loved one, again, go to recovery.com. Okay, so this one is long, three hours in fact. So I'm gonna keep this short by simply saying this is a completely fascinating,

straight up masterclass on everything you need and ever wanted to know about sleep and the profound impact it has on every facet of our lives. I urge all of you to absorb this conversation in its entirety, take notes, because I think it's essential listening for every human, potentially life-altering, and simply put, everything I hoped it would be. So here we go. This is me and Dr. Matthew Walker. Well, Matthew, so delighted to have you here.

People who listen or watch this show know well my level of obsession with sleep. I'm gonna try to refrain from making it basically an indulgent referendum on my sleep peccadilloes. That's great as well. I'm sure I will diverge into that at some point because I think it's instructive, but I've been looking forward to this for a very long time.

Huge fan of the work that you do and it's just a pleasure and an honor to have you here today. Well, it's a privilege and a delight to be sitting across from you. And I'm a long time listener as well. So thank you for all that you do. Yeah, absolutely.

I wanna kick off with this. One of the super interesting hypotheses in the book that you purport is this idea that sleep evolved before the brain, hence before wakefulness. So the lens through which we think about sleep is sort of in reverse, right? The question shouldn't be, why do we sleep?

The question is really, why are we awake, right? And whether or not that's true, I think it's super interesting and instructive to kind of shift that lens. And when you think about it from that perspective, everything seems a little bit different. Yeah, it isn't. And I have no good sound evidence

for that theory right now. But I think from an evolutionary perspective, the first thing which perplexes me is the idiocy of sleep. You know, when idiocy of sleep. You know, when you think of sleep from an evolutionary perspective, firstly, you're not finding a mate, you're not reproducing, you're not caring for your young, you're not foraging for food,

and worst of all, you're vulnerable to predation. So on and on. Not only that, you're an insane person, right? You go through this whole thing, like if you were awake and you were experiencing the states that you experienced when you're asleep, you would be institutionalized. That's right, yeah. And that's what we call dream sleep,

which seems to be normal. But on any one of those grounds, sleep should have been strongly selected against in the course of evolution. But the fact that sleep has fought its way through along every step of the evolutionary pathway. In fact, if we look back, we can even find sleep-like states in earthworms,

which are ancient from an evolutionary perspective. So in other words, sleep evolved with life itself on this planet. And then despite all of those trappings, it fought its way through heroically every step along the evolutionary pathway. In other words, if sleep doesn't serve

some absolutely vital set of functions, it's probably the biggest mistake that the evolutionary processes has ever made. And we've now realized that it didn't make a spectacular blender. But that premise that sleep evolved is usually founded on the idea that we were awake and then we evolved to sleep.

And one thought that crossed my mind and I was perhaps stupid enough to write it in the book, I wonder if it's the other way around. Why did we assume that we evolved sleep? Why don't we assume that sleep is the defacto state of all birth life on planet earth? And it's from sleep that wakefulness emerged and evolved. Now, shy of a time capsule or some serious smelling salts,

I'm probably not gonna be able to go back and figure that out. But I think it's an interesting sort of way to sort of- Well, the evolutionary advantage of wakefulness is self-evident, right? We need to procreate, we need to feed ourselves. But less obvious is the evolutionary advantage of sleep. It just strikes us as being something that gets in the way

as opposed to crucial for all the functions that you kind of go through suriatim in the book. And I think that's perhaps one of the reasons that people are so misunderstanding of sleep and so understandably neglecting of sleep. Because most people, if you didn't understand what sleep is, you would think, well, my body gets some rest

and my mind is dormant and nothing could be further from the truth. There is an immense cascade of health benefits, this constellation of nighttime gifts that sleep will provide to your body. And every operation of the mind that we know is overhauleded some spectacular things. In fact, during certain stages of sleep,

your brain is up to 30% more active than when you're awake. And so it's so understanding that we would think, well, if I didn't know anything about sleep, surely I can just shave off an hour here or two. And it just doesn't work like that. One hour we can think of this incredible global experiment that's performed on well over 2 billion people across 70 countries twice a year.

It's called daylight savings time. And what we've discovered is that in the spring, when we lose just one hour of sleep, there is a 24% increase in heart attacks the following day. So crazy. Yet in the fall. And then the reverse in the fall, right? Yeah, exactly.

You sort of see, I think it's a 21% reduction in heart attacks. So that's how fragile. And yet if everybody was sleeping eight hours a night, it would be irrelevant, right? So it's less about daylight savings time than it is about our social constructs around when we need to get up and go to work

or go to school. That's right, yeah. I think, you know, society has firstly stigmatized sleep with this label of laziness that, you know, if you're getting sufficient sleep, you're maybe slothful. And sometimes when I'm at speaking events, people will come up and they'll usually wait right until the end of the line of questions. And they'll whisper sort of to me, look, I'm one of those people who needs, gosh, probably about eight hours of sleep. And, you know, as if this, this, the worst secret,

the worst, the most shameful thing that you could ever suggest. So I think that's the first issue, but then we're working longer hours and pre-pandemic, commuting times had also increased. And when you think about that, so we're leaving the house earlier, we're arriving home later, no one wants to short change on time with family or Netflix or whatever it is.

And so the one thing that gets squeezed like vice grips in the middle of the night is this thing called a full night of sleep. Yeah, you're almost some kind of punk rock revolutionary if you protect your sleep time, right? It is the one thing that's negotiable or dispensable when you're looking at how you allocate your time. That's right, it seems to be.

And of course the reality is that sleep alas is not an optional lifestyle luxury. It's a non-negotiable biological necessity. It is your life support system. We all know the people who say, I only need four hours or I only I'm fine on five hours. And I think you have, I've heard you say something along the lines of

0% of people need less than X number of hours. Like that's all a story that people tell themselves, but it's simply not the case. That's right, yeah. So I think if you look at the weight of the evidence, the number of people who can survive on five hours of sleep or less without showing any impairment rounded to a whole number and expressed as a percent of the population is zero. And to me, you would ask the question, well, why do people think that they're doing okay? And what we've

discovered is that your subjective sense of how well you're doing when you are insufficiently slept is a miserable predictor of objectively how you're doing when you're insufficiently slept. And so, you know, it's a little bit like a drunk driver at a bar. You know, they've had six or seven shots and they pick up their car keys and they say, "'Look, I'm fine to drive home.'" And your response is, "'I know that you think you're fine to drive home, "'but trust me, objectively, you're in no state.'"

And it's the same way with a lack of sleep. So that's one of the sort of the frightening aspects of insufficient sleep, that you think you're doing just fine. And gradually over time, that deficient form of you becomes the new norm. And most people don't go from sleeping eight hours down to five hours.

It's this sort of gradual chipping away at their sleep time. And they don't realize the version of themselves. And a great example of this clinically is in sleep disorders, such as sleep apnea. And these patients will say to you, look, doc, I think I'm fine. I think I'm doing pretty well. And then you treat the sleep apnea

so they start sleeping better. They're not snoring, they're not gasping for breath. And within a few weeks, they cannot believe the transformed state of themselves. I had one patient who said, it was as though with the sleep apnea device, I'd come along and I'd wiped a frosted window clear and finally I could see again.

Wow. And that's the type of mental benefit that you get. And of course, physiologically, it's amazing. Yeah, yeah, yeah. I mean, I just know, you know, when you're younger, sleep comes easy. As you start to age, it becomes a little bit more fragile and elusive.

And I found myself having to really be much more intentional about it. And the difference between having a good night's sleep where I get my eight hours and, you know, I know that I've been in a sufficient amount of REM state and NREM deep state, all of that, my whole experience of my life is completely different from those nights

where I struggle and wake up and had maybe six and just not so good. Like everything from mentally, emotionally, physically, productivity wise, like everything from, you know, mentally, emotionally, physically, productivity wise, like every single, there is nothing that is not positively impacted by having a really good night of sleep. And yet it's for me, we'll get into this later, but you know, replicating that day in day out becomes tricky.

Yeah, and it is a hard thing, you know, and I think one of the lessons I learned from publishing the book, you know, at the time, I think the book came out in 2017 and it took about four years to write. So prior to that, sleep was really the neglected stepsister in the health conversation of today. And I was so upset by the suffering

that was happening in society caused by this global sleep loss epidemic. And as a consequence, I was almost a little bit heavy handed, I think, in sort of dishing out some of these facts. And I have to be honest, I have to speak the truth of the science as well. But for certain people

that almost made them sort of more anxious, particularly for people with insomnia, who of course would come to a book called, "'Why We Sleep." The book wasn't called, "'How to Cure Your Insomnia'." But I'm sure of course, they're still going to buy that book. And I think I learned my lesson

to offer some kind of preface regarding that, that this book is going to be very triggering and challenging if you don't sleep well. And therefore when you're not daisy chaining those nights of good sleep, just as you're describing night after the night, and you understand the detriments of sleep, it can be concerning.

And I'm the worst for that. Just like you, I can't string it together. Now I'm getting older, I'm well in the foothills of middle age. You look fabulous by the way. Thank you, I just had 70 the other day, so it's great. But I think it's that I feel that anxiety. And for me, it's terrible because I'm lying in bed awake

and realizing that my dorsolateral prefrontal cortex is not shutting down. I'm not releasing this neurochemical. My cardiovascular system is going to be this, my immune system. And at that point, you know, you're dead in the water for the next two hours. You have no chance.

So you become the sort of like the Woody Allen neurotic. And you're the guy, like I'm the guy who's supposed to have this figured out. That's right, yeah. And that just shows you that, you know, even if you have, you know, all of this knowledge, you know, biology can still teach you have all of this knowledge, biology can still teach you a few lessons.

Well, there's so many directions I wanna take this, but I think it probably would be wise to just spend a few minutes talking about, like sort of defining our terms, like what is sleep? Like going through the various stages and kind of explaining the terrain. Yeah, so sleep in humans at least and most mammals and birds

is broadly separated into two main types that you'd mentioned. On the one hand, we have non-rapid eye movement sleep or non-REM sleep for short. And non-REM sleep has been further subdivided into four separate stages. In fact, unimaginatively called stages one through four, we're a creative bunch, clearly as sleep researchers,

decreasing in their depth of sleep. So stages three and four are those really deep stages of restorative sleep. That's what your sort of sleep tracker would say, that's deep sleep. Stages one and two, they're light sleep. And then on the other hand, we have rapid eye movement sleep or REM sleep

named not after the popular Michael Stipe band of the 1980s, but after these strange horizontal shuttling eye movements that occur under the eyelid as you're in this stage. And REM sleep is the stage during which we principally dream. And that's where you have your most sort of florid, most narrative, hallucinogenic, emotional sort of dreams. And it turns out that those two types of sleep, non-REM and REM, will play out in this incredible battle for brain domination throughout the night.

And that sort of cerebral war is going to be won and lost every 90 minutes and then replayed every 90 minutes, at least in humans. And that creates the standard cycling architecture of sleep. What's fascinating though, and we actually still don't quite understand why, is that the ratio balance of those two types of sleep, non-REM and REM, changes across the night.

And what I mean by that is in the first half of the night, the majority of those 90 minute cycles are comprised of lots of deep non-REM sleep, but very little REM sleep. And so as you push through to the second half of the night, are comprised of lots of deep non-REM sleep, but very little REM sleep. And so as you push through to the second half of the night, now that seesaw balance will actually shift. And instead you get much more rapid eye movement sleep,

particularly in the last couple of hours. And it's not just important to sort of understand one's sleep, but understanding that structure has implications real life. So let's say, for example, that I normally get my eight hours sort of, and it doesn't, you know, we can speak about timing on the clock face and what makes sense for people. But let's say that I'm a guy who goes to bed at 10 and I typically wake up at six, but today I've got an early morning meeting, or I want to sort of cut my sleep short to get a jumpstart on the day to get to the gym. And I wake up two hours early.

So I wake up at four rather than six. How much sleep have I lost? Well, I've lost two hours from eight hours. So I've lost 25% of my sleep. Well, yes and no. Yes, I've lost 25% of my total sleep. But because REM sleep comes late in the morning, I may have lost 50, 60,

maybe even 70% of all of my REM sleep. So it's not just sort of academic to understand, even though it's fun for me, but for many people, it does have real world implications. The complexity of it is fascinating. I mean, sleep really is right up there with outer space in the depths of the ocean in terms of its mysteries and the idea that we're just beginning to learn

what's actually going on. And it's not a matter of, I'm sure you get this question all the time, like, well, what's more important REM sleep or non-REM sleep or what's the sort of significance of being deprived of one over the other, but it's really the interplay of all of these things. And the more complex you realize it to be,

it becomes impossible to consider that it's not crucial to all facets of human health. That's right. And when we go back to that evolutionary story of how detrimental sleep is as a state, and it is, let's face it. If there were any stage of sleep that were not important, that mother nature could have come in and excised

and had you doing all of these benefits of wakefulness, I'm quite sure she would have. And what we've learned is that every stage of sleep is important. Different stages of sleep perform different functions for the brain and body at different times of night. And so, yeah, I'll often get that question. People will say, how can I get more deep sleep?

How can I get more REM sleep? And I often say, well, why do you want more of that? And they say, well, isn't that the good stuff? And they're both absolutely critical. Now I could make a scientific argument that REM sleep could be a little bit more important from a simple mortality state because there were studies done back in the 1980s with rats

and they've actually never been replicated again. I found them difficult to read. I do research in humans. I don't do animal research. And I think they won't be replicated for good reason. What they wanted to do is see if a lack of sleep is deathly, is a lack of sleep fatal. And they had three different flavors of the experiment. In the first, they took rats and they just a lack of sleep fatal. And they had three different flavors of the experiment. In the first they took rats and they just deprive them of sleep, you know, night and day after day, night and day after day.

And what they found is that those rats died within about 20 days. So in other words, rats will die as quickly from a lack of food as they will from a lack of sleep. That's how fundamental it is. Then the two additional flavors of the experiment, they selectively deprive them of either just rapid eye movement sleep

so that they could get just non-REM or they did the opposite. They just deprive them of non-REM and gave them REM. And firstly, both of those were fatal. But what was interesting is that the rats died from REM sleep deprivation within about 30 to 40 days. And they died from deep non-REM sleep deprivation within about 50 or 60 days.

So if we want to sort of do a Coke Pepsi challenge between sort of, you know, non-REM and REM, which one wins out in the mortality battle. It seems to be REM sleep. And to me, that's interesting too. If you'd asked me where I would place my bets, I would have said non-REM. The reason is because non-REM came first.

If you look during the sort of the time course of evolution of cross phylogeny, non REM sleep was the first sleep to emerge. And it was only when we went from reptiles, amphibians and fish, and then there was that bifurcation to birds and then mammals, did the evolution of REM sleep emerge. So REM sleep is the new kid on the evolutionary block.

And furthermore, REM sleep evolved twice independently in birds and mammals, which I find is fascinating too. So to come back to your point, I'm sorry, I'm drifting, but all stages of sleep are critical. No one stage of sleep you can do without suffering detriment. Right, it is fascinating that sleep deprivation is fatal. And you talk about this in the book,

there used to be before they were outlawed these contests, people would see how long they could go without sleep. And there's one case study that I recall from the book where the guy went mad and then literally, I don't know how long it took him, like 10 days or something like that before he passed away. Well, there were two things that firstly you're right that there was, they used to Guinness, the World Book of Records used to recognize record attempts at insufficient sleep.

And then as the evidence mounted as to how deleterious a lack of sleep is, they found it medically, you know, impossible to They found it medically impossible to recognize and ethically impossible to recognize. So Guinness no longer recognizes any attempt to break the world record for a lack of sleep. And to put that in context, we think of Felix Baumgardner, that incredible Austrian who went up in the Red Bull sort of space capsule

as it were. And when he ascended the outer atmosphere of the planet, he opened up his door and he leapt out. And then he hurtled back down to earth. And I believe he broke the sound barrier with his own body. Now Guinness says, that's fine, but depriving yourself of sleep, no, no, no. That's the relative sort of aspect

that we're thinking about. There was a famous case of a radio disc jockey in New York in the 1950s called Peter Tripp. And he wanted to try and break the world record, which was going eight days straight without sleep. And he was doing this for the March of Dimes. And he would sort of sit in Times Square and he was going to do this play a spin his records.

And after three days he was hallucinating and he was psychotic. After five days, he believed that people were trying to poison him and that the secret service was coming to get him. And then he did apparently break the world record. He went eight days straight without sleep. And then he slept for a little over 20 hours. He woke up, he ordered his papers, had his breakfast and people said, oh, it seems to be back to normal. But Trip was no longer Trip after that.

He started to have problems at work. He got caught up in what was called the payola scandal, where people were sort of paying DJs under the desk to play their tracks. His marriage fell apart and the last people heard was that he was selling books door to door in the Midwest. Wow, and so you're attributing that to this crazy experiment that he did. Well, that was the belief. Now, other people I should note

have gone past his level of sleep deprivation. And although they went through the same experience during the lack of sleep, psychosis, memory loss, emotional instability, they seem to go back to normal. So I think what's happening here, and I'm sure we'll come on to sleep and mental health at some point, in those people who are in that vulnerable range where they haven't crossed

the threshold of mental ill health, but they're right there and anything that pushes them past it, be it a traumatic event, be it a difficult divorce, or a long stretch of no sleep, can actually pull that trigger and send them over that sort of teetering precipice down into a state of prolonged mental ill health.

Right, that's wild. But those are kind of fringe cases in the sense that people are doing this wacky kind of thing, but the more relatable prevalent situation is chronic sleep deprivation, which I don't know what the statistics are, I'm sure you do, of how many people just on a day in day out basis are not getting enough sleep

and how that plays out long-term in terms of their physical, mental, emotional health. Yeah, it's quite shocking. And I guess this is sort of the insomnia disclaimer if you've heard to sort of listen away. But firstly, what we know is that one out of every three people that you pass on the street is not getting the sleep that they need.

So the CDC right now recommends, stipulates a minimum of seven hours of sleep to maintain human health. And it doesn't, as you said, most people are not pulling all nighters frequently or trying to break world records, but it doesn't take that. We've already mentioned the daylight savings experiment.

I'll just give you a few other examples. If I take a healthy young male and I limit them to, let's say four or five hours of sleep for a couple of nights, their level of testosterone drops to someone who is 10 years their senior. So a lack of sleep will age a man by a decade in terms of that critical aspect of wellness and virility.

And we see equivalent impairments in female reproductive health, by the way, follicular stimulating hormone, abnormal menstrual cycles, difficulty in conceiving. So that's hormones that go awry. We also know, for example, that if I were to take you and put you on a diet of, let's just say, four hours of sleep a night for a couple of nights.

At the end of those four nights, your blood sugar levels would be so disrupted that your doctor would classify as being pre-diabetic. That's crazy. Which, you know, it stuns me. And to induce that kind of a deficit, a 40% deficit in your sort of glucose optimization, you would have to gain about 20 pounds of obese mass

within four days, or you could do it by under sleeping. We also know, for example, that if you're not getting sufficient sleep in the week before you get your flu shot, you produce less than 50% of the normal antibody response. I'm sure we'll discuss that when we speak about immunity. There was an amazing experiment though done by some colleagues in the United Kingdom

and they put healthy participants through two different conditions. In one condition, they were limited to six hours of sleep a night for one week. And then they were given a full eight hour opportunity for one week. And then they measured the change in their gene activity profile

relative to when they were getting sufficient sleep. And there were two striking findings. The first was that a sizable and significant 711 genes were distorted in their activity caused by that lack of sleep. And this is not dramatic sleeplessness. This is six hours of sleep a night. Yeah, I mean, most people say six hours, I'm good.

That's pretty good. Right, and that just doesn't seem to be the case biologically. What was also interesting, however, was that about half of those genes were actually increased in their activity, or what we call overexpressed. The other half were decreased

or switched off in their activity. Now, those genes that were suppressed caused by a lack of sleep were numerous genes associated with your immune system. Yet those genes that were actually increased in their activity were genes that were associated with the promotion of tumors, genes that were associated with cellular stress

and as a consequence, cardiovascular disease and genes that were associated also with metabolism and changes in metabolism. And what that study taught me at least is that there is no aspect of our physiology that seems to be able to retreat at the sign of sleep deprivation and get away unscathed. Yeah, one of the striking things in the book

that really hit me was the relative lack of elasticity in the human body in that just one night of dysregulated sleep a week has much more of a profound deleterious effect than you would think. You would think. You would think like, well, I sleep pretty well most nights, but you know, once a week, like my stuff got screwed up, but you know, I'll recover.

But the downstream implications of just a little bit of dysregulation are much more serious than one would suspect. Yeah, I mean, a good example is another study where if you take healthy adults and you limit them to just four hours of sleep for a single night, the next day we see a 70% drop

in critical anti-cancer fighting immune cells, seven zero called natural killer cells. Now today, you and I have both produced cancer cells more than likely. What prevents those cells from becoming and manifesting as the condition that we call cancer is in part these critical cancer-fighting immune cells, natural killer cells.

That is a dramatic state of immune deficiency. And it happens quickly after just one bad night of sleep. So you could imagine the state of your immune system after weeks, if not months of insufficient sleep. Yeah, one of the things that is very vivid in the book as well as this process that takes place when you're sleeping, this kind of detoxification process, right?

Where you're kind of cleansing the brain and washing out the beta amyloids and all the kind of negative things that accumulate in the mind throughout the day, because wakefulness is really the toxic state, right? And sleep that is the restorative state, obviously. And you likened it to the island of Manhattan where all the skyscrapers shrink

and like a wave washes over them and cleans all of them. And all this nasty stuff that we don't want is washed away. And when you impede that process, those things start to accumulate, right? And that's why we see so many of these downstream, diseases cropping up everything from Alzheimer's, diabetes, cardiovascular disease, et cetera.

Yeah, I mean, from the perspective of your brain, this sounds a little bit extreme, but biologically I think it's accurate that wakefulness is low level brain damage and sleep is sanitary salvation. And this I think is one of the most exciting areas in sleep science over the past five years, it's just ballooned and we've been fortunate enough

to do some of this work, which is the relationship between a lack of sleep and over the past five years, it's just ballooned. And we've been fortunate enough to do some of this work, which is the relationship between a lack of sleep and Alzheimer's disease. And it really has become a four part story, which is association, causation, mechanism, and then treatment hope. So what we understood about four or five years ago is that people who are typically sleeping

less than six hours a night went on to develop far more of those sticky toxic protein elements that are the culprits underlying Alzheimer's disease called beta amyloid and more recently, this thing called tau protein. They're the two proteins that we believe underlie the condition of Alzheimer's disease. Then what we also found is that people

who have sleep disorders such as insomnia or sleep apnea also have a significantly higher risk of going on to develop Alzheimer's disease later in life. But they're just associations, they don't prove causality. And then several years after that, scientists demonstrated that if you take a healthy adult and you deprive them of sleep for just one night, or you deprive them of just deep sleep for one night,

you see an immediate escalation in that Alzheimer's protein beta amyloid circulating in the bloodstream, circulating in the cerebrospinal fluid, and also within the brain itself using brain imaging technology. So that proved causality that you can take an otherwise healthy person,

take away that thing called sleep, and you can trigger that instigation of what seems to be like the emergence of an Alzheimer's cascade in pathology. If that's true, then we ask the question, well, what is it about sleep that deescalates that Alzheimer's disease protein in the brain? And there was just, I mean, this is,

I think it's Nobel prize worthy, but a researcher called Megan Nedegaard at the University of Rochester made three remarkable discoveries. She was looking at mice and what happened when they slept. And the first thing that she discovered is that the brain has a cleansing system. And we didn't think it did.

Now we knew that the body had its own cleansing system, which everyone will know about called the lymphatic system. We didn't think the brain did. And she discovered, in fact, it does have a cleansing system called the glymphatic system named after the glial cells that make up this process. Right, and those live in between the brain cells, right? That's right, glial is sort of,

if you look at the Latin and Greek sort of derivative, the entomology is the glue, because we used to think that they were just the cells that kind of glued the actual brain cells there. Well, they're all brain cells technically, but would glue the neurons together. that kind of glued the actual brain cells there. Well, they're all brain cells technically, but would glue the neurons together. But they sort of outnumber your neurons by many fold.

And they're critical. They perform lots of functions, but they form this network, this sewage system. So that was the first discovery. Then she found that that cleansing system wasn't always switched on in high flow volume across the 24 hour period. Instead, it was when those mice were asleep and when they went into deep sleep, that that sewage system really kicked into high gear. The final discovery, and that's what makes it relevant to Alzheimer's disease, is that she found that one of the metabolic byproducts,

one of the pieces of metabolic detritus that that sleep was washing away was this toxic protein of beta amyloid. And just last year, scientists in Boston actually found a very similar pulsing cleansing mechanism in human beings. So that was a mechanism that helped us realize how this could all connect together.

For me though, it may all sound very depressing, just as you mentioned for yourself and I experienced this, the older that we get, typically the worse our sleep and the older that we get, the greater our risk of Alzheimer's disease. And so it may sound quite a depressing story, but I think there's a silver lining here because unlike many of the other factors

that are associated with aging and Alzheimer's disease, for example, changes in the physical structure of the brain or even changes in the blood flow dynamics of the brain, they're fiendishly difficult to treat. And in medicine, we have no good wholesale approaches, but that sleep is a missing piece in the explanatory puzzle of aging and Alzheimer's disease is exciting because maybe we can do something about it.

Perhaps what we could do is in midlife, which is when we start to see the decline of deep sleep, that's when we could intervene with optimization of sleep with lots of different methods that are being developed. And in that way, could we bend the arrow of Alzheimer's disease risk down on itself? Could we shift from a model of what we have right now, which is late stage treatment to midlife prevention?

Going from a model of sick care to actually healthcare. That's one of our sort of moonshot goals. I'm incredibly excited. Yeah, yeah, yeah. I mean, that's the holy grail, right? Yeah, yeah. And I think about this all the time when I wake up after an amazing night of sleep

and then my experience throughout the day is optimal. And then the following night, I have a degraded version of that. And I wake up and I think, why can't I just, why can't we figure out a way to replicate this day in and day out without pharmaceutical intervention? Like I'm trying to do all the right things and yet it is so elusive.

And part of that, yes, is age because when you're a teenager, you can just fall asleep in an instant and seem to get a good night's sleep no matter what. But I'm constantly thinking about like, how do you figure this out and master it? Because if you could, it would literally change everybody's lives.

Yeah, and if you take the reverse of that, we know starting with this recommended sweet spot of between seven to nine hours a night, going in the downward direction, there's a very simple truth, which is that the shorter your sleep, the shorter your life. Short sleep predicts or cause mortality.

Right, which is so ironic given that, you know, the hustle culture, you know, it's all about maximizing those daylight hours and I'll sleep when I'm dead. Right. And you're just hearkening that death. Yeah, it's, you know, it's mortally unwise advice, anyone who tells you that.

But to me, I think sleep could be seen as the Swiss army knife of health. Whatever ailment that you're facing, sleep normally has a tool in the box that can help. And so for me, I think the Shangri-La is perhaps less about trying to elongate lifespan than it is really about prolonging people's health span. Because when you ask most people,

that's what they really want when they're trying to sort of, you know, live a clean, healthy lifestyle. They don't want a life with disease and sickness. But when you are starting to shortchange your brain and your body of sleep, that's what you're inviting. You know, and the elastic band of sleep deprivation will stretch only so far before it snaps.

And if you fight biology, normally you lose. And the way you know you've lost is disease and sickness. Yeah, the human hubris over all of this though is something to behold because we always think we can find an end round around these things. And as beautiful and magnificent to behold because we always think we can find, you know, an end run around these things. And as beautiful and magnificent as the scientific method is, it tends to be very binary in its approach, right?

So if X, then Y, controlling for variables. But when you're dealing with systems that are so complex, my sense is that oftentimes it leads to unintended negative consequences, right? Like take this pill and you'll sleep well, but we're not realizing or looking at all these other things that are occurring and it isn't until much later when researchers like yourself can pull the covers on that

and say, this was not such a good idea. Yeah, pull the covers, no pun intended. Right, right, right. But I think you're right. There is a very understandable, again, I don't want to sort of be finger wagging or chastise people. If you don't know the science of sleep,

I would be just as unknowing, but it took mother nature 3.6 million years to put this essential thing called, a seven to nine hour sleep need in place, to think that with hubris or arrogance that we could come along and within five or 10 years, if we're, you know, medical, sort of forcing medical residents

to go through these ridiculous sort of schedules, or, you know, if you're in some other professional industry that you can just find a way to hack that system is unfortunately misfounded. The stuff that you said about Alzheimer's and dementia makes a lot of sense, but how does that work with cardiovascular disease? I mean, obviously brain health is vascular health

and heart health certainly is vascular health, but what is the relationship between sleep, sleep quality and taking an insurance policy out against heart disease? Yeah, I mean, so we mentioned the daylight savings time example, but more than that, we know that people who are typically sleeping less than six hours a night,

on average will have about a 200% increased risk of cardiovascular disease or a heart attack in their lifetime. We also know from a prospective study that came out of Harvard Medical School, that they took a large range of people who had no preexisting signs of cardiovascular disease. And then they tracked them across five or six years. And what they found is that those people

who are sleeping less than six hours a night, they had a 200 to 300% increased risk of calcification of the coronary artery. And that coronary artery is essentially, that's the corridor of life for your heart. When you hear people saying, gosh, they had a massive coronary, what they mean is that that coronary artery had become blocked calcification. And that's exactly what we see.

Now, again, this was a prospective study. No one had any signs of that before. But when you looked at that sleep shaving, sleep coming down and down, that was the predictive factor. We also know that, however, sort of turning the tables in the positive, why does sleep give you that benefit?

During deep sleep, our heart rate decelerates, our vascular system, our vessels start to relax. You can think of deep sleep, our heart rate decelerates, our vascular system, our vessels start to relax. You can think of deep sleep like the very best form of blood pressure medication that you could ever wish for. We also see that it's during that nighttime phase when we drop levels of cortisol, which otherwise if left in high concentrations, it's a stress- related chemical. It's an adaptive chemical too, we all need cortisol. But if you're just chronically high in cortisol, that is deathly for your cardiovascular system. And sleep will actually ratchet down that level.

Also sleep will quiet the fight or flight branch of your nervous system. It's called the sympathetic nervous system, which I think is terribly named. It's anything but sympathetic. It's agitating, it's aggravating. And it's during deep sleep that we actually shift over from that fight or flight branch to the more quiescent calming branch

called the parasympathetic nervous system. And so now we can start to understand why we see risks for heart attack, risks for cardiovascular disorder. We published a paper a couple of months ago demonstrating that short sleep and particularly not just short sleep, but also fragmented sleep.

And this is, I think, another important point that we've learned in the most recent years. It's not just about the quantity of sleep, it's also about the quality of that sleep. And we found that people who had fragmented sleep had a higher likelihood of their blood vessels becoming hard to what we call atherosclerosis, the hardening of the blood vessels,

which can then be a direct pathway to cardiovascular disease and heart attack as well. That's interesting. And is there a sense of where that falls in the pecking order of importance when you compare it to nutrition or exercise or these other kind of contributing or ameliorating factors with respect to heart disease? It's just as heavy a hitter.

If you look at the combination of quantity and quality of sleep and you look at the effect sizes, it's right up there. You can almost play the game. And I don't mean to do this because I'm someone who pays, I'm very dedicated to a practice of physical activity and exercise, I'm not quite at your level, but, and I eat very cleanly, I too am a vegetarian.

So I respect those things because I know how utterly important they are for my health span and my lifespan. But I can do a thought experiment where I say, I take you Rich Roll, and I'm going to deprive you of either exercise for 24 hours, of food for 24 hours, of water for 24 hours or of sleep for 24 hours. And sleep by-

There's no comparison. By a country mile will dwarf the physiological and mental deficits that come by way of that. I think the only other thing that's perhaps will overtake sleep is oxygen. You know, if I start your function, you will, I hold my hands up, I lose out to oxygen. Right, but you've said often that, you know,

when you think of the pillars of health, sleep isn't a pillar, it's the foundation upon which all these other pillars are erected essentially, right? Yeah, I used to think it was a third pillar, but then the more I've done this research over the years, the more I realized that I was wrong. It is a foundation on which those two things sit. I can give you a good example.

If you're trying to manage your weight, if you're trying to diet, let's say, and lose weight, but you're not getting sufficient sleep, 70% of all the weight that you lose will come from lean muscle mass and not fat. Right, the body when it's fatigued in that way wants to hold onto those fats. Exactly, your body becomes stingy in giving up its fat.

So in other words, when you are under slept, but you're trying to watch your diet, watch what you eat, you will lose what you wanted to keep, which is muscle, and you will gain what you wanted to lose, which is fat. Right, and on top of that, that's when those crazy cravings for terrible foods happen, right? I just know when I'm under slept,

that's when I start thinking about all these foods that I shouldn't eat. And it comes by way of two different routes and they're non mutually exclusive. One is a brain route, the other is a body route. What we've firstly discovered is that when you're not getting sufficient sleep, it be it six hours a night, five hours a night,

four hours a night for several nights, there are two critical appetite regulating hormones that go awry. These hormones are called leptin and ghrelin. I sometimes joke that they sound like hobbits, but that's just my British Tolkien obsession. But leptin is the hormone of satiety. When you release leptin, it says to your brain and your body, you're full with what you've just eaten. You don't want to eat anymore. You're no longer hungry. Ghrelin is the opposite. Ghrelin is the hunger hormone.

It says, no, no, no, you're not satisfied with your food and you want to eat more. And when you are underslept, those hormones go in the opposite direction in ways you don't wish them to. Firstly, leptin, which is the satiety signal, that drops away. So you lose that signal of being full

and you constantly feel hungry. If that weren't bad enough by itself, ghrelin, the hunger hormone, that actually increases. So now you may have eaten a standard meal that normally otherwise would have been satisfying, but it doesn't feel satisfying and you still want to eat more. And on average, people will typically eat anywhere

between two to 400 extra calories each day under these conditions of insufficient sleep. What was also striking from these studies is not just that you want to eat more, which in general you do, and you want to snack more, but it's what it is that you have a craving for. Because when you are under slept, you have this increase, particularly a dominant increase

in wanting to eat those heavy hitting carbohydrates, also sugars, as well as salty snacks. All of those are foods that we know in excess will put you on a path towards this obesogenic profile. Right, it would be interesting to take a look at whether or not the rate of people going to the drive-through increases on daylight savings, right? On that day when everybody's lost an hour of sleep,

they're a little bit more tired, I would suspect it would follow that a lot of people are hitting McDonald's on the way to work. I wish I could get that data. I wish there was like a McDonald's app where I could look at the usage statistics and then do that sort of study. So in the body, that's part of the reason,

but in the brain, there is also a pathway. And we did a study several years ago where we took a group of healthy adults of normative weight and we either gave them a full night of sleep or we took sleep away a full night of sleep or we took sleep away for a night. And then we put them and same individuals. So it's the same people going through two different studies. And inside of the brain scanner, we were showing them these different food items and they had to rate how desirable those food items were. And we made this

a little bit more real by saying, look, at the end of this brain scan, we're gonna pull you out and we're going to give you one of those foods so that you have to eat it. So, you know, they're not just saying, oh, okay, I should just be good. And I know that, you know, that I should say is nice. And what we found firstly is that people,

when they were underslept, their hunger increased. Secondly, what we found is that they were rating junk foods as far more desirable as a consequence. And then when we looked at the brain scan, something fascinating happened. There were the deep hedonic emotional centers of the brain. They were revved up as a consequence of a lack of sleep. These sort of impulsive sort of, you know,

almost these addictive brain senses. In fact, they are a part of the same centers that go awry in addiction. What was also interesting is that other parts of the brain, particularly a part right upstairs above your eyes in the frontal lobe that had shut down, which normally keeps our hedonic desires in check. And as a consequence,

the underslept people were sort of no longer reaching for leafy greens and a handful of nuts. They were reaching for ice cream, pizzas, these salty snacks, et cetera. So it's both within your brain that explains why you know for a fact, when I'm not sleeping, I'm just, I'm always hungry.

Right. I can never get satisfied. I can never get full and I don't know why it is, brain and body. Well, I feel seen and heard because as somebody who's been in recovery for a long time, I, you know, in an end of one experiment, I know when I'm under slept or I've had a terrible night of sleep,

all of those kinds of addictive compulsions, because I have some self-awareness around them, I'm able to like understand that that's what's happening. But it's always been confusing that it correlates, like why do I like feel like acting out or eating this thing or like sending the email I shouldn't send or all of these things that happen when I'm underslept, that's very interesting.

Yeah, and thanks for bringing that up too about addiction disorders. We've done a little bit of work in this area too. What we found is that when we shortchange someone's sleep, these dopamine centers within the brain that are what we think of as reward-based centers, and they're the centers in the brain that addiction will hijack,

those become increased in their sensitivity. So your reward sensitivity increases, your risk taking increases, your impulsivity increases. What we know is that those people who are underslept are far more likely to develop an addiction disorder during use. We also know, and this is perhaps even stronger of a relationship, when you are trying to abstain

and go through recovery, sleep is a huge predictive factor. When you're getting enough sleep, your chances of remitting and recovering are far higher than when you're not getting sufficient sleep. Yeah, that makes sense. Well, this is a good opportunity for me to indulge you in my own history here. Yeah.

Because just reading your book again and getting ready for today, I started thinking more profoundly and deeply about my own history with sleep over the years. And I just, I had this like dawning, depressing epiphany of just how sleep deprived I have been up until like literally my late 30s with how I've lived my life.

I mean, I, from age like 14 to 21, I was a competitive swimmer. I was waking up throughout junior high school and high school at 4.45 every day to go to swim practice for two hours. Then I'd go to school, then I'd go to swim practice again for two more hours, do my homework, go to bed, repeat,

chronically sleep deprived through those years, going to college, the same thing. And just, you know, I have memories of just sleepwalking through my life, just so exhausted, not just from the sleep deprivation, but on top of that, like very rigorous training, right? So I literally had no energy for anything. And then around 21 is when my alcoholism

really started to kick in. So the next 15 years was a cycle, a progressive cycle of course, of, you know, sleeping, sort of drinking to blackout, passing out, going on three day benders, and then experiencing those sleepless nights that occur in the wake of that. It would take three or four days to normalize

and terrible nights of laying in bed, sweating, and staring at the ceiling and unable to sleep and shaking and the whole thing, only to finally get, by Wednesday, getting one good night of sleep, feeling okay, and then repeating it again, right? And I did that for 15 years. And it wasn't, I got sober at 31.

And then I transferred a lot of my addictive tendencies onto workaholism. So it didn't get that much better. But looking back, it's just unbelievable how much I shortchanged myself from sleep. And I think, what is the relationship between that early sleep deprivation and my alcoholism? What is the relationship

between the alcoholic sleep deprivation and my ability to be a functional human? And all I can tell you is that when I look back, I think back on those years, I can barely remember a single book that I read. I couldn't tell you anything that I learned in law school. I barely remember college. And my memory overall is not so good.

It's really like unbelievable when I think about how profound that is and the impact that it's had good. Yeah. It's really like unbelievable when I think about how profound that is and the impact that it's had on my life. On top of that, this is separate, but I slept walked like all the time when I was a kid, ultimately I grew out of that, but I don't know how that plays into it. But when you hear that, like, what is your reaction?

Yeah, so, you know, firstly from the memory point that you mentioned, we know that sleep is critical for learning and memory in at least three different ways that we can speak about, but what about the long-term consequences of that? Well, we have a little bit of data from the situation of airline pilots who typically have to undergo jet lag,

they're chronically sleep deprived. And firstly, what scientists found when they looked at matching those pilots with sort of someone of similar age, some of similar background, education, lifestyle, et cetera, et cetera, they found that parts of their brain had actually shrunk. It's what we call atrophy, they'd lost brain cells. Where had they lost brain cells?

They'd lost them particularly in the memory centers of the brain, a structure that we call the hippocampus. And the hippocampus, which sits on the left and the right side of your brain, like a long cigar shape on the left and the right side, it's almost like the informational inbox of your brain. It's very good at receiving new information and memories and holding onto them. And that part of the brain had actually deteriorated because of that disrupted sleep schedule. Now you could argue, well, perhaps it's just something about bias selection that, you know,

I don't know how it would be, but airline pilots, Those kind of people like to become pilots. Yeah, because of poor memory, they don't go into profession X, they go into piloting, now piloting is essential with memory and so I don't think that's the case. But a better demonstration of that was then they looked at how long that they'd been on the job.

How many years had they been going through that sort of sleep deficiency? And that predicted the magnitude of brain shrinkage, which made me think, okay, I think it's more likely that it has to do with the sleep as well. So is there a potential long-term organic atrophy consequence of insufficient sleep on the brain?

We seem to think that there is, yes. But again, I think I want to be really careful here and I don't want to be causing people alarm. And what I would say is that it is never too late to start sleeping better. And that's not just me sort of pulling out the pom poms and trying to be positive, we've got data. So in a series of studies, and we've done a lot of work in,

as I mentioned in older adults, but if you take a group of midlife adults who are suffering from untreated sleep apnea, heavy snoring, and then you put them on treatment, which is called a CPAP machine, C-P-A-P, the continuous positive airway pressure. And by the way, if anyone's listening to this and they think that they suffer from sleep apnea

or they have a partner who does, please go and get diagnosed. It is a deathly disease, untreated. And what they found is that about half of those participants complied to the treatment and about half didn't. And they track them over a 10 year period. And what they found is that those individuals

who complied to the treatment and whose sleep was improved as a consequence, they staved off the onslaught of Alzheimer's disease and cognitive decline by anywhere between 10 to 15 years relative to those who remained untreated or uncompliant with their treatment. In other words, even in midlife, there is evidence to say it's never too late

to start sleeping. But can those brain centers that have atrophied be regenerated or is that a permanent thing? We don't know. It depends on what extent of atrophy. We used to think maybe 30 years ago that the brain didn't produce new brain cells. Once it had matured and once you are an adult,

that was your sort of smorgasbord of brain cells. And as you lost them through time, you never got them back. When you drink, you kill brain cells, they never come back. They never come back. Well, that's not true. There are in many regions of the brain that is true,

but there are a couple of regions that it's not true. And in fact, these memory centers, the hippocampus, that's one of the centers that does actually seem to have some degree of regenerative capacity. How capable of meeting the demand of brain atrophy and damage that that system is of regeneration is unclear. What I should note by the way, is that that system of the creation of new brain cells,

it's what we call neurogenesis, which I think is a great alternative name for a band rather than just genesis, Phil. If you deprive a rat of sleep, it fails to have the regulation of that neurogenesis. You lose the capacity for neurogenesis when you are underslept. So it becomes this self-fulfilling,

negative, vicious cycle of prophecy that if you are not getting sufficient sleep, those brain cells start to deteriorate and atrophy. And then the one thing that could help you get them back is the one thing that you keep depriving yourself of. So you lose even the salvation of the sort of the salvaging, sorry, I should say of that. Wow.

You mentioned pilots traveling from time zone to time zone. On top of that, I wanna talk about the medical profession because herein lie the greatest irony. These people who are dispatched with, tending to our health have this complete myopic perspective when it comes to prioritizing sleep in their own profession. And there's this systemic kind of infrastructure set up

that prioritizes lack of sleep. These residents who have to work these 30 hour shifts, this legacy of an old tradition that was set in stone long ago and continues like unbelievably to be the standard operating procedure today, which is unbelievable. And I loved how you told the history of this,

this guy Halstead, right? Yeah. Who basically was a hard ass back in the, at the turn of the century and just said, this is the way we're gonna do it. And today we still do it in the manner that he kind of established back then, but it turns out he was like a raging cocaine addict.

That's right, yeah. So William Halstead was the guy who set up the first resident training program in the United States at Johns Hopkins University. And it's called a residency for a reason because you're going to become a resident. You're going to live in the hospital. And he was known for being able to go

these heroic long stretches without needing sleep. People were stunned. And he expected his junior residents to match him in that. And gradually after his death, it emerged the reason why he was able to do that. Halstead in his early career was actually studying the anesthetic properties of cocaine. And unfortunately he started to use cocaine himself

and he became an accidental addict. And that was how he was able to just go days straight without seemingly needing sleep. And apparently set the expectation that everybody else should be able to manage it the way that he was. To go the same degree. Now, there were times, there were stories

where people would say, he would, in the operating theater, he would have to go and take a break because he was saying he was not feeling well, he was sweating a lot, he seemed to be cold and he would have to go take a break and it's because he was detoxing during the long surgery. So he had to go and administer again. And you know, it was because he was detoxing during the long surgery. So he had to go and administer again. And he knew that he was an addict

and he sought to go into rehab under a different surname. And at the time they were treating cocaine addiction with morphine. Right. And unfortunately what happened is that he came out of that rehabilitation program with no resolution to his cocaine addiction, but now he had a heroin addiction.

And the story goes that he would have his shirts, his white shirts sent away to get laundered in places like Paris, France, and they would come back both white and starchy, but there would also be other white related compounds. So, and we've never let go of that, arcane and I think inane practice. And it's not medical residents who are at fault here.

Speak to any of them and none of them will tell you that that's what I want to be doing. And I've had conversations with a dear friend called Peter Atiyah, who went through the medical practice, his wonderful medical doctor. And he describes some shocking history with a lack of sleep. And the statistics are just damning. Firstly, what we know is that medical residents

who have performed a 30 hour shift will make 460% more diagnostic errors in the intensive care unit. Secondly, we know that if you're going to have elective surgery, let's say, and your surgeon has slept less than six hours in the previous 24, there are 170% more likely to cause a major surgical error,

such as rupturing a blood vessel or damaging or puncturing an organ. Then the irony is that a medical resident who's worked a 30 hour shift, when they get back in their car to drive home at the end of their shift, they're 168% more likely to get into a car crash. Now returning to the accident and emergency room

from which they probably came, but now as a patient rather than a doctor. And, you know, I've tried with many other people to lobby the medical institute or institution and try to understand why is this the case? And I think some of it has to do with the old boys network that it's almost like a hazing that, you know, we went through it, so you have to do it.

You know, man up, suit up, boot up, woman up, you know, you need to get through this. This is a rites of passage. And again, it comes back to that idea that thinking that you can fight mother nature and evolution is just thick headed. And that's what this just demonstrates. I get the idea that you have to develop a level of rigor

and emotional resiliency to handle that kind of job. And there is something to be said for, you know, putting people in challenging situations to see how they function under high stress. But the sleep deprivation aspect of it is just ridiculous. If when you go through medical school, you take an oath, which is to do no harm, and then you're placed under conditions

of insufficient sleep, that statistically will guarantee that you will do more harm than if you were sleeping or working, let's say just a 16 hour shift. I think some of the pushback that you receive or I've received is, look, my mind's made up, don't confuse me with the data.

And you think, okay. You're the scientist. What can I do? You know, isn't this self-evident? And one of the arguments though, I think that has some legitimacy is that of continuity of care that if you are flip-flopping back and forth

between a resident every six hours, the continuity of the patient care can decrease. But then I thought about that argument for a long time. And then I looked at a number of medical systems throughout the world. And I asked, how long does it take to train their residents and how good is their medical care? And what I found is that there are places like New Zealand,

France, Switzerland, they all have their residents working no more than 16 hours and their quality of healthcare is actually ranks far better in the worldwide statistics than the United States. So you can't tell me that you can't train an individual within five years or less at a reasonable amount of sleep and not maintain high quality of medical practice. Well, part of the problem tracks back to the fact

that there's no education on this in medical school, right? So these doctors who then become hospital administrators don't have the proper background to make a better decision about this. That's exactly right. So I also, myself and some other researchers, you look at the medical curriculum throughout many of these first world nations.

And what you discover is that the average medical resident will receive somewhere between an hour and a half to two hours of education on sleep relative to the entire medical program. Now that strikes me because that's one third of their patient's lives. And that one third of their life spent asleep makes a profound difference

to their two thirds of waking health life. Why aren't we investing more in the education of sleep for our medical residents? Well, why aren't we? Have you seen since the book came out and you've been speaking regularly on this, have you seen changes, positive movement in this regard? A little, but not too much, unfortunately.

I think there are some medical programs around this country, at least that are doing better than others. There's quite a variability. So some are prioritizing it and understanding its importance, but overall, no, I think that same sort of, some of that hubris is still present.

What do we do to change that? Well, I tried early on speaking about this from the statistics of the patients, from a point of view of compassion and empathy for our young residents. And that sort of just falls on deaf ears. What I realized is that you have to speak in a currency with which medical institutions and administrators

will listen to which is dollars and cents. And when you start to rack up the numbers regarding malpractice suits caused by insufficient sleep. They start paying attention. They start paying attention. So I was just stupid. I thought about appealing in the wrong language. You gotta follow the money.

Yeah, I know. But this Halstead reminds me of that TV show, The Nick. Did you watch this show? No, I didn't. Steven Soderbergh did a limited series several years ago. I think it was for Showtime, I can't remember. But it's about this surgeon played by Clive Owen at the turn of the century, it's literally 1900.

And he is an opium addict and then he gets introduced to cocaine and heroin, but he's this talented surgeon and he goes into the theater and you see the crazy surgeries that they were doing at the time. It's quite an interesting document. I think you would really like it. Okay.

But I couldn't help but think, I wonder if this character is modeled after Halstead. I suspect so. I suspect if, you know, drug abuse, cocaine, and such was involved, then he was this extraordinary power and force that sort of birthed into being, you know, this new way of medical practice.

I well imagine it was based on- Right, right, right, right. Well, the relationship between substance and substance abuse and addiction and sleep deprivation is another way in on this, you know, in this terrain. I mean, when you have all these doctors who are being compelled to stay up so late, they're gonna find exogenous ways of, you know,

enhancing their ability to do their jobs. The treatment center that I went to many years ago was known for having lots of doctors and pilots, like the two people that you completely sort of divest yourself of any of all control over to. And I just remember being struck at how many surgeons and pilots were in this treatment center. Like there was a brain surgeon who was a morphine addict

and there was all kinds of pilots that were addicted to Vicodin. There were anesthesiologists that were fentanyl addicts. They would steal it when they would not use the entire vial and they were using them primarily so that they could function in their job capacity. That's right, yeah. That's how it starts.

To sort of try to come back from the disruption. But what we know is that the risk or the probability of someone abusing drugs of abuse in the medical profession is significantly higher than the general population. To me more striking and well, an equally striking and equally worrisome statistic recently is that the rates of suicide are far higher in young residents. And what we've discovered over the past maybe 10 years

and we've been doing a lot of this work too is the intimate relationship between sleep and your mental health. And what we know is that when you are not getting sufficient sleep, your suicidal thoughts increase, suicidal planning increases, suicide attempts increase, and tragically, suicide completion also increases as well.

And more generally, what we've discovered, and I've been doing this for about 20 years now, we have not been able to discover a single psychiatric condition in which sleep is normal. And so I think sleep is a profound story to tell in our understanding, our treatment, maybe even our prevention of grave mental illness. Well, certainly in saying that,

it should be the first stop on the kind of treatment protocol, right? Like how is your sleep? Let's deal with that first before we look at pharmaceutical interventions. Yeah, it's a stabilizing force. And we know it's a stabilizing force, both in terms of your psychology,

as we mentioned, impulsivity, but also just from a basic reward brain sensitivity, that your addiction potential from a brain perspective is higher with insufficient sleep. Same individual, two different sleep conditions, two different addictive profiles. Wow, I have to reassess my whole life now. Oh, I'm so sorry.

No, it's fine. No, it's good. I wanna talk about sleep in adolescence and in teens, because I think the work that you're doing here and the issues that you're trying to raise awareness around are super important. The implications of chronic sleep deprivation in young people, the relationship to early school hours

and how this plays out in terms of academic potential and the mental health implications that you just mentioned. Yeah, so there's been a remarkable amount of work looking at this issue of early school start times, this incessant model of marching back the school clock hours. And the summary of the evidence really, I think it goes the following. Firstly, we see that academic, when you shift schools to a later school start time,

so when you do a causal intervention, what happens? Firstly, academic grades increase. Truancy rates decrease. Psychological and psychiatric referrals also decrease. But what we also discovered is that the life expectancy of those students increased. And you may think, well, hang on a second, how do you, how does that work?

Well, the leading cause of death in late stage adolescent teens is actually not suicide. It's road traffic accidents. And here sleep matters enormously. And there was one good example. I think it came from Teton County in Wyoming. They shifted their school start times from around 7.30 in the morning

to just before nine o'clock in the morning. The only thing more remarkable than the extra hour of sleep that those kids reported getting was the drop in road traffic accidents. That following year after the time switch, there was a 70%, 7-0 reduction in car crashes in students 16 to 18. Statistically unbelievable.

It blows my mind. Now, statistically, you can give a relevance to that. Think of the advent of ABS systems in cars, anti-lock brake systems that stop your wheels from locking up into hard braking. That dropped accident rates by around 20 to 25%, and it was deemed a revolution. Yet here is a simple biological factor,

giving our kids the sleep that they need that will drop accident rates by up to 70%. So if our goal as educators truly is to educate and not risk lives in the process, then we are failing our children in a most spectacular manner with this incessant model of early school start times. When sleep is abundant, minds flourish.

When it's not, they don't. Right. There's so much education I think that needs to be done in this area as a parent of two teens, I've got four kids, two older boys. Any parent knows how difficult it is to wake up a young adolescent in the morning and the frustration that comes with that.

But what I've come to better understand by dint of your work is how crucial sleep is for that developing brain. And during COVID, we have one child, our younger child who's being homeschooled right now. We've let her sleep in as long as she wants. And we don't start her first class until noon. And so she's getting a ton of sleep. But if you even tried to wake her up at nine o'clock,

I mean, forget it. You're gonna spend the next hour and a half trying to get this kid up. So clearly there's a reason why that state of sleep is so deep, right? Like that it is crucial in this developing mind. Yeah, and we often have that classic idea of a parent at the weekend pulling the sheets off,

the teenager ripping open the curtains and saying, you're wasting the day. But firstly, what we know is that it's not their fault because during that adolescent transition, there is a biological shift in their 24 hour rhythm that they now want to go to bed later and wake up later. So asking a teenager to wake up at seven o'clock in the morning and operate and conduct themselves

with good grace and be able to learn effectively is like it's an impossibility an adult you know to wake up at 3 30 or 4 in the morning and be the best version of yourself you know if if i was to wake up at you know three o'clock in the morning and come through to the kitchen and or we both wake i'd have to say to my partner you know i would say to look darling and she would say like why are you moody? I'm just not the best version of myself because I've woken up too early. And she will definitely tell you that. But I think it's the same, you know,

misgiving because we don't understand how sleep works with our teenagers. And so putting them in the school at that time, seven or eight in the morning, essentially is, you know, educating them amnesic. They are at that stage, they are leaky sieves and what will go in will just come out the other side. So that's the first thing that's happening.

It's not their fault, it's just their biology. And then second at the weekend, they're trying to sleep off a debt that we've lumbered them with during the week because of these early school start times. And if you ask parents, if you sort of question parents of teenagers, what proportion of parents think

that their teen is getting sufficient sleep? And more than 70% of them say, I think my teen is doing fine. I think they're getting the sleep that they need. When in reality, less than 15% of those teens are actually getting the sleep that they need. When in reality, less than 15% of those teens are actually getting the sleep that they need. So there is a parent to child mismatch in sleep understanding. And as a consequence,

there is a parent to child transmission of sleep neglect. Parents don't see it, they don't understand it. And so in 15 or 10 or 20 years time, that teenager, lo and behold, seems to have amnesia. And they, with their own kids will do the same thing. They'll pull the sheets off and say, you're wasting the day because it was taught to them by their parents that sleep and getting the right timing

of sleep and the right amount of sleep is something shameful. So for that young person, do they need more hours? They do. So the eight hour rule doesn't really apply. No, that's for adults. And in fact, the brain doesn't stop developing until it's about 25 years old. And sleep plays a critical role

in what we call brain plasticity, which is modeling the brain. It plays a role early in life in the first couple of years. Sleep seems to actually help wire up the brain. So it's almost like sleep at that time of life comes in to a new neighborhood and like an internet service provider, it wires all of those homes with high speed fiber optic cables. But then later in life, that's when during the teenage years, we've actually realized which homes

are using the high bandwidth and which homes aren't really sort of drawing on that sort of, you know, that broad band speed. And so then the role of the brain, it goes from expanding and creating lots of connections, which is called neurogenesis, to then actually synaptic pruning, which is where we now have to make the brain efficient

for adulthood. We sculpt away the unnecessary and we keep the necessary. And sleep performs that role too in later teenage years. And as a consequence, if you are chronically under sleeping a teenager, you're effectively stunting brain development. And no one would wish that for their child. Right, so you impede neurogenesis.

So there's fewer pathways to choose from. And then as you age, then you're selecting, you're basically, you have less to choose from, right? So you're just limiting the brain's capacity to do its job well. So early in life in the first five or so years, you want to sort of, it's almost spray and pray attitude, a little bit like investing.

You just gift all regions of the brain, lots of connections. And then you let experience and time teach the brain which highways and sort of tributaries and avenues and lanes would you like to keep and which should be removed. So now as you shift later in life, it's all about efficiency.

Let's get this brain efficient. Because right now when you've got this too much, too much connectivity, it's good to sort of as a general blueprint to lay down, but then let life tell you which of those sort of networks you should enhance and which you should actually remove. And it's later in life that we're removing those.

And as I said, it's not until we're about 25 that the brain has finished all of that maturation. And that's why the recommendation is seven to nine hours in adults and I would argue in adults once they're past 25 years old. Before that, you need much more sleep. So what would be the ideal amount of sleep for the adolescent or young teen?

Yeah, it's usually somewhere between eight to 10 hours and going up to maybe 11 hours, depending on that teen. And if people want to find out, there's a great informational sheet. They can just go to the National Sleep Foundation. It's the nation sleep foundation.org. And you can look at the current guidelines that we and other scientists have sort of tried

to gather all of the information and say, look, where should we position these windows of sleep duration based on different age ranges? So it's a great resource if people are thinking about that for their kids and for themselves as well. So if you could bend the ear of the Secretary of Education, I mean, what would be your recommendation in terms of school start time, like 9 a.m.?

I think for teenagers, I would say 10 a.m. 10, yeah. 10 at the minimum. And what's interesting is that the younger kids, they can actually wake up earlier because they haven't gone through that adolescent transition. So they probably could be going to school and learning effectively at let's say 9am or even 8.30am. But in those studies, they carefully asked the question, we can't set different times for

different age brackets. You know, it's just not practical. And I understand why there is resistance in the school system. You can say, why are we starting that early? Some of it has to do a little bit with the bus unions, the bus networks that try to get kids to school. And I get that. I get, you know, it's not an easy problem to solve, but I also realized that we've put people on the moon and I think we can solve this.

There's been tougher problems to solve. Yeah. And so I'm not trivializing it. It's a big problem and I don't have all of the moon. And I think we can solve this. There's been tougher problems to solve. And so I'm not trivializing it. It's a big problem and I don't have all of the answers. I'm just a scientist. Well, there's the kind of mechanistic logistical aspect of solving that problem, but there's also the mental hurdle,

which comes with education, right? Like getting somebody's head wrapped around the idea of why a 10 a.m. school start is in the best interest of the child is a hurdle. Right, and for most parents, that's the genetic legacy. That's what you invest in. They're like, I gotta get to work too. Like, what am I supposed to, so.

Right, and that's the hard part. So what they did is they looked at say, okay, let's say that we start at school at 10 o'clock. That's only going to help the teenagers, but would it hurt the kids who are younger? Because that would then say, well, we can't do this one time fits all phenomenon. And what they found is that it didn't hurt the younger kids.

They were learning just as effectively, but in the teenagers, they were learning far more effectively. In fact, if you look across the day and you ask, where are those school start times really hurting the teenagers? It's in the first half of the day because they're mostly asleep.

And you ask any high school teacher, what does my class look like first thing in the morning versus in the afternoon? They're usually very different as an audience. What about dealing with things like SSRIs and treating ADHD with Adderall and Ritalin and the over-medication of our young people and the implication on sleep and brain development?

Yeah, I wrote a little bit about this in the book. It is unfortunate that if you look at ADHD, the current recommended treatment are things like Adderall and Ritalin. And they are some versions of something that looks very much like amphetamine. And I'm not dismissing the idea that ADHD exists. I'm not one of those people. It clearly does.

I also am not anti-medication by any means. But what I would say is that unfortunately, those medications are very strong wake promoting medications. I mean, if you ask an amphetamine addict, if they need sleep when they're using amphetamines, they will laugh at you, right? They'll say, are you kidding me?

I can go straight without sleep. And so maybe we need to think differently about at least the timing of that medication. Do we want to be medicating kids in the morning or in the evening? Because if those things are wake promoting, we know that kids with ADHD have non-normal sleep. They actually have disrupted sleep.

And we're also starting to find that those medications themselves are sleep disruptors. And so one wonders what would be the efficacy, the benefit of those medications, which there are, but just timed correctly. And you are at least able to try and protect sleep. Or what if we could just come up with better medications that aren't so destructive to sleep? I think that to me would be a better approach.

Is there research on antidepressant medication like the SSRIs and the implications for sleep? There are, yeah. So sleep is usually not normative when you're taking antidepressants. Now that's a general statement and it's too general. In fact, it really depends on which type of antidepressant because different antidepressants

will shift different neurochemical systems in the brain. So SSRIs stands for selective serotonin reuptake inhibitor and serotonin is a key neurochemical in the regulation of sleep. We have found historically that people taking antidepressants will typically have a reduction in REM sleep. It really seems to hit hard on REM sleep. And as we may come on to discuss,

sleep and particularly REM sleep provides a form of emotional first aid. REM sleep is what I've described as overnight therapy. And there's nothing that I've seen that, you know, sort of is that much further from its effect size based on the evidence. And so one wonders whether or not we can look to alternative medications that again,

have at least some conceptual sensitivity to the things that regulate sleep and try to stay away from disrupting sleep. You know, if sleep offers some form of assistance to depression, and we know that insufficient sleep predicts depression. We know that people who are depressed don't sleep very well. They have abnormal sleep patterns.

So if sleep is a part of that disorder and disordered sleep is a part of depression, then shouldn't we think about the medications that they take that are also sleep disruptive and maybe think about finding ways where we time again the the onset of the medication i don't know how many doctors describe to their patients not just take two of these but when you know seven o'clock in the morning could be very different than seven o'clock in the evening in

fact that's true of many medications in terms of their sleep disruptive capacity yeah Yeah. For somebody who, for whatever reason, schedule wise or whatnot, can't seem to carve out the eight hours of sleep a night, can this be made up for through napping or biphasic or polyphasic sleep. Like there always seems to be people who are doing all kinds of experiments with polyphasic sleep.

But to my mind, I mean, you know, obviously way more than I do, but it seems like those experiments always, like somebody is like, I'm just gonna sleep every two hours, every four hours, but that never lasts very long, right? They always end up going back. It doesn't.

So this sort of idea of what's called highly polyphasic sleep, some people will describe it as the Uberman sort of schedule. Some people have said, Da Vinci had once described it. It's part of this like self optimization. Right, biohacking. It doesn't work, right?

Not a good idea. No, it really doesn't. And there is nothing in our biology that would suggest that's how we should be sleeping. And in fact, it's quite the opposite. In fact, there's a lot in our biology screaming, you should not be sleeping like that. You're not designed to be highly polyphasic in your sleep, meaning multiple bouts of sleep.

The only time that we do that is when we're infants. You know, and it's sort of, I think Billy Crystal is a long time insomniac. He's got this joke and he says, I sleep like a baby, I'm awake every two hours. And that seems to be this highly polyphasic mentality too. So that doesn't seem to be the case. That doesn't seem to be how we should sleep.

And I would strongly advise people not to do that. Should we be sleeping though differently than the way that we are in modernity? And I actually think there is an argument for this because if you look at hunter-gatherer tribes whose way of life hasn't changed for thousands of years, they don't sleep the way that we do. They don't sleep in what we call a monophasic pattern, which is trying to get one long single bout at night and then we're awake for 16 hours.

They sleep biphasically. So typically, depending on what season, be it winter versus summer, they will sleep for anywhere between sort of six to seven hours at night. And then they will have this siesta-like behavior in the afternoon where they have a nap, getting this sort of fuller opportunity.

So I think modernity you could argue has actually dislocated us from how our natural edict of sleep schedule. Is there any other evidence to support that? There actually is. Most people will know this. Somewhere between about 2 to 4 p.m. every day, you will have a drop, a pre-programmed

and it's genetically hardwired drop in your alertness. It's sort of, you know, that you're around the boardroom table after lunch and all of a sudden you start to see these head bobs going on. You know, it's not people listening to good music. They're just giving way to what we call the postprandial dip in alertness. And it is decoupled on some level from the food coma, right?

Like part of it is, oh, I ate a big lunch, but this is independent of that. You can prevent people from having lunch and they still have, you know, and I put electrodes on their head, we can still measure this alertness drop. So it is independent of food. Right, so siesta.

So siesta, and you can ask, well, if that is how we were designed to sleep, is there any evidence that something goes wrong when you change that natural behavior? And that actually happened as a natural, well, an unfortunate natural experiment in Greece a couple of decades ago. They decided that they were going to do away

with the siesta policy. So if you went to Greece in the 1980s and you walked around the towns, you would see on the shop windows, it would say open from 10 to 2 p.m., close from 2 to 5 p.m. and then open from 5 to 10 p.m. because there was a standardized siesta practice.

They decided to do away with that. And so Harvard researchers said, we're going to see what happens, what are the consequences? And they focused on cardiovascular disease. So they tracked the sleep and the health, the cardiovascular health of well over 23,000 Greeks. And what they found is that across that five-year period,

there was a 37% increased likelihood of having a heart attack. In fact, it was worse in males. In males, there was a 60% increase in likelihood of having a heart attack. And what was happening, it seemed, if you looked at the data, is that they were still sleeping the same,

maybe just six hours a night. And they were doing away with the nap during the day and they weren't replacing that sleep time back into their night phase. They were staying true to what they'd been doing before at night and they'd just been shortchanged of their sleep during the day. And that led to cardiovascular health consequences.

Wow. So if no siesta, you gotta make sure you get the eight hours. But if you're engaging in that hunter gatherer practice, you can go six and two or whatever. And that seems to be fine. I would say that there's probably a couple of caveats

with naps though. Naps are a double-edged sword. If you are struggling with sleep at night, the recommendation is do not nap during the day because what you want to do is build up all of that healthy sleepiness. And it's a chemical called adenosine. It's sleep pressure essentially.

And the longer that you've been awake, the more of that adenosine, the more sleep pressure essentially. And the longer that you've been awake, the more of that adenosine, the more of that sleep pressure builds up. And it's not a mechanical pressure in your brain, don't worry, it's a chemical pressure to sleep. And then after about 16 hours of being awake, there seems to be enough adenosine, enough sort of sleepiness to be weighing down

on your shoulders that now you can fall asleep and then stay asleep. So if you're someone who has fragile sleep or insomnia, you shouldn't nap during the day because taking a nap during the day will actually just, it's almost like a pressure valve on a steam cooker. You just release some of that healthy sleep pressure that's been building up.

And now when it comes time to fall asleep or stay asleep at night, it's that much harder. So the advice would be, if you don't have sleep problems and you can nap regularly, then I would say naps are just fine. But if you can't do it regularly, and especially if you suffer from sleep problems, try to stay away from naps.

If you are going to nap, nap before 2 p.m. in the afternoon. Going later than that can be problematic for your sleep. It's a little bit like snacking before your main meal. It just takes the edge off your appetite. It's the same way with naps. I'm sure you or somebody has studied what happens if you take exogenous adenosine, right? Like wouldn't that seem to be the way in

to resolving this problem for people that have insomnia? exogenous adenosine, right? Like wouldn't that seem to be the way in to resolving this problem for people that have insomnia? Hard to get it across the brain barrier, which is a protective layer around the brain. And there's some issues around toxicity as well. So yeah, that certainly would have been the idea. But what's lovely is that you can increase sort of sleep pressure in a number of non-pharmacological ways

and exercise is a great demonstration of that. And I think we can speak about all of these different over-the-counter medications that people try to invest in and think that that's going to give them a good night of sleep. But there are probably two really simple things that you can do non-medication

that if you look at the data, are almost guaranteed to improve your sleep, which is some form of physical activity most days, or at least several days a week. And the second is deal with your anxiety. Anxiety is the principal cause of insomnia. It's not the only cause, but it's our current working model of insomnia that people who have a high fight or flight activation

of their nervous system, branch of the nervous system, they also have high levels of stress chemicals such as cortisol. And that seems to be very predictive of their insomnia. And if you can start to manage your anxiety, for example, meditation is a fantastic practice. And, you know, before I was writing the book and I was sort of starting to research,

I was a bit of a stupid, hard-nosed scientist. You know, I just thought this meditation stuff was maybe a little bit woo-woo and sort of, you know, come by our and we all hold hands. And I started to look at the data. The data was immensely powerful and very robust that people, when they are suffering from insomnia, if you put them into a meditation and mindful practice,

you can actually drop the severity of the insomnia in a way that medications, such even prescription medications can't come close to. Yeah, I mean, I just know, well, first of all, if I don't exercise, forget about it. I know I'm gonna struggle with sleep at night. And if, and when I have difficulty falling asleep or I wake up in the middle of the night,

I've become very attuned to what my mind is doing. And it will generally default to some problem that I'm having or conflict that I'm trying to resolve. And I'll just loop some narrative. And that produces a tremendous amount of anxiety, which obviously prevents me from falling asleep. So I noticed that, and then I course correct through either some kind of mindfulness practice to kind of create space

and push that narrative aside or, you know, overcome it with a different narrative. And sometimes I'll just think about a book that I'm reading or a movie that I saw, and I'll just immerse myself in that narrative. And that's like a distraction that literally short circuits that other anxiety producing narrative and I fall asleep. You're so right. So I think, you know, in this modern day and age sort of, you know,

the MTV fast food 24 seven society, we're constantly on sort of reception, particularly with now all of this digital technology and rarely do we do reflection. And unfortunately the one time when we do reflection is when our head hits the pillow. And that's the last time that you want to go into rumination. You don't want the Rolodex of anxiety spinning up, which is what you were sort of describing

because that leads to something that we call catastrophization, that you start thinking, oh, what didn't I do today? And what do I need to do more of tomorrow? And then I forgot this. And at that point, good sleep is not going to be invited into the brain. By the way, counting sheep does not work.

There was a scientific study done by a colleague of mine at UC Berkeley that demonstrated, in fact, if anything, it hurts your sleep. And what if you're catastrophizing, it would probably be better to start counting sheep. It could be, but what you described was actually what she found. Far better was to engage in some kind of a mental aspect.

And what they found was take yourself on a walk. Think about a walk that you know in the forest or in nature or down on the beach and just start to try to walk yourself through that or think about a book that you're reading or think about sort of a podcast and anything to get the mind off itself. So for example, I feel embarrassed to say this,

but I love racing cars. And so if I'm struggling with sleep, which I do too, I am not immune to bad nights of sleep and I have had bouts of insomnia. So comforting to hear that. You know, I'm just as fragile. And so what I'll do is, you know, I'll put myself and I'll think about the track

and I'll drive myself around the track. I know when I need to, which gear I need to be in, where my breaking zones are. And then the next thing I know is I'm waking myself around the track. I know when I need to, which gear I need to be in, where my braking zones are. And then the next thing I know is I'm waking up in the morning and I just drifted off. Yeah, yeah, yeah. It's great.

It's sort of a different version of what I do. What kind of cars do you race? Oh gosh, I've raced all sorts, BMWs, Porsches, but my real love and the car that I own is a little Mazda Miata. When you're a professor, you can't really go racing in half million dollar cars. And I love it to pieces.

It is a car unlike Ferrari or Porsche. When you're going 40 miles an hour, it feels like you're doing a hundred. Whereas in a Porsche, when you're doing a hundred, it feels like 40 miles an hour. So I'm usually the slowest guy on track, but it brings me a lot of joy and satisfaction. That's cool.

Well, let's talk a little bit about best practices then. I feel like we're at that juncture. And I wanna do this by walking you through the extreme lengths that I've gone to. I know a little of your sleep history. So- Tent included. Yeah, I sleep in a tent.

Causes a lot of consternation and confusion from people that listen to this show. But I'll just provide a little background to that. Like historically I've had issues falling asleep. Part of it, and I'm interested in your take on this, is I think my sense is that it germinates somewhat from being like an extreme ultra endurance athlete. I've gone through periods of my life

where I've put my body through just unbelievable rigor, like 25 hour training weeks where you're just so exhausted. Sleep is a non-issue. Sleep is not a problem when you're pushing so exhausted, sleep is a non-issue. Sleep is not a problem when you're pushing yourself that hard. But it's been many years since I've been kind of habitating that space. And now, but I've acclimated,

my physical body is acclimated to doing that, right? So now if I go out for a one hour run or I go on a casual bike ride, it's not enough. Like I'm not getting enough of the fatigue to create the restful state that I aspire to be in. Like I really, I have to exercise more than the average person, which is challenging when you're a busy person.

So there's that. On top of that, my body's like a furnace. Like I literally burn hot. And my wife likes the bedroom a lot warmer than I do. And we would have this back and forth over many years where it's too cold for her. I'm on top of all the covers. She's underneath them shivering.

It wasn't working. And as kind of a joke, I went and we have a flat roof off of our bedroom. And I went and I just, you know, pulled a twin mattress up there and slept there one night and had an unbelievable night of sleep. I thought this is fantastic. It's nice and cold out, the desert air, even in the summer.

And that I graduated from that into getting a tent. And I've been sleeping in a tent ever since. I absolutely love it. The cold air, being under the stars and being under a bunch of blankets, including a gravity blanket, which I'd love your thoughts on, which I found to be really helpful

speaking about the sympathetic nervous system and trying to calm myself down. And eye mask and nature sounds and magnesium, like all kinds of stuff. And the idea being of course, to create the optimal situation for the best opportunity for eight hours of sleep every night. And like yourself, I don't always, despite all of that,

sleep still eludes me many nights, but more often than not, I'm getting more high quality sleep than I used to. But I'm interested in how this kind of measures up with what you found through your studies about best practices, specifically temperature, air quality, all these kinds of things. Yeah, and so I think there are probably maybe five tips

for better sleep tonight, if you sort of suggest that or start trying to optimize your sleep. And temperature, regularity, darkness, walk it out and then alcohol and caffeine. And I'll say to the last one, cause it usually, if you don't find me deeply unappealing right now, you will after that fifth one. Temperature is a fascinating one.

We know that your brain and your body need to drop their core temperature by about one degree Celsius or about two to three degrees Fahrenheit for you to fall asleep and then stay asleep across the night. And that's the reason that you'll always find it easier to fall asleep in a room that's too cold than too hot

because too cold is taking you in the right thermal direction for good sleep. And that's why sleeping in a tent, you're, you know, now we understand we're in Southern California, but nevertheless, you know, it can get, it gets cooler at night than it is during the day. Yeah. I wouldn't be doing this in Boston. Right. Yeah. It's still, I mean, typically it's low 40s and it goes down into the high 30s and I've never not slept in the tent because it was too cold. I know that in your research,

you found there is an inflection point at which point perhaps too cold is not so good. Yeah, once you get into an extreme it- But I have to tell you, like, when it's 38 degrees, I'm happy. Like, and I sleep pretty dang well. Yeah, and that- I mean, I'm happy. Like, and I sleep pretty dang well. Yeah, and that- I mean, I got a lot of blankets on, but-

Yeah, and so it's sort of, you know, the local temperature may not quite be that. And here's the other thing. I always have my feet sticking out. I cannot have my feet under the covers. Do you know why? Yeah, I think I know, but go ahead. Because it's your hands and your feet

that are these incredible radiators of heat. Your hands and your feet are highly vascular. In other words, there is this crisscross of vessels very close to the surface, and it's very rich in its vascular nature, both your hands and your feet. And so at night, what the body wants to do is almost like a snake charmer,

draw the heat out of the core of the body and evacuate it through the extremities. And the extremities in this case for us human beings are hands and feet as well as head. And that's why you will sometimes see rebellious, you know, when you see kids and you kind of tuck them in all nicely and you look at your wife and you smile

and it's all beautiful. And then you go back in two hours later, just before you go to bed and these rebellious legs are dangling out, you know, sticking out. It's because you're trying to evacuate the heat. So you're wise in doing that because they are wonderful thermal discharges.

So that's temperature. And we do need to drop that temperature. It's different for different people, but I think the recommendation would probably be about, you know, 65 degrees or so for most people. Now that's obviously averaging across men and women and it's different there too, as you mentioned, which is around about, if I do my math correctly,

it's probably around about 18, 18.3 degrees Celsius. So that's temperature. And that's why I think you definitely will start to sleep better than you at least would do otherwise on a constant temperature. Because there's another way that modernity has dislocated us from our natural edict of sleep, which is we set a thermostat of maybe 70 or 72 degrees throughout

the day and the night. And that's not how we were sleeping. Now, if you go back to those hunter gatherers, by the way, for whom you are in some ways mimicking their sleeping existence, they don't go to bed really on the basis of light, which is what we thought. They usually will go to bed about an hour and a half to two hours after sundown. And then when they wake up and they don't have alarms, if you ask them about this idea of, you know, artificially terminating sleep with an alarm, they're perplexed.

Also, you know, rates of insomnia in the general first world population is somewhere between 10 to 15%. In those hunter gatherer tribes, it's less than 5%. So some things- They're also moving all day long. They're moving all day long. And we can look at diet as well,

but what is determining their sleep onset and their sleep offset is not light, it's temperature. So when, and if you ask people, if you just bring them into the laboratory and you say, you know, at what point do you feel sleepy at night? It's at the point where their core body temperature is on the steepest decline. Now they don't know that even though unfortunately

we've placed a rectal probe inside of them, which is no fun for either the experimenter to insert or for the participant to receive, but they are on the awesome downslope of the thermal evacuation. And that's when they feel sleepy. And when those hunter gatherer tribes wish to wake up is before dawn, just before dawn,

but it's as the temperature starts to rise back up. So it turns out that we actually need to warm up a little bit to get cold. We need to bring the blood to the surface of the skin. That's why cold it must be in the bedroom, but you can wear socks if you want, or you can have a hot water bottle, but keep it cold because warming the feet

or sticking them out of the mattress will help your body evacuate the heat and plummet your core body temperature. And it's the reason by the way that hot baths and showers work for good sleep as well. You think that- In a counterintuitive way, right? Cause you think you're warming up.

I mean, you're nice and toasty. Yeah, you're vasodilating. When you get out of the bath, you've got rosy cheeks, all of the blood comes to the surface. And when you get out of the bath, your core body temperature is dropping precipitously. That's why you fall asleep. It's called the warm bath effect in sleep science.

It's so reliable. And then when they're starting to wake up is when they're starting to warm up. So we need to sort of, you know, warm up to get cold to get to sleep. Then we need to stay cold to stay asleep. And then we need to warm up to wake up. Right.

If that's the sort of temperature transition. So that's temperature. The next is regularity. Go to bed at the same time and wake up at the same time, no matter whether it's the weekday or the weekend, or even if you've had a bad night of sleep, don't change it, resist the urge. My recommendation to people who've, you know,

had a bad night of insomnia, they'll say, should I get to bed earlier? Should I wake up later? Do nothing. Don't go to bed any earlier. Don't try to wake up any later. Keep to your schedule. And by the way, I'm giving these sort of, you know,

these tips or these rules. People don't respond to rules. People respond to reasons, not rules. And that's why I'm, if you don't mind, I'm sort of trying to give some explanation as to underlying it. But the reason that regularity is king is because it will anchor your sleep

and it will improve the quantity and the quality of that sleep. Because deep within your brain, there is a master 24 hour clock and it expects regularity and thrives best under conditions of regularity, including the regulation of your sleep-wake schedule. Sorry, I just wanna interrupt with one thing,

which is on that subject of the internal clock, does it matter in the context of getting eight hours if you choose to go to bed at nine o'clock or you go to bed at 11 o'clock if you're getting eight hours, is that going to impact the quality of your sleep? Like I know personally, like I need to go to bed early. If I still get eight hours, but I go to bed late,

it's not the same thing. Yeah, and so we mentioned that, you know, overall for the average adult, you know, you get most of your deep sleep in the first half of the night, most of your REM sleep in the second half of the night, but it's not quite that simple. And by the way, you know, some people will say to me,

isn't the sleep that you get before midnight twice as valuable as that you get after midnight? You know, the stroke of midnight, you know, there's nothing about the sleep that you were getting at 1159 PM and the sleep that you're getting at 1201 AM. That's a fallacy. But what you described is important and it's a nuance. And it comes back to what we call chronotype.

Are you a morning type, evening type, or somewhere in between? And it's about a third split across the population. You don't get to decide. It's not, if you're a night owl, it's not your fault. It's gifted by way largely of your genetics. It was gifted to you at birth and it is hardwired. And we now know the genes, at least six different genes

determine whether you're a morning lark or an evening owl or sitting somewhere in between. But it's interesting to know that that's a genetic disposition. You can't compel a night owl to be a morning person. No, people have done all sorts of incredible things. And there is some degree of wiggle room you can do. I think there's about five or six different things

that they tried, but all you can really do is drag a night owl back by maybe 30 minutes and that's really it. So what you're describing there in terms of the quality of your sleep is important because it's less about where any adult places that eight hours on the 24 hour clock face. It's more about where that individual adult

is trying to sleep in harmony with their chronotype rather than against their chronotype. Now, unfortunately, modernity is predisposed to a heavy bias and a discrimination towards morning types. It's this type A culture that rise and grind, you get up in the morning and it's all about the early bird catches the worm. Well, I can also tell you that,

the second mouse gets the cheese. So you need to be really mindful of your chronotype. Now you can figure out your chronotype if you want, you can just go online and you can, what's the best? Probably search something called morningness, eveningness questionnaire. And I can send you a link that we can even put's the best? Probably search something called morningness, eveningness questionnaire. And I can send you a link that we can even put in the show notes, the MEQ.

And it's a series of questions and you will determine what type you are. Trying to then sleep at the right timing in accordance, in harmony, rather than in desynchrony with your chronotype is when you will get the best quality of sleep. That's why you say, if I go to bed at midnight and I sleep in it till eight,

sometimes I kind of have a sleep hangover. I just feel miserable. But if I get to bed at whatever time you normally do earlier in the evening and wake up earlier, that's my sweet spot. Most people probably know what their type is. They do. Well, I think yes and no, because in some ways,

even the middle ground folks will think that they are, perhaps more evening type than they actually are because of technology. Now we've done a lot of work in the sleep field, we the Royal we, by the way, in this podcast, when I've said we did something, I mean that sort of, or when I say I did something, I mean we did something.

And when I say we did something, I mean they did something. But so we've done a lot of work looking at technology and the invasion of technology into our lives and into our evenings and into the bedroom. And certainly those blue light devices are damaging to the release of melatonin, which we'll come on to when we speak about darkness. But it's not really that which now seems to be carrying the vote of technology-based sleep disruption.

It's that these things are activating. They are designed to capture your attention and make you more alert. And in fact, it's what ends up happening is that you have sleep procrastination where you're using these devices, you're working on your laptop and you think, I'm not sleepy.

I don't feel tired. But if there were to be some electromagnetic pulse that wiped out all of technology, what you would realize is that at 10.30, all the lights went out, you couldn't do anything. Within five or 10 minutes, you think, wow, gosh, actually, you know what? I really am sleepy.

And technology will mask your sleepiness. That activating nature of technology hits the mute button on your sleepiness. That activating nature of technology hits the mute button on your sleepiness. So you don't perceive it. Right, in a multifaceted way, right? There's the dopamine induction of social media scrolling, but there's also the light spectrum and all of that, right? That's impacting your body's ability

to properly self-regulate. Yep, yeah. And so, I often, if you really have to take your phone into your bedroom, I don't personally, but again, that's just me. I would say the one rule I would offer to you is that if you're going to be using your phone in the bedroom, you have to be standing up.

And at that point, after about five or six minutes, you're like, do you know what? I just wanna, if you sit down on the bed, I'm sorry, phone goes away. Here's what's depressing though. You talk about this, like how long before you need to go to bed should you shut the screen off? And it was like a number of hours, right?

Like if you watch a movie and then go to bed, that movie should be concluded like, I don't know, what did you say, like two hours or something like that? Well, it really depends on sort of the, watching television or a movie, as long as it's not inside of the bedroom, we really shouldn't be watching television inside of the bedroom.

Because you want to associate your bed with simply the place of being asleep or for intimacy. That's really what we recommend the bed for. Don't be working on there, don't be eating on your bed, don't be watching television on your bed, consuming Netflix. And I think it's really about computers and iPads and cell phones or laptops, sorry, tablets. I think watching television outside of the bedroom is okay.

One of the dangers, however, when I ask people, if they say I'm having sleep problems, I'll say, do you nap during the day? And they'll say, no, I never nap. Then I'll say, well, but when you're watching television on the couch in the evening, do you sometimes fall asleep watching television? They say, yeah, I do that all the time.

That's an accidental nap. And it's the worst time to nap too, because again, it's right before your main meal of sleep. So I would say that if you're doing something that helps you wind down and just disengage from the day, disengage from those stresses, that's fine. Be it reading a book, watching a mindless movie, but in the last hour before bed,

stay away from anything that you know is cognitively and especially emotionally activating. Don't be checking emails, don't be sending texts, don't be engaging in movies that are action horror movies that have you wired. Right. Try to stay away from those things. So let's talk about caffeine and alcohol, right?

So disappointingly, caffeine has like an eight hour half-life, right? So if you have a cup of coffee in the morning, you're still contending with it when you go to bed. It's tough, yeah. So alcohol and caffeine. So everyone knows that caffeine is an alerting substance. It's in a class of drugs

that we call the psychoactive stimulants. Interesting, it's one of the only psychoactive stimulants that we readily give to children without too much concern. So, you know, many people know that that's how caffeine works, but people may not realize that caffeine can have two additional damaging effects on your sleep. The first comes down to, as you said, the duration of action.

That caffeine has, for most people, a half-life of what we call about five to six hours. In other words, after about five to six hours, 50% of that caffeine is still in your system, which means that caffeine has a quarter life of between 10 to 12 hours. So if you have a cup of coffee at, let's say, 2 p.m., a quarter of that caffeine could still be circulating

your brain at midnight. So it would be the equivalent of, a 2 p.m. cup of coffee is the equivalent of getting into bed and just before you turn out the light, you speak a quarter of a cup of Starbucks and you hope for a good night of sleep. It's probably not going to happen. There are differences from one individual to the next.

It comes down to the specific enzyme that degrades caffeine. Some people have a genetic variant, what we call a polymorphism that has a faster metabolic rate for the degradation of caffeine. Other people have slow that usually determines I'm a sensitive person, I'm not sensitive. But even if you're one of those people and some people say this to me,

look, I can have an espresso with dinner and I fall asleep fine and I stay asleep. So no problem. That's not quite true because even if you fall asleep and stay asleep, caffeine can actually decrease the amount of deep non-REM sleep that you get, can decrease the quality of that deep sleep by up to 20%.

Wow. Now for me to drop your deep sleep quality, I would have to age you by a decade or you could do it with a cup of coffee in the evening, you know, each and every night. And the problem is that then those people, when they wake up the next morning, they don't remember struggling to fall asleep.

They don't remember waking up frequently throughout the night. So they don't put two and two together, but now they feel unrefreshed and unrestored by their sleep because they weren't getting the deep sleep. And now they find themselves reaching for- Gotta drink more caffeine. Three cups of coffee in the morning.

And then because they may not be able to get to sleep at night, then they're reaching for sleeping pills. So it's this sort of, you know, it's the stimulant in the morning, it's a sedative in the evening, and it's a very difficult cycle to break. So that's caffeine, alcohol.

Alcohol is probably the most misunderstood sleep aid that there is out there. It's anything but a sleep aid. And you've mentioned how your sleep was so disrupted. Firstly, alcohol is in a class of drugs that we call the sedatives and sedation is not sleep. But when we have a couple of drinks in the evening and we say, gosh, I just fell asleep like that,

you're mistaking sedation for sleep. So if I were to show you your electrical patterns of brainwave activity with and without alcohol, they're not the same. It's not naturalistic brainwave activity. The second problem with alcohol is that it fragments your sleep so that you wake up many more times throughout the night.

So not only is your sleep going to be poor quality as we'll come on to, it's also just not going to be consolidated. It's not that nice long duration of uninterrupted sleep. Because as your body is processing the alcohol, the depressant aspect of that drug is wearing off and there's a sort of rubber banding stimulant reaction to it, right?

So you wake up at two or three in the morning. Yep, so it actually will start to, just as you mentioned there, it will trigger activation of the fight or flight branch. So you start to come back online in terms of that stress-related branch of the nervous system. Also stress-related neurochemicals we know are starting to get increased as the alcohol is metabolized. And that's what causes the fragmentation of your sleep.

The final problem with alcohol is that it's a very potent suppressor of your REM sleep, of your dream sleep, which we've mentioned before in terms of all of its benefits. And so, you know, I think that's the reason that alcohol should just be strongly advised against, you know, against the nightcap by medical practitioners.

But I would just say two things. Firstly, with tongue in cheek, you know, you could look at that data and say, well, then I should just go to the pub in the morning and that way the alcohol is out my system in the evening and no harm, no foul. But yeah. Problem with me is should just go to the pub in the morning and that way the alcohol is out of my system in the evening and no harm, no foul. But yeah. Problem with me is if I go to the pub in the morning, I'm at the pub at night too.

And so I would never say that as a healthcare professional. But what about like just a glass, like, hey, I'm having a glass of wine at dinner. Yeah, I would love to say that, you know, based on the data that doesn't have an impact. But if you look at the data, even a glass can have a measurable impact. But look, the other thing I want to note is this,

and I think it's something that I've learned in, after the book was published, and I'm embarrassed in the way I was acting before. I don't want to be puritanical here, Rich. I don't want to tell people how to live their lives. I'm just a scientist. All I want to try and do, and I may be too enthusiastic in doing this,

is gift people with the science and the knowledge of sleep. And then they can make an empowered choice as to how they want to live their life if they're trying to optimize their sleep. So I do want to mention that. I'm not finger wagging and I shouldn't be telling anyone. Matt, I don't think anyone's getting that impression.

I think it's like, look, this is what's going on. Like make your own, you know, choose accordingly. Right, but just so everybody knows, like let's be clear about what the science says in terms of how this impacts you. Yeah, but I think I've been sometimes overstepping the mark. So it's good to say. You're such a gentle guy.

But I also should say, like, I love how enthusiastic, cause you talk about this stuff a lot, but you're so enthusiastic. Your whole body like lights up when you talk about this stuff. It's the most, I fell in love with, I fell for sleep like a blind roof. It was just the most amazing thing

as I was starting to study it. And it is a love affair that has lasted me 20 years and I am still beguiled by this beautiful thing called sleep at night. Yeah, there's so much more still to be learned, right? Like, you know. I mean, it's, you know, I think it's remains one of the last great scientific mysteries.

I would say though, and the reason that you're able, you know, someone like me is able to write a book I think it's remains one of the last great scientific mysteries. I would say though, and the reason that you're able, someone like me is able to write a book that's over 130,000 words is because, we've learned more in the previous 50 years about sleep than we did in the previous 5,000. And even just 30 or 40 years ago, we used to ask the question, what is sleep good for?

And the crass answer was that, well, we sleep to cure sleepiness, which is the fatuous equivalent of saying we eat to cure hunger. That tells you nothing about the nutritional, physiological, metabolic benefits of food. Now, 30 or 40 years later, we've had to upend that question.

We've had to ask, is there any major organ system in your body or is there any operation of the mind that isn't wonderfully enhanced when we get sleep or demonstrably impaired when we don't get enough? And the answer seems to be no. Right. I have to ask you this. Every full moon, I don't sleep.

And I don't sleep. And I don't know if it's psychosomatic or there's some kind of lunar gravitational pull occurring, but have you looked at this? We have. Have you? Yeah. Please do tell. There's some conflicting evidence. So some reports have found this effect, other reports have not.

And it may be different for men and women, even some of the reports are saying. On average, people sleep less with the full moon. So have you ever thought about the term or what the term means lunatic? And it occurred to me when I was doing that work based on the relationship between sleep and your emotional health,

that you essentially, your emotional integrity falls apart when you're not getting sufficient sleep. You know, you become emotionally unhinged, you become pendulum like in your emotional irrationality. It occurred to me, I wonder if part of the derivative of that term, you know, we've got all of these things, you know, the werewolf and people getting crazy.

It goes back forever, right? Yeah, yeah. Like when the moon's out, people lose their minds. Right, and I think some of that is due to different practices around the celebration of the moon phases, et cetera. But I think if you believe some of the reports, but again, some of the reports have failed

to find this effect, sleep duration decreases. Why would that be? There are some theories around that, which actually I should finish up my tips and there's just two more of them, but this is nice because it brings us back to this. With a full moon, obviously, as long as it's not a cloudy night, you get more luminance.

And that light of that luminance can actually decrease the hormone of melatonin. And this comes back to what were, I think the fourth out of the five tips, which is darkness. We are a dark deprived society in this modern era, and we need darkness at night to trigger the release of this hormone called melatonin. And melatonin is often called sort of the vampire hormone,

not because it makes you want to look longingly at people's necklines and bite in, it's because it comes out at night, it's the hormone of darkness. And melatonin helps time the healthy onset of sleep. And so the recommendation would be in the last hour before bed, don't just stay away from those blue light emitting devices,

try dimming down half of the lights in your house. You would actually be surprised at how sleepy and soporific that change can be. And that's why I love the idea of sleeping in a tent because all of a sudden, you know, you are removed from all of that, you know, polluting electric light, even at night. Now we should reverse engineer that trick during the day.

In the first half of the day, it's critical to get some exposure to daylight. You can go outside, but it doesn't mean that you have to go outside. Just being next to a window, try to get at least 40 minutes of direct sunlight each and every morning. And that will really help try to get at least 40 minutes of direct sunlight each and every morning.

And that will really help because that will then stamp the brakes on melatonin. It will shut it down and you will feel more alert. The more alert you feel, the more healthy sleepiness, the more of that adenosine, which is the sleep pressure chemical that you will build up. And then the better your sleep will be at night. Right. So that's sort of darkness. And then the better your sleep will be at night. Right.

So that's sort of darkness. And I think that's perhaps part of the explanation why the full moon can maybe disrupt our sleep because it's nowhere near like sunlight, but it's still a light invasion. But I wear the eye mask and the whole thing. I think there's something more mysterious at play. I don't know, but maybe I'll try taking melatonin.

I know that you've said, taking melatonin as a matter of course is not a good idea. It's really for when you're traveling across time zones. But maybe I'll try it when the next full moon cycle comes and see if that makes any impact. Yeah, you can try it. I mean, melatonin, as I mentioned, it regulates the timing of your sleep,

but it doesn't actually really help in the generation of sleep. If you look at people who are not jet lagged and who are under the age of 50, melatonin in all of the placebo controlled studies that we found doesn't really change the quantity or the quality of your sleep. Melatonin, you can think of it a little bit like

the starting official at the 100 meter race. Melatonin is the thing that will gather all of the races to the start and then begin the great sleep race. But melatonin doesn't participate in the race itself. That's a whole different set of brain chemicals. But I would say two things regarding melatonin. First, if you think that it's working for you, then the placebo effect is the most reliable effect

in all of pharmacology, with the exception of probably an adrenaline injection to your heart. So no harm, no foul there. The caveat that I would like to add to that secondarily is it's over the counter, at least here in the United States, which means it's not regulated by the FDA.

And in a study that looked at over 20 different brands of melatonin, what they found is that based on what it said on the bottle relative to what was actually in those melatonin pills, it was anywhere between 80% less up to 460% more than what it said on the bottle. So it's a wild West. You don't really know what you're getting. between 80% less up to 460% more than what it said on the bottle. So it's a wild west. You don't really know what you're getting.

Is there a trusted brand? Well, I think, you know, firstly I should also mention that melatonin is still largely a safe compound, you know, even in high doses, you know, it's concern from that aspect is perhaps lower, but because it's unregulated, one of the things I've been seeing right now,

are melatonin gummies for kids. And maybe we'll learn more about melatonin and it could help kids with sleep problems or sleep disorders. But if it's unregulated, you don't know what dose you're giving them. Wouldn't the concern also be, if you're taking it all the time,

doesn't that signal your body to stop producing it? That's right, so that's the other major sort of issue is that most people are taking too much melatonin. They're taking usually between five milligrams up to 10 milligrams. I would recommend based on the science, somewhere between just 0.5 to three milligrams, because if you're dosing any higher,

your body has this beautiful network of feedback loops. And it starts to think, well, my goodness, I don't need to produce melatonin because I'm getting it every night in very high dose. I can just shut down my own melatonin production. So that's the danger, just be a little bit mindful. On the subject of light, talking about the light on a full moon,

I've come to develop a greater appreciation for the brain's capacity to process spectrums of light and how that relates to how we calibrate our internal clock. Like I had neuroscientist, Andrew Huberman here, do you know? Oh yes, from Stanford. Actually, we've never met. You guys gotta meet. We know of Oh yes, from Stanford. Yeah, actually we've never met.

You guys got to meet. We know of each other and we should, at some point we should get together and mind meld because I think we'd have a lovely time together, yeah. Yeah, he's doing some interesting work, but he talks a lot about how really the eye is, you know, is the brain, right? Like the optic nerve is part of the brain

and the sensitivity of the optic nerve to all these variations in light spectrum. He talks about looking at how looking at a sunset, kind of helps calibrate all of that, all of these different things. And I was thinking about that the other day, cause I play this game when I wake up with myself, when I wake up in the morning, I open up my eyes,

I don't have an alarm clock, and I try to guess exactly what time it is. And it's pretty amazing. Like I'm generally, I don't always get it right, but I'm generally like within two minutes of the precise time. And I thought, is that because my eye knows the specific light spectrum of what time of day it is,

or is it my internal clock? Like what is that? But there is this deep knowing I think that we have when we are more in nature where we're attuned to these rhythms. I think it's a combination of both. And by the way, his work is just fantastic. If people, I know you've had him on your show,

he is just a brilliant scientist and he's so eloquent and beautiful. He's a very effective communicator. He knows how to explain things in a way where people can really understand what he's talking about. Yeah, he's wonderful. But so I think it's a combination of those two things. I think many of us, even if we've got blackout curtains

and sort of, you know, we're wearing an eye mask, we will wake up. And I think we have some general sense, but maybe plus or minus an hour in terms of accuracy that, okay, it's still probably the middle of the night, or it kind of feels like late in the morning. And in part that's because you do have an internal 24 hour clock.

But I also think that there's something that we've lost in terms of our light exposure that you have gained back, which is that it's not just that your internal clock, which may get you within one hour plus or minus, it's not bad at doing that. But when you open up your eyes and you get additional exogenous information, which is from the outside world,

rather than the endogenous clock time that your 24 hour clock is giving you, then you shift from plus or minus an hour of accuracy to maybe plus or minus five minutes. And so when I retire, maybe I'll look at this because there's something very strange about sleep and time that is utterly paradoxical. And what I mean by this is you can say,

okay, I've got to wake up cause I'm going to fly out and meet Matt Walker in Berkeley and we're gonna grab coffee and I've got to get this early morning flight from LAX. And you set your alarm for five o'clock in the morning and guaranteed you will wake up at 4.58. 100%.

How is that possible? It happens too frequently for it to be just by chance. So somewhere your brain has this quartz like precision of clock counting. However, there is an absence of time, particularly in dreaming. Because all of us have probably had that experience that our alarm goes off

and we were in this strange dream and then we hit the snooze button and our snooze button is just two minutes. And we go back, we go right back into the dream again. And then the snooze button goes off. And you think, no, hang on a second. I was, that felt like almost an hour of an experience.

So there is this temporal mismatch where when we go into the dream state, we can almost fold and compress time like a concertina. It's like inception. Yeah, and I think it's no big surprise that Nolan picked up on that, with the help of maybe some sleep specialists offering that advice.

We know that you get this dilation, I've called it sort of dream dilation or dream time dilation, where time is no longer time. Right, so what do you make of that? Like what would be the evolutionary advantage of that? Well, it may be that there is no necessarily evolutionary advantage, but there may be a brain mechanism that explains it.

Because what we know is that memories are replayed during both deep sleep and REM sleep. Now, when we are in deep sleep, memories are actually sped up. The brain will actually be replaying those memories anywhere between five to 20 times faster. But when we go into dream sleep, the replay is actually much slower. And so that may be why, you know, if you want to speak about, that's usually the one question I look forward to least when I give talks, someone put their hand up and say,

is inception possible? And my heart just sinks. I start seeing a spinning top and the music that comes by. But I think that that's why Nolan had that beautiful idea that when you descend down into these different levels of sleep, a minute of time in the real world could be

five minutes of time in the dream world. And then if he gets you to deeper dream states, then a minute of time in the real world is two hours or two days or 50 years. Well, with the premise being, I'm gonna anchor this memory or this concept or this idea in this human's brain. And the way to do that,

how do you do that in an effective way where it's gonna stay, right? And when you think about this in the context of, you know, morphing time constructs, if you have a dream state in which memories are accelerated, that's certainly gonna aid in the development of skill acquisition, right? Like you're repeating a memory or a behavior,

or just imagine, you know, you're in jujitsu and you learned a new maneuver or whatever, and you're replaying that in your mind, of course, that's gonna anchor that. And then the slowing down is almost like a visualization. Well, both of those things would work in tandem to really, you know, sort of calcify neural pathways around like a new concept.

You need to be a scientist, Rich. Would you direct my sleep sense? My mom would be very happy. Back to medical school. No, you're too precious in what you do otherwise. But you're absolutely right that I think what we know is that deep sleep will, one of its functions is that it will hit the save button on your memories so that you don't forget.

So deep sleep will future proof that information within the brain. And in part, it's just, as you said, it's deep sleep that's basically scoring the memory trace, almost etching it into the glass of the brain. But then, dream sleep comes along. And what we've realized is that dream sleep does something very different for memories. Sleep is much more intelligent than we ever gave it credit when it comes to information processing. Sleep not only strengthens individual memories,

it will intelligently stitch and associate those new memories together. And it seems to be during sleep, particularly during dream sleep, when we perform, it's almost like informational alchemy, or it's like group therapy for memories. Maybe that's a better analogy. That sleep gathers in all of this information

that you've been learning during the day and everyone gets a name badge, but sleep forces you to go and speak to the people, not at the front of the room that you think I've got the most obvious connection with. It forces you to speak to the people at the back of the room that you think you've got no connection with at all. Now it turns out that you do, and it's a non-obvious connection, but it's a potentially powerful one nonetheless. Because when you start to fuse things together that shouldn't normally go together, but offer marked advances in evolutionary fitness, it sounds like the biological basis of creativity. And that's where we see dream sleep

providing a benefit. You wake up the next day with a revised mind wide web of associations, with a revised mind wide web of associations. And you are capable of defining solutions to previously impenetrable problems. It's the reason that you've never been told to stay awake on a problem. Right, sleep on a problem, but it has a very strange and elusive relationship with memory.

Like memory doesn't seem to really be required for this. Like sometimes you remember some of this stuff and then it fades, but nonetheless, the brain is doing its job in that state and you're able to come up with a creative solution or solve a problem that mystified you the night before. Yeah, and I have another, it's probably second only to the idiocy of my idea

that we never evolved sleep, that we have, it was from sleep that wakefulness emerged that we started at the top of the podcast. The other stupid theory is that in fact, we remember all of our dreams. Most of us, when we wake up, if we can remember a dream, it's usually very difficult and different people have different dream recall strengths.

And the harder that we try, the more unlikely it is. But I think that that's not a problem of memory imprinting. I think that's a difference in memory science that we call accessibility versus availability. I think when we wake up in the morning, we lose the IP address to the memory, so we can't find it. So it's availability is still there, but it's accessibility is prevented.

And the reason I think this is a tenable theory, and I've got some ideas as how to test it, is because you can wake up in the morning, think, oh, I was having this incredible dream and you just can't bring it back to mind. And you think, okay, it's just gone. And then two or three days later, you're walking down the street and you see a sign or you're in the shower and you see the shampoo bottle.

And all of a sudden there's a cue that triggers the unleashing of that dream memory and it all comes flooding back. In other words, that memory was there all along. You just didn't have accessibility to a still yet available and present memory. Now, if that's true, what it could mean is that we store all of our dreams.

And the reason I find that sort of hand-waving, wacky and fun philosophically to think about is we know that memory operates largely in a non-conscious manner. You know, you can, for example, if you're walking up a set of stairs and you've got your pad of paper and you've left a drink on the stairs, you know, you're sort of,

you're reaching down to pick it up. That's an immensely complex challenge. You had to sort of compute the physics of where your hand was. You had to know what the weight of that cup was. This is all based on memory and it operates way below the radar of consciousness. Most memories do.

If that's true, that our behavior is certainly influenced non-consciously by our memories, it's what we call implicit memory. And we remember many of our dreams, then all of a sudden it becomes interesting to ask, how much does our waking life reflect or is shaped by our stored dreams? In an unconscious way. In an unconscious way.

In an unconscious way. Now this is getting very Freudian and I have to say, I'm not a big advocate of Freud. I think he did a remarkable service to the science of sleep. He brought dreams into the world of the mind before it was in the Greeks, it was coming from gods, Hypnos, Somn know, Morpheus. And then Chinese cultures had an idea

that dreams came from the soul, but it was Freud who actually placed dreaming squirrelly within the mind. In other words, Freud made dream science a domain of brain science, of neuroscience. Now, after that, it all kind of went south, you know, and I often joke that I think Freud was 50% right and 100% wrong. And so, and it's not a testable theory. When it got into of went south. And I often joke that I think Freud was 50% right and 100% wrong.

And so, and it's not a testable theory. When it got into their interpretation aspect. Exactly, and that's just, and we've demonstrated that it's why it's no longer embraced by the scientific community as a scientific hypothesis, because it's untestable, it has no solid predictions. And I think it's good to keep in mind that, there are some reports that at the time,

Freud was doing enough cocaine to kill a small horse when he was coming up with some of that too. So maybe you want to- Back to cocaine. Yeah, I know. Well, what is it about me? I can't seem to get away from it. So I think I have this enamored theory about dreaming and it's just not very fundable.

So it's hard to get the funds. I mean, I think it's the ultimate, you know, unknown terrain and just unbelievably fascinating. Like the idea that our brain is so complex and it's performing this mystical dance and computation while we sleep. And the extent to which we barely begin to understand what that's all about, I think is just super interesting.

I mean, and you mentioned this, you know, very early on in our taping about dreams, it is another very strange state, you know, because last night you and I both became flagrantly psychotic. Right. And we did that multiple times throughout the night. Now, before you dismiss my kind of, you know,

diagnosis of our nighttime psychosis, I'll give you five good reasons. Firstly, when we went into dream sleep, we started to see things which were not there. So we're hallucinating. Second, we believe things that couldn't possibly be true. So we're delusional. Third, we get confused about time, place and person.

So we're suffering from disorientation. Fourth, we have wildly fluctuating emotions, something that psychiatrists call being affectively labile. And then how wonderful you and I woke up this morning and we forgot most, if not all of that dream experience. And we were paralyzed. So we're suffering from amnesia. We were paralyzed throughout.

Many people don't realize this, that when you go into dream sleep, your brain paralyzes your body so the mind can dream safely, so you don't act out your dreams. And there is the parts of the brain that actually control the different stages of sleep in part are deep down within the brainstem.

Now, when the brain is ratcheting up, it's upstairs activation of the brain for REM sleep, for dreaming, it sends another signal down along the spinal cord and it paralyzes what are called the alpha motor neurons in your spinal cord. These control all of your voluntary skeletal muscles. So when you deliberately want to move your hand, move your foot, sort of change your mouth, speak, et cetera.

So you are locked in physical incarceration during REM sleep. You are imprisoned within your own body. So when you have that, or I should say, when I've had these experiences where I'm being chased or something's happening and I feel like I'm stuck in molasses or I wanna scream and I'm being chased or something's happening. And I feel like I'm stuck in molasses or I wanna scream. And I'm like, my wife Julie will like the next morning,

she'll be like, you were making the weirdest noises. And I'll have some memory that will trigger a memory. Like, oh, I was being pursued and I was trying to get away. And I couldn't, you know, and I was screaming out for help, but I couldn't even make a noise. That's exactly why. You see too much of good science. So is sleepwalking then a malfunction

in that paralytic system? Like what's happening when you're sleepwalking? No, so sleepwalking, sleep talking, there are a group of disorders called parasomnias, which sort of essentially means just disorders that happen around sleep, para meaning around. Sleepwalking and sleep talking actually don't come from REM sleep.

You would imagine that they do and it's a very logical thing. In fact, what happens is that when we are in deep sleep for reasons that we don't quite yet understand, but it may be that there's a jolt of nervous system activity. And all of a sudden your brain races, or it tries to race from the basement of deep sleep

all the way up to the penthouse of wakefulness, but it gets stuck somewhere in between, like the 13th floor, for example. And what's strange, and we can do this in the sleep laboratory where we've got these electrodes and what we're seeing outside in terms of the brainwaves is deep sleep. But when you look at the camera,

all of a sudden the patient is out the bed and they're sort of moving around. So if you wake someone up who's having a sleep walking or sleep talking event, and you say, what was going through your mind? They usually won't tell you anything. Right. And the reason is because they're in deep sleep,

they're not in dream sleep. That's so interesting. Yeah, I have some epic sleepwalking stories from when I was a kid. Yeah. I went out, I got up in the middle of the night and went outside in the middle of a thunderstorm and like walked a block away from the house

until my dad discovered what I, and I woke up standing in the middle of a thunderstorm and like walked a block away from the house until my dad discovered what I, and I woke up standing in the middle of the street in a downpour. There are some remarkable case studies, some of which I discuss in the book where people have these episodes and some dangerous and some unfortunate things really happen in those.

But then I just grew out of it. Like how normal is that? It's very normal. So the incidence of sleepwalking and sleep talking is far higher when we're kids. And most adults will grow out of it. Not all adults, but most adults will grow out of it. And it's not really a sleep disorder necessarily. I think, and again, I'm not, you know, I'm not a clinician,

so I'm not trying to pretend to be a sort of a doctor in any means, but I think the general advice is if it's not causing you distress and it's not putting you in harm's way, then one may not need to worry about it if it's sort of infrequent. But if it is causing you distress and it is putting you in harm's way,

then you can go see your doctor. And I should note, by the way, something too on those sort of five tips. And I should mention walk it out, which is the last one. None of those tips are really going to help anyone who has insomnia or sleep apnea. It's like me being your performance coach. I can give you all sorts of tips to optimize your performance, but if you've got a broken ankle, none of those tips are going to help you.

We've got to get you to a doctor, treat the broken ankle, and then we can come back to sort of optimizing your sleep. So the tips I'm giving are just that. Right, I understand. But what percentage of people are truly insomniacs versus people who have habits that prevent them from getting a good night's sleep

and call themselves insomniacs? It's actually very difficult to tell because part of the treatment for insomnia, which is now no longer sleeping pills, the first line treatment has to be something called cognitive behavioral therapy for insomnia or CBTI for short. One of the things that works towards, as you can tell by the name cognitive behavioral,

there is an aspect where we work on the mind and we work around, you know, your beliefs and your expectations and your understanding of sleep. That's the cognitive part of CBT-I. The behavioral part is actually asking what behaviors are you engaging in that are harming your sleep and what things are you not doing behaviorally that can help your sleep? Alcohol, caffeine, regularity, light, et cetera. So those do play a role,

but usually it's much more of a combination of different things with CPTI. It's much more extensive than that. It's just as effective for sleeping pills in the short term, much more effective in the longterm. Unlike sleeping pills, when you start working with your therapist, the benefits of CBT cognitive behavioral therapy

for insomnia last for up to five years. But for sleeping pills, when you stop using them, not only do you typically go back to the bad sleep you are having, you actually have even worse sleep. It's called rebound insomnia caused by these sleep medications. Yeah, I have friends who are in recovery for Ambien

and the stories they tell are just harrowing. Yeah, yeah. And there is a time and a place for those medications. They're usually recommended for acute short-term significant episodes. So let's say that you're really struggling with a trauma or bereavement or something along those lines.

Then in combination with therapy, they can be advised for short-term use. The problem is most people aren't using them in a short-term use model. And the reason in part I know this is, I think it took George Lucas about 30 or 40 years to amass something like 2 billion in profit from the Star Wars franchise.

Took Ambien less than 24 months to do that. That's so you can't do that with acute use. So again, sleeping pills have been associated with a high risk of death as well as cancer. Do we know that that's causal or not? No, we don't right now. And I can make an argument as to why it may not be causal, but I can also make a scientific argument

as to why it is causal. We probably won't ever find out because based on the association between mortality risk and things such as cancer and sleeping pill use, it's probably going to be unethical to do a study where you put people, healthy people on sleeping pills for several years because of the risk. Yeah, no way.

There's no way you could ethically justify that. No. We've been going almost three hours. We have gone. But I can't let you go. I do wanna ask you before I let you go, I know that you work with Google and I'm interested in- I used to work with Google.

Oh, you used to, okay. In that capacity, were you able to help them implement certain policies? Like what kind of transpired there in terms of the work culture that was going on and the impact that your work had on that culture? Yeah, so I was actually working with a part of Google that was called Verily,

which is sort of, that was the Google Health arm. So it wasn't focused on- So it wasn't really focused on going into there and changing the culture. It was more about sort of, you know, developing either technologies or it was also, you know, they have some remarkable studies and they're public about this.

So there's some aspects that I can share where they're looking at how things such as sleep impact different aspects of human health. So they're doing wonderful things in trying to augment things like diabetes risk, cardiovascular risk. And so, I think what they realized is that when you're looking at all of these disease states based on everything that we've spoken about

for the past three minutes, which now is now three hours, talking about time dilation. Right, we're having our own inception. Yeah, we are really. And so- We are dreaming. I think I'm gonna wake up and the alarm goes off and I thought, oh, I'm so sad. I thought I was on the ritual podcast.

It's tomorrow. Yeah, and so knowing how critical sleep is, the foundation, they realized that there had to be some component of sleep appreciation within that framework of everything that they were trying to do. So I was so fortunate enough to be able to do that. And I no longer work with them.

I've got a couple of startups that I'm now advising and working for. And so that was really, I think the push there, which was that sleep is the tide that rises all the other health boats. And I remember when I was sort of speaking early with them, I almost had this analogy where if you think about a music studio

and those recording decks with all of those dials and you can sort of mix and just sort of tweak them, what we're doing in health is trying to sort of go to individual dials. We're trying to manipulate cardiovascular health or change immune health or change, you know, metabolic and diabetes health. But there's that one sort of dial

all the way over to the left that if you move it all the way up, all of the other dials go up as well. The master dial. That's sleep. Sleep is the Archimedes lever. You know, if I think if I were to have something, The master dial. That sleep, sleep is the Archimedes lever. I think if I were to have something, a single sentence, I would say that sleep is the single most effective thing

that we can do each day to reset the health of our brain and our body. That would be a beautiful place to end this, but I just realized there's an important thing we also didn't talk about that I would like you to touch on quickly. Yeah, of course. Which is you talked at the outset

about what happens when you get a flu shot and you're sleep deprived. We're still in the midst of this pandemic. We're slowly emerging out of it. But can you talk a little bit about what you've learned about sleep, COVID, immunity, and how people should be kind of thinking about their relationship with the virus.

Yeah, so let me, I'll speak about sleep and immunity sort of more generally, and then come on to sleep and COVID because sleep has changed in at least four different ways because of COVID, quantity, quality, timing, and dreaming. So I'll try to mentally put those stickies up on my cerebral wall so I come back to them. But in terms of sleep and immunity, there is a very intimate association between your sleep health and your immune health.

Firstly, what we know is that individuals who report sleeping less than seven hours a night are almost three times more likely to become infected by the rhinovirus, which is the common cold. Second, we know from a prospective study in, I think it was well over 30,000 women, women sleeping five hours or less a night are more than 60% more likely to develop pneumonia

across a five-year period, which of course is a critical part of the COVID mortality equation. We've also mentioned that statistic about if you're not getting sleep in the week before you get your flu shot, you can't produce the normal antibody response. Do we know that that's the case for COVID yet?

No, we don't, but we're looking at that. We also know it's the case for hepatitis A, hepatitis B vaccination too. So I think there's an interesting case to be made that it could make a difference. We also know that just as we mentioned before, just one night of short sleep, just four hours will drop those critical

anti-cancer fighting cells, natural killer cells by 70%. If that's true, then what is sleep doing for our emotional health? And sleep provides us two different benefits. Firstly, it's during sleep and particularly during deep sleep where the body will be stimulated to produce many more of those critical immune factors. Even better, sleep will actually increase the sensitivity

and the receptivity of your body to those increased immune factors. So you wake up the next morning as a more robust immune individual, sleep will restock the weaponry in your immune arsenal. So on that basis, I think sleep has become very relevant in this pandemic. How has sleep changed right now?

Well, as I mentioned, firstly, the studies show on average, which may be surprising to some people, sleep duration has actually increased somewhere between about 20 to 30 minutes if you look at the handful of studies that are published so far. So people aren't commuting. Not commuting, don't have to get kids to school.

So that's the first issue. Now, if you look at that data a bit more closely, it's not that clean cut or straightforward. There is a cloud of data of people for whom sleep has actually become worse. You know, people have lost their jobs. People don't know if they will still have their jobs. People are just very anxious about the pandemic.

All of those things will decimate sleep, of course. So sleep quantity has changed. Sleep quality has changed also. But we also know that sleep timing has changed. How are you getting that extra sleep? Well, people are going to bed a little bit later, but they're waking up significantly later. And I think this comes back to our discussion of chronotype. Now COVID, because we don't have to commute and wake up or do early morning meetings or get the kids to school. Many people have been able to sleep back in synchrony with their natural chronotype.

You know, it's revenge of the night owls in that way. And then the final component is that people, and I think we don't yet have enough data, but there's too many people saying this, that they were dreaming more and dreaming more about COVID. Why would this be? I think there are two logical explanations. The first, just as we mentioned before, the later that you sleep into the morning, the more you go into that REM sleep rich phase. So you're just

giving yourself probabilistic chance statistically of having more dreams. But I don't think that's the entire explanation. We also have spoken about this idea that REM sleep provides this form of emotional first aid. It's overnight therapy. In fact, there's an American entrepreneur, E. Joseph Kossman, who had this lovely line. He said that the best bridge between despair and hope is a good night of sleep.

And I think when we're going through these, you know, difficult emotionally upheaval time of a pandemic, no wonder the brain is trying to self-medicate it, you know, this emotional situation with the thing that it knows provides a nocturnal soothing balm, which is this thing called REM sleep and dreaming. I think that's probably another explanation

as to why we're not just dreaming more, but we're dreaming about the pandemic itself. Trying to make sense of it, trying to process it, trying to figure out a way to kind of have a healthier relationship with it. That's right, yeah. It just, you know, sleep divorces some of the emotion from the memory so that you come back the next day

and you feel better about those emotional experiences because sleep has essentially stripped the bitter emotional rind from the informational orange. So it's not as though you wake up the next day and you don't remember that emotional experience, you do, but it's no longer as emotional itself. And so it's not time that heals all wounds. It's time during sleep and specifically dream sleep

that provides emotional convalescence. On the immunity subject, it would be interesting to do an evaluation of people that got COVID, how severe their case of COVID was and track that onto their sleep habits and patterns. People are doing that and we're looking at that. We're also looking at when you get vaccinated,

what are the consequences? Some people are describing disruptions to their sleep. Are they? Usually what will happen is that you will have some degree of fever. When you go into fever, that increases your core body temperature. When your body temperature increases,

you're not going to get good sleep. There are some devices that are now, and I wear the Oura Ring sleep tracking device and full sort of disclosure, I advise the company, so take anything I say with a grain of salt, but I was wearing the device for two, I've worn just about every sleep tracking device. And it was just the one that for me,

was a sticky device and I liked it. So I was wearing it for two years before I decided to join the company. But they have a fascinating model, what they've been able to find because the Oura Ring, unlike many of these other sort of devices, it tracks temperature. And what they were finding is that in some people

who then went on a day later or two days later to find out that they tested positive for COVID, there was this spike in their relative temperature. And so, we're now starting to explore this idea that it could be a useful diagnostic tool. A precursor. Pre-emptive. Exactly. I mean, I've got the whoop on

and they manage that not through temperature, but through metabolic rate. Yeah. And they have some interesting science on that as well. So it's cool how these wearables are sort of developing and how the technology is evolving. But I think we're only beginning to understand like the significance that they can play.

Yeah, exactly. I think I mentioned this invasion of technology into the bedroom and it has been a deleterious force, but perhaps unlike some other sort of sleep scientists, I'm not puritanical about technology. You know, that genie is out the bottle and it's not going back in anytime soon. So if you want to rail against it, you'll lose.

But what we're now seeing is this beautiful sort of cycle where technology is starting to solve some of the problems of technology. And it's like that light in the matrix, programs hacking programs. And it's technology starting to hack the ills of technology. So I do think that wearable technology has a part to play and a place in our subsequent future health,

this idea of personalized medicine. And for me, I'm interested in personalized sleep medicine. That's why I'm trying to sort of develop some of these companies. But I also think we need to be a little bit careful as now something called orthosomnia, which is a sleep disorder caused by obsessive sleep tracking where you become so anxious.

And so now it seems to be maybe 10 to 15% of the people who are using these suffer from, by the way, ortho means straighten in medicine. You know, you've heard of orthopedics, orthodontics, straighten teeth, straighten bones. Here, it's about people getting too concerned about getting their sleep straight. Yeah. Orthosomnia.

Yeah, yeah, I mean, 100%. I mean, I think they're just tools. It's about your relationship to them. But if you become obsessive about them, they work across purposes with their intent. Like I know there are certain days where I'm not sure I really wanna look at whatever the whoop score is because I got stuff to do.

And if it says like, I'm not ready for it, that's gonna screw me up. Like, I just would rather, I'll check it later. I use them as, I think they're, for me, my relationship to them is more in the macro. Like I can look at trends over time. Exactly. Or I play a game where I wake up in the morning

and I'll think, I'm pretty sure here's where I'm at. And then I'll check it. And that helps me calibrate my intuition around these things. And the more intuitive you are about them, the less reliant upon them I think you become, but you have to hold them a little bit lightly. I love that. I think that's, it's such a beautiful way

of thinking about it. You know, often what I will say to people when they say, look, I had this really bad night of sleep and I don't wanna look at my ring. Firstly, everyone has a bad night of sleep. Don't worry about it. It's not the end of the world. The second thing, when it comes to trackers of any kind,

and particularly with sleep, follow weekly or monthly trend lines. Don't follow nightly headlines. Don't worry about those things. And I think the reason I believe sleep tracking is perhaps a little bit different than other aspects of health wearable tracking. When I go to the gym,

I kind of know if I got a good workout in or if I didn't. And when I'd be eating throughout the day, I know if I've been eating clean and in a healthy way, or if I haven't. You don't wanna score on that? And I think I probably will know it and some days I'm ashamed of it. But what's interesting about sleep is that

for the most part, it's a non-conscious process. And so if I were to ask you, you know, Rich last night, how did you sleep? You can tell me. But if I said to you, Rich, how did you sleep last Tuesday? By yourself, you probably don't know. But that's where I think the power of some of this technology, it can identify trends and patterns.

And if we can start to measure those and then intervene to give people useful tips as to what they should do in a personalized manner, because everyone is sleeping poorly for different reasons. That's really where we unleash the power of these things. Matt Walker, we gotta end this thing. So great talking to you. Will you come back and talk to me again sometime?

If you would have me and if your listeners don't lose the will to live because of my inane voice, I would be delighted to come back. You are a gift, my friend, the work that you're doing, I think is super important. It's a privilege and an honor to help amplify it a little bit. So I really appreciate what you do.

It's a great act of service to humankind. So thank you for that. And thank you for spending the afternoon with me. I say exactly the same thing back to you based on what you're doing. Your honesty and your vulnerability of story has impacted people I know. And what you're doing with this movement

around this podcast and empowering people with mind, body, guidance, and information, I think is fundamentally critical. So you are a gift. And now I anoint you as a sleep ambassador as well. So Rich, thank you so much. Now the pressure, you know. I'll have a terrible night of sleep tonight.

Just call me, put me on speed dial, I'll help you. I'm gonna call you every night. Am I doing this right? Yeah, don't worry. I will be right there for you. Thank you so much for having me, Rich. Thank you. You can find and learn about Matthew

at the sleepdiplomat.com, right? Yes, sleep diplomat. Or if you want, you can read the book, which is called Why We Sleep. You don't have to read the book. You just have to buy it is what the publishers tell me. No, you gotta read it. But no, just buy a used copy.

I'm not interested in monetary stuff. But if you're interested in learning more about sleep, the book is a good way to do it. Good. Well, let's do this again sometime. I hope so. All right. Thank you, Rich.

Peace. Thanks. Thanks for listening, everybody. For links and resources related to everything discussed today, visit the show notes on the episode page at richroll.com. If you'd like to support the podcast, the easiest and most impactful thing you can do

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See you back here soon. Peace. Plants. Namaste. Thank you.