How To Fix Your Sleep & Supercharge Your Life - Dr Matthew Walker

you might be the British man with the best hair that I know at the moment I think it is the greatest cry of a midlife crisis that you are ever going to see it's a total train wreck I'm suggesting that no one told me the pandemic was over and that you can get your herut this is the consequence of it so um for anyone who is watching any therapy pill uh bills that you have to uh have after seeing me and being fronted by me send them to me I will pay for them oh my goodness fantastic well uh what a good opening to look it is it is it is what it is um talking about sleep today we've had a lot of conversations about it on the show previously but I really want to dig into some sort of more rare insights that people probably know that they need to know but don't yet know so just to get started how do you come to think about what good sleep is how do we conceptualize good sleep yeah it's it's an interesting question because I think everyone most mornings let's say you've got a significant other you come down the stairs and you say you know how do you sleep and I'll say I slept well or I didn't sleep well so everyone themselves has a subjective estimate of what this thing called good versus bad sleep is science is a little different though and Medicine teaches us that there are essentially what I would describe as the four macros of good sleep and so three macros of food fat carbohydrate and protein four of sleep and you can remember it by the acronym qqr T quantity quality regul ity timing and there's all sorts of stuff on the internet about you know take this supplement do this particular thing and and it's the shangar of all good sleep and you'll have this utopian Blissful night honestly if you just focus on these four main principles you're 80% of the way there so quantity is what we used to espouse in sleep as the measure of good sleep which is somewhere between 7 to 9 hours for the average adult and there is variability um the next one is quality and I think this is probably actually I need to jump in on the quantity before you even move on yeah quantity of sleep time in bed time of sleep astute question most of us conflate the former for the latter and it's potentially dangerous so if you are a good sleeper you will have what we call a sleep efficiency of at least 85% which means uh so sleep efficiency of the time that you're in bed what percent of that time are you asleep and really good sleepers will have let's say 80 to 90% sleep efficiency so even if you're in bed for 7 hours you're not getting 7 hours of sleep looking it closer to six correct so to get at least the minimum according to the CDC of 7 hours you actually have to be on average in bed maybe about 8 8 hours and 15 minutes so it's a really astute point point that we sort of misconstrue the question of Total Sleep duration as total time in bed and you have to subtract one from the other and that's why I think there is some legitimacy in looking at say sleep tracking data because at least that will tell you Total Sleep time I absent of you know exactly that was the biggest realization i' I uh looked at my end of your review for whoop and um I've worn this thing for 1,600 nights since way before they were a partner on the show and uh the biggest realization I've said I think who's great and you can sign up for it if you want but I can tell you what the realization is the main realization that you're all going to come to which is 8 hours in bed does not mean 8 hours of sleep that's the biggest realization everybody comes away from they go well I was sure I was in bed for eight I thought I got 8 hours he goes it told me that I was actually only in bed for seven and a half I kind of had a bit of a bad nights I had like 615 of sleep last night I thought I was in bed for 8 you go that's a red pill that everybody needs to take yeah so I think it's it's one of those areas that is not highlighted enough and that's why you can actually then come on to the second of the cues which is quality and that in fact is efficiency sleep efficiency well there's two ways we measure quality the first is sleep efficiency so as I said I want to see you at least asleep 85 to 90% of the time that you're in bed if you are staying in bed let's say for 9 hours and your sleep efficiency is 70 maybe 65 then my recommendation is perhaps surprising do not get into bed that early and do not stay in bed that late I want to cinch you down to maybe even just 6 and a half hours of time in bed and we've already said well hang 6 and a half hours of time in bed is too little to get 7 hours of sleep by the mathematics even maybe six but what I'm going to do by way of constraining your bedtime though is force efficiency out of your system I go to the gym I'm there for an hour I start working out I do the 11th rep pull out my phone I'm there looking at Twitter you know looking at Chris Williamson's content and then you know I'm chatting to people I'm not efficient and maybe I am only working out for 30 minutes next day someone comes in two bouncers on the door you've only got 25 minutes in the gym first couple of days I'm just as lazy and I get maybe 40% of my workout done and I get ejected by day three or 4 my the pressure that's built up for me to want to exercise and get it all in is so high that I go into the gym my phone's down on the counter I speak to no one and I blast through my workout and I get it done it's the same with sleep I build up night after night this increasing hunger where your system was lazy before it had inefficiency and after a while it's essentially like hitting the reset button on your Wi-Fi rout I retrain your brain to realize I don't have 8 and a half 9 hours of time in bed anymore to be lazy he's only giving me 6 and a half hours I've got to get busy and all of a sudden you've got 95% sleep efficiency because as soon as the you get into bed you are asleep and you sleep almost through the night then gradually I will step you back out if you start to get lazy again we stitch you back up again and gradually that's how we retrain the system what about the reverse when it comes to Sleep Quality that somebody is staying in bed for a good amount of time but that quality doesn't seem to want to change cinching it down doesn't really seem to make that much of a difference they're just waking up too much throughout the evening they're not hitting REM they're staying quite lights they're getting up earlier than they want to etc etc yeah at that point we've got to then start to ask if the if we've driven enough pressure in the system what we call Sleep pressure or sleep debt and you are still waking up throughout the night first medical conditions let's do blood work let's see if you're suffering from a sleep disorder like sleep apneia restless leg syndrome if we exclude all of those that you're medically healthy then we have to ask what are you doing in your life exogenous components principally caffeine alcohol light and the principle principal one that we don't talk about is Stress and Anxiety if there is a principal reason why most people in society absent Sleep Disorders are not sleeping well it's because of this wired but tired phenomenon we have people come to my sleep center all the time and they say I am just so tired I'm so tired but I'm just so wired that I can't fall asleep or stay asleep so at that point when we've built up all of that pressure forced you to be efficient and you haven't been efficient we exclude you medically that you're healthy No Sleep Disorders then we've got to figure out what's going on in your life let's take into that wide but tied stress thing what is going on in the body from a sleep perspective in the body and the Brain uh when you're in a high stress lifestyle yeah there's probably at least two things going on in the body and at least one thing going up in the brain the first in the body is the balance between the two branches of your nervous system one is the fight ORF flight branch called the sympathetic nervous system it's very poorly named it's anything but sympathetic it's very agitating and activating and then there's the parasympathetic that's the kind of quiescent branch of your nervous system if you're a good healthy sleeper and you don't have too much stress in your life you you naturally switch over to that restful quiescent branch of the nervous system and that is the Royal kind of Pathway to good sleep and the alacrity of sleep the speed with which sleep arrives to you when you disengage from the fight or flight branch is really speed medium rather beautiful if you are so wired though however the sympathetic the fight ORF flight branch is activated your heart rate is jacked your blood pressure is too high your temperature because of that activated State your core body temperature is also too high if you are too hot your heart is racing and your blood pressure is high it's very difficult for you to fall asleep at a top of that a second system in the body which is what we call the HPA Axis or the um it's essentially the stress axis which descends down from a brain stem area the hypothalamus down to the pituitary releases adrenaline all of a sudden you are cortisol flooded and I think everyone has had that sense where whether it's let's say you've been on stage you've been on tour you come off stage and you are wired now this is not you're anxious but you're still wired cortisol is streaming your heart rate is jacked and you can say I was up at 7 this morning and it's now 2:00 cuz all is said and done I am still unable to fall asleep I'm so tired but I am way too cortisol you know sort of concentrated yeah exactly so those two things in the body are what we will presumably I think most people will cleave to as the the ingredients to the Ty wide phenomena I also think upstairs and they are interrelated upstairs in the brain you start to get this Rolodex of anxiety and I think we've all had that were we're stressed you in the modern world we're constantly on reception very rarely do we do reflection and now the only time based on modernity and how it inflects us that we do reflection is when our head hits the pillow at night that's the worst time to do reflection because when you start to have that kind of Wheel of anxiety woring you begin to ruminate when you ruminate you catastrophize everything seems twice as bad in the dark of night versus the light of day and at that point you're dead in the water for the next two hours and that will then only feed in to jacking up the fight or flight Branch CU you're kind of going through what didn't I do today what should I have done what do I need do tomorrow I forgot to do that thing that's critical for next week it's it's a mental sort of you know train wreck in terms of your sleep that then just further perpetuates those two Downstream physiological Mal sort of consequences to the and then they ramp up and that leads to more yeah talk to me about interventions for those three so the principle one is that you've got to process that and this is the hard part of the equation mental health work is tough work you can take medications and that can be one path for people you can take certain medications that can try to lower your heart rate shift you back over into that quient state but most people don't want to reach for a pill immediately necessarily one thing you can do is just catharsis two or 3 hours before bed not right before bed pad of paper and a pen and just just write down I just want you to vomit out all of your stresses and anxieties and it turns out that simply doing that will decrease the time it takes you to fall asleep by 50% zero yeah it's a great study Michael skulling fantastic work so the first thing is just get it all out of you so it's not inside of you that said you can still be burdened with this egregious kind of Stress and Anxiety nevertheless so what do you do about that at that moment in time whether it's you falling asleep or you've woken up at 3:00 a.m. and it's happening and you need to get back to sleep at that point let's get your mind off itself that is the goal how do you do that maybe at least four things first meditation the data is really strong now I was researching this for um a book and I just thought look you know I'm a hardn scientist I'm here at UC Berkeley you know San Francisco FL it's all a bit woo woo this meditation thing I'm sort of holding hands and people strumming guitars at the end of the day what is going on I don't believe this studies were so powerful though so I thought I best Bloody try some of this myself and that was six years ago and I now meditate for 10 minutes every night before bed um so the first is meditation but people just may not feel particularly compelled towards meditation no problem next one is breath work and you can do you can just Google different types of you know box breathing sort of you know 374 there's all sorts of different patterns but that breathing can also just try to bring the nervous system back down into that zone of sleep permission versus sleep prevention when it's too high if that isn't your thing you can do a body scan so just close your eyes start at the top of your head and just start to relax back feel your neck feel how tense it is start to relax it maybe even your forehead is that tense and just move through the rest of the body go all the way down through your arms through your chest your back and just you're not making any judgments you're just being aware of your body that's fantastic too the final thing if none of those appeal mental walk in hyper detail so think about let's say a walk that you do with your dog and what I want you to do is think about this at the level of okay I open the drawer which leash am I going to take the blue or the red I'll take the blue one clip the dog in with my right hand closing the drawer with my left open the front door with the left I go down the stairs I look across there's that weird Berkeley house it's kind of just a little bit hippie but no problem and then the cars always come too quickly around that bed that's the level of hyperd detail and what's interesting if you look across all four of the things I've just described the commonality is that they all get your mind off itself meditation you're starting to focus on something other than your mind if you're doing box breathing you're all of a sudden body Centric not mind Centric if you're starting to do some type of body scan again it's hard for you to think about your worries and your stresses if you're doing it mental walk same thing because sleep at that time of night is a little bit like trying to remember someone's name the harder you try the further you push it away sleep sleep is something that happens to us it's not something that we make happen and when you get get that mind distracted away from itself the next thing you typically remember is the alarm going off in the morning why because you got your mind off itself okay so first one quantity second one quality that being a component of that is there anything else to say on quality before we move on yeah probably the other way that we measure and most people can't do this but um is in the Sleep laboratory we place electrodes on your head you look like a Spaghetti Monster and the other way we measure quality is the depth of your deep non-rem sleep so we have two main types of sleep REM and non-rem nonrem for most sleep trackers you divide it into light non-rem and deep non-rem deep non-rem is where you get these incredible deep powerful slow brain waves they're just epic um and the depth the size of those brain waves and how dense they are the number of them that you're having is another great measure of the quality the elect physiological quality of your sleep versus the are you waking up lots throughout the night and therefore you're spending a lot of time awake that sleep efficiency that's another measure of quality so they're sort of orthagonal but both bleed into this kind of second Silo of Sleep Quality so QQ next one is regularity going to bed at the same time waking up at the same time and you think this sounds fairly rudimentary and basic part of reason is because you have a 24-hour Master Clock in your brain and that clock thrives under conditions of regularity and when you feed it signals of regularity like going to bed and waking up at the same time it improves both the quantity and the quality of your sleep that's what I used to preach as why it was important until there was a great study published probably 2 and a half years ago and it was I think over 300,000 individuals that they tracked with sleep um assessments over a good period of time and then they looked at them across a much longer LIF spam period of time and they looked at mortality risk and they also looked at different forms of mortality risk cancer mortality risk cardiovascular disease mortality risk and they measured sleep quantity sure enough just like we've seen in many other studies using that sweet spot of 7 to9 hours the shorter your sleep the shorter your life short sleep predicted all cos it that's the quantity measure they looked at regularity regularity demonstrated the same thing those who were in the lowest quartile the those who were least regular highly erratic they had far higher rates of mortality relative to the people who were in the top quartile who were incredibly regular how did that compare to the quantity in terms of predictive power genius and that was the Brilliance of the study that really made me double down on regularity because then what they did they said well if we've got these two measures quantity and regularity let's not look at them individually let's put them in the same statistical model and do a c Pepsi challenge between the two and all of us in the Sleep field you know you're betting that quantity is going to be the more powerful statistical um variable wasn't regularity beat out quantity in predicting all cause mortality cancer mortality cardiovas vascular mortality now it's not to say that you can get away with short quantity of sleep even if you're highly regular you know getting four hours of sleep at the same time every night you still have markedly elevated mortality risk but nevertheless I was pretty stunned by how powerful that was and made me even someone who was pretty regular before get a bit more Evangelical about it you know we'll get back to talking to Matthew in one minute but first I need to tell you about sleep there are thousands of dollars of Lights pointed at my face right now but because of mantis sleep mask all I can see is complete Blackness literally I it feels like I'm in Pitch Black at the moment that's why I'm a massive fan of them the problem with most sleep masks is that they're made with cheap materials they let too much light in they push up against your eyelids and they're just uncomfortable especially for side sleepers look at that you can see here how amazing this like the inner part of the eye mask is where it doesn't touch your eyelids at all mantis's masks were made with all of this in mind to make the perfect mask for all types of sleepers made of soft breathable materials they've got an adjustable strap that can fit even the weirdest shaped head Dr Mike isrel this could be for you I use this mask every night when I'm at home I use it when I'm on travel there's one in every single travel bag I've got even for Midday naps this thing is unbeatable so comfortable and they've got a 60 night sleep trial so you can buy it and sleep with it on for 59 nights if you don't like it for any reason they'll give you your money back plus they offer free us shipping and they ship internationally right now you can get 10% off the best sleep mask on the planet by going to the link in the description below or heading to Manas sleep.com wisdom and using the code modern wisdom a checkout that's m n sleep.com slod wisdom and modern wisdom a checkout how big of a wobble are we talking in terms of Tolerance here people can't just go to go to sleep at the same time the same minute every single night what's an acceptable tolerance window for s and is there a difference for going to sleep time versus waking up time how can people navigate this regularity landscape yeah beautifully put so it's a 2 by two you know is it um is it offset versus onset of sleep getting into bed get out out which is the more powerful right now we don't know which one you should keep as more regular we haven't been able to dissect that yet however to your question what's the amount of wiggle room I'm describing here in terms of the four macros this ideal world of good sleep and it turns out drum roll none of us live in the ideal world we all live in this thing called the real world so just for goodness sake stop being so puritanical it turns out that you've got a wiggle room of about 15 to 20 minutes on either side of it so there is some degree of play in the system not much but not too much but and this is to be uh this is to not have sleep regularity have a negative impact on your mortality outcomes is that the measure that we're looking at correct or just your mortality in terms of cancer or your mortality in terms of cardiovascular disease or all of the mortality buckets thrown together into a big old mix presumably including car accidents and all manner of other things that can occur correct by way of micro sleeps and all of that you know that's the way that a lack of sleep will pop you out the gene pool you know very quickly rather than chronically through disease sickness okay so talk to me you know people might not be able to work out what the different quartiles would be if 15 to 20 minutes of wiggle room for both going to sleep and waking up I would actually guess that most people more people in terms of regularity will have their wake time versus their sleep time in that most people have a thing that they need to do correct uh the alarm goes off and whether you like it or not you are up for many people yeah the same isn't true when you go to sleep so I'm going to imagine that there's more wobble on the bottom end yeah less wobble on the top end uh but talk to me about what's the upper quartile and what what are we looking at here how how uh deep does the trough go of of swings yeah the highly irregular people were somewhere between two to 2 and a half hours variable so in other words they may have an offset of going to bed or waking up or just some wiggle room of an hour you know one side of the mean of and then an hour the other side of the mean so again it it doesn't sound like too much that much I mean how many times have you watched one extra episode of Game of Thrones or something and then oh [ __ ] that's that's that's me at the bottom quartile yeah of wiggle room and then maybe you wake up later maybe you haven't got work in the morning you know I mean God I said this to you before we got started but I was running night nightclubs for my entire 20s 15 years and uh the first time I ever had a stable sleep and awake pattern was CO as an adult the first time I ever had it I would go Dunning yeah I mean it's crazy I also have to say to you it's a a it must be interesting for you I wonder whether you've ever considered how many years of life you've saved on the entire planet because I certainly know that before your first episode on Rogan I didn't care about sleep yours was the first time when you spoke to Jo I think it was 1109 yeah uh the uh podcast number and was the first time that I ever thought oh I really need to care about this like you know the number of doctors or surgeons that end up back in the same uh hospital after they've gone home to do this thing but that was me so I would you know wake up at say 10: or something like that get up I'd train a bit of a walk do whatever I needed to do work and then I'd set off to go to Manchester from Newcastle at 7 p.m. get there at 9:30 set up the club run from 10: until 2 two cash the till which is the most cognitively demanding task before you're about to finish get back in the car 2:30 drive back to Newcastle get in at 5:00 a.m. and we did that I did that once a fortn night for four years uh there would also be one night in Newcastle where I'd be up until at very least 2:30 in the morning because I was cashing the till at one of our sort of we would call it a domestic event one of the home games as opposed to no away game and uh you know I'd alternate that with my business partner and then there was you know just the vacillations of being a 20-year-old club promoter in the north of Eng so you know that was all of that stuff was happening and uh yeah that happened until I was 32 and then you know Co comes along and that's the first time in my entire life that I go to bed and I wake up at the same time and uh how did you feel feel subjectively any and be truthful just yeah yeah yes I mean uh look for me the single biggest determinant in my mood is my sleep um if I'm underslept uh also if I've slept in that a lot of that's to do with the story that I tell myself um I think I wanted to start becoming a morning person and I thought oh you know genetic night maybe we can get onto it genetic night owls early birds that must be one night owl thing it's like kind maybe but also you've had to survive in this industry for the last 15 years so maybe your body's just compensating for what it is that you have to do but I found that um the quality of my mood the quality of my thoughts uh my emotional regulation uh these things took a you know a marked uh turn for the better um I found myself being able to regulate my appetite more uh what it was that I wanted to eat even if I was getting the eight hours because I wasn't getting ripped around by basically doing shift work uh that didn't happen um yeah a lot of things my my ability to introspect changed as well lots of things yeah and isn't it it's almost like being in a room where the refrigerator compressor turns off and it's only when it turns off that you realize it's been on all the time correct I just thought that the same right exactly and it's only when you finally disengage from the brutality of that schedule do you realize my God this is not me in my 30s there's a different form of me sitting underneath all of this well I mean this is the bizarre thing when you start to think about who are you and what does it mean that you have a nature well okay you have a nature you have a a a disposition for anger or discomfort or introspection or sadness or happiness or whatever it might be Joy okay let me double your testosterone just that one intervention now let's see what you think you is well you are still you but also the daily experience of you the sort of landscape that you inhabit internally and the way that you show up externally has probably changed at least somewhat okay let me chop your sleep in half what does that mean like who are you on half the amount of sleep for two weeks yeah who are you you now but you're still you but we have this sort of sense of who we truly are which is kind of like a best version of us like a th flourishing thriving version of us and then we have this other one but again as you say you know kind of like the uh the Stockholm syndrome of our own sleep deprivation or sleep irregularity maybe um we don't know who we could be or who we are with regards to that and uh over the last 18 months I've been fighting with sleep again sort of really trying to dial in Sleep Quality and struggling quite a lot and uh that again makes me qu okay well who is who what is it that I'm fighting with here how much of this is me and how much of this should I identify myself with and how much of this is just a byproduct of what's going on at the moment it's really interesting and you've also got to ask yourself the question at some point you know what is it that I want out of life because I think so often in life you know the professional gun goes off and you're off into the rat race and the thing is even if you win the rat race at the end of the day you're still a rad so why not just stop and look up and firstly ask do I even want to be running in that direction and do I want to be this physiologically kind of distraught person by way of that run that this life is is enacting on me and that's what it was with and now being shortened as well and you're right precisely and also it's not just that we're going to live a shorter life but that shorter life is going to be more likely filled with with disease and sickness which is not your lifespan but your health span and I think what you're describing is we've done we do a large amount of work in sleep and mental health and I would say that one of the most sensitive faculties that is that takes a nose dive like a dart into the ground when you are even sleep shortened versus totally sleep deprived is your mood and your emotional stability and we understand all of the brain mechanisms as to why but when you're get sleep all the covid experience my guess is that you woke up and you are now dressed in a different set of psychological clothes and sleep is almost like a set of emotional windscream wipers that it just adds the rose back into the tint of your life glasses every single day and when you look it's not necessarily and we've done these studies when you are underslept it's not as though you slide down into the negative more and you experience negative things more negatively you do somewhat the main thing is that you lose the pleasurable feelings of normally pleasurable things that's what we call anhedonia the lack of anhedonia correct and anadon is the principal underlying feature of depression and that's why we see such strong links between you know sleep in fact in the past 20 years of studying we have not been able to discover a single psychiatric condition in which sleep is normal to me that is one of the most I think demonstrable indications of this tenuous link between your sleep health and your mental health they are so intertwined and there's a lovely quote by an American entrepreneur e Joseph Cosman and he once said that the best bridge between Despair and hope is a good night of sleep that's exactly what the data demonstrate what else is there to say in regularity so we mentioned gold standard 15 to 20 minutes of wobble for sleep time 15 to 20 minutes of wobble for Wake time yep black standard at the bottom end freaking bottom quartile two hours of wobble so from when you typically on average would go to sleep an hour earlier or an hour later and the same at at your wake time is there anything else to say when it comes to regularity I think there is I think it's probably you you came onto it beautifully with the Netflix you know description which is where most of us get hammered with our regularity is the front end of sleep going to bed and the Netflix phenomenon is really what we call Sleep procrastination which is you are plenty tired enough to sleep but there are things that are getting in the way be it online shopping checking social media and what to do about that I would just at least say set a Tibet alarm not just a wakeup alarm but a Tibet alarm it goes off one hour before bed maybe even let's just say 30 minutes before bed and live in the real world at that moment at least dim down half of the lights in your house and see if you can do at least a digital detox fine keep watching your Netflix on your TV but for the most part see if you can put your phone away my goodness that's the other thing that will activate you we used to think it was the blue light from tablets and screens and there was a great study from Harvard indicated certainly 1 hour of you know blue light exposure before bed blunts something called melatonin which this is bioactive nighttime hormone which signals sleepiness and it certainly did that and it disrupted sleep and we were all on the good bus of blue light is you know the nefarious agent that will you know fleece you of your sleep then came along some great work by a guy called Michael gradisar and he actually argued now I think very powerfully it's not the blue light it's that these devices are attention capture devices and they are designed to ruthlessly fleece you of your attention economy and my goodness are they good at doing it because they've spent hundreds of millions of dollars developing that technology and as a consequence you become so cerebrally activated that it masks your state of sleepiness so you could be saying okay if there was an electromagnetic itic blast that came through Austin at 11:00 p.m. at night you would normally say look I'm not sleepy until midnight my and and I just don't feel sleepy right now because I'm on my phone and you're getting activated all of a sudden that goes out within 10 or 15 minutes you actually get hit by this wall of sleepiness and you think Jesus actually am pretty sleepy because it hits the mute button on the signal the physiological signal of sleepiness because it overdrives it with activation well I mean the converse which is pretty I I I think that you're so right as well that um there is something triggering about activating about that kind of use you're you're involved it's engaging you you're sort of thinking about stuff it's kind of passive but boring at the same time but also engaging very interesting uh but I used to use it if I was uh stuck in traffic or whatever and I was tired after driving back I would make sure I had a really compelling YouTube video on so I would use that effect on the opposite side I you engineering yes to keep you aw exactly correct quick note talking with Matthew really drives home how much our overall health depends on the basics like getting a good night's rest which is why I've been prioritizing tracking my health more closely and function has made it unbelievably easy to get a clear picture of what's Happening inside of my body they run lab tests twice a year that monitor over a hundred biomarkers they've got a team of expert Physicians that then take that data and put it in a simple dashboard and give you insights and actionable recommendations to improve your health and lifespan they track everything from your hormones to your nutrient levels two key areas that affect your sleep they even screen for 50 types of cancer at stage one which is five times more data than you get from your annual physical best of all Dr Andrew hubman Dr Walker's colleague is their Scientific Advisor so you can trust that the data and insights you receive are scientifically sound and practical getting your blood work done and analyzed like this would usually cost thousands but with function it's only $500 right now you can get the exact same blood panels I get and bypass their weight list by going to the link in the description below are heading to function health.com wisdom that's function health.com slod wisdom I'm interested in I saw a study a little while ago I don't know whether I ever got replicated looking at e-readers and looking at the eff of e-readers most of them now you know the the best Kindles have got a warmth level as well as a brightness level have you looked at a lot of people want to read but if you're reading and you're reading a paper book that means you got to have a light on light's quite bright yeah so you can go to a Kindle and you can pull that down but that's a screen have you looked at anything to do with light exposure from e-readers impacting Sleep Quality really interesting and that's actually a great way to continue to engage with you know digital media in terms of reading if that's all you're doing so the page is black the text is a cream or a white therefore the amount of lookx that's coming from the screen is already lower versus because obviously the background is the far more dominant constituent of that page so so black paper white text that's perfectly fine you've got to be a bit careful in terms of what you're reading if it's the content you know if it's all sorts of salal stuff then you know maybe the heart rate is going in the wrong direction but for the most part that's completely fine um but I would say even if you two things about your phone if you have to take the phone into your room because again I don't want to be panical that Genie of the phone being in the room is out the bottle and it's not going back in no matter what I say two rules if you can you can find some software that can try to turn the screen monochromatic so everything goes black and white and it's pretty surprising at how reduced in terms of the activation my phone's next door let me show you this I'm going to hang on wait there people I promise people who are listening we did not plan this this is completely so you'll know that there's a accessibility function that allows you to turn things grayscale yeah have you ever seen anyone do that oh that's genius and turn it turn all of the blue off and turn it just red so you can see here how on Earth did you do that just internally on the on iPhone so you go into settings and accessibility and then you the same as you triple click to go grayscale the same function but you just use the slider on the red side you kill all of the color except for red and that means it's so much darker so when you do this especially if you need to use it a little bit later later on the evening uh you just and I triple click and it goes from you just stack the two things which is first it's almost monochromatic but second it's desaturated the blue light and it's the blue light which is the lower wavelengths that are most delerious to harming your melatonin it's that belt blue light that's G by the way do you know why it's the blue light that's so bad for your melatonin why it's so powerful in terms of is that because when the sun is lowest in the sky in morning it's oh when the sun is highest in the sky sorry it's more blue and when it's lower and it's going through more atmosphere it's redder is that why some of that is true but it's not the main reason it's because where we evolved from we evolved from the ocean from the sea okay and there because of the way that light is refracted through water the principal color of the Sea of the ocean are blues and so where we evolved our San rhythm originally was under the water and the way it was regulated was using light but the color of light under the water was principally blue because it was kind of desaturated from the Reds and the yellows that amazing that's so C this isn't even reptile brain this is fish oh no this is you know reptiles amphibian fish we are way before you know Avan and mamalian you know sort of emergence and by the way it's only in birds and mammals that we see this thing called REM sleep or dream sleep and it's it's a surprising thing and it's we still don't understand what that tells us about the functions of REM sleep REM sleep is the principal stage in which we dream and before with every living species that we've studied to date sleeps what that means is that sleep probably evolved with life itself on this planet and fought its way through heroically every step along the evolutionary path uhgo if sleep doesn't serve an absolutely vital function it's the biggest mistake The evolutionary process has ever made and we now realize why it didn't make a blunder but what's interesting is that what first came into being was this thing called nonrapid eye movement sleep and for Millennia there was no rapid eye movement sleep there's no dream sleep something happened when we went from amphibians reptiles and fish up to birds and mammals now birds and mammals evolved separately in two separate lineages from reptiles amphibians and fish birds have REM sleep mammals have REM sleep what that means firstly is that REM sleep evolved twice independently in the course of evolution when you see the same thing evolve twice or more times like eyes for example it tells you that it's probably a fundamental trait of of of a living species um so what we don't still understand though is why do do birds and mammals require REM why did REM sleep emerge into being now we've got some theories because the one of the differences is that birds and mammals regulate the temperature we are homeotherms we get the ability to control our core body temperature all of those other species don't so it has to be something to do perhaps with metabolic control to produce themo regulation there's probably other theories too but nevertheless going back to the evolutionary story and we'll come back to don't I haven't forgotten the final t for qrt but I've put forward a theory that sleep actually never evolved why do we think that sleep evolved why don't we think that sleep was the default state of all life and it was from sleep that wakefulness evolved I've always been confused why we don't well because you wouldn't be able to survive if you just slept but you could survive if you just woke the idea would be though that if sleep is this initial default state it is enough to support life and its existence and some of those species could reproduce potentially asexually so you wouldn't have to necessarily be awake to find a mate you could at least have a Proto version of life and the Proto version requires this stasis state that we call sleep it would somehow accumulate nutrients by falling through gravity and correct you know think of you know there's any manner of static living organisms that stay in place that don't move around but then at some point there was enough evolutionary pressure to demand this thing called movement and demand higher levels of consciousness and it was so that's one way of seeing it I think the other is let's say wakefulness came first why don't we then just have wakefulness why do we need sleep sleep is clearly the price that we pay for wakefulness that's another way around we can see it so I've gone off on an evolutionary tangent there based on your um Brilliance but I can always come back to the final T if you like but yes please timing timing so timing so qqr T timing sounds like regularity and you think hang on a second that's the one and the same it's not timing is your chronotype are you a morning type evening type or somewhere in between if you're an evening type the headline piece of news is it's not your fault because it is largely genetically determined there are at least 22 different genes that dictate your morningness or your eveningness and therefore you don't really get to decide it's gifted to you at Birth and it's very hard to change they tried it with a great study out of Australia where they took night hours who were kind of 1:30 a.m. 2 a.m. type people and they gave them I think it was a total of 11 different rules and I'll forget some of them but it was wake up 2 hours earlier as soon as you wake up have breakfast right after that get at least 30 minutes of daylight don't nap cook caffeine off after midnight don't nap in the afternoon in the afternoon if you go outside you've got to wear shades start to get dimness already eat 2 hours earlier and make sure that you're eating at least 3 hours before bed and then make sure you get into bed at least an hour and a half before you normally would do and they were able to bring those night owls back by about 60 minutes but if you go to bed at 1:30 a.m. normally and you drag back you're still a 12:30 a.m. type person and that was extreme imagine trying to do that every day for the rest of your life with those 9 to 12 different rules the adherence to that protocol is probably going to be very difficult and sustainable throughout life so even with all of that extreme it's hard to do why is your chronotype knowledge important by the way you can just go on to Google and just type meq test which stands for morningness eveningness questionnaire test takes about 3 minutes and it gets you about 80 to 90% accurate close to your actual genetic chronotype um distinction so it's a pretty good test for what you are you probably already know what you are you can probably answer it by a simple question if we put Chris on a desert island nothing to wake up for no responsibilities no clocks no nothing what time do you think your body would naturally like to go to bed and naturally like to wake up and the Reason by the way I say your body rather than what time would you you're already too biased by society's predilection to mourning types are the best types you know it's the early bird catches the worm type mentality so you I to which I would say by the way that the second mouse gets the cheese but I'll let's move on the I would still say though that it's so difficult to fight against that and we see this also at the Sleep Center people will come in and say I've got terrible sleep onset insomnia that I get into bed for the first hour and a half 2 hours I'm awake I just can't fall asleep I've got insomnia and then we do a chronotype test with them and for some of them what we find is that they're a night owl and they'd like to go to bed at midnight but because of the way life is structured for them they're getting into bed at 10 p.m. and they're awake for the first two hours they don't have insomnia they have a mismatch between when they're trying to sleep versus when their biology wants them to sleep and when you sleep in synchrony with your chronotype you get a beautiful distribution of quantity and quality when you fight against your biology you normally lose and the way you know you've lost is typically disease sickness and bad sleep so so that's why I would always try to emphasize your chronotype as a critical last component so I think I'm probably a pretty good example of somebody that was uh like like a how would you say chronotype fluid um being being in my oh you're a genius Chris I love it uh being in my 20s and like I say I was adamant I'm just you know I'm a I'm I'm a night owl um I finished my every single assignment at my two degrees at Uni were all done at 3: in the morning you know that was sort of where I came alive I used to have my most my most sort of creative moments between about 10: p.m. and maybe 1: in the morning I really sort of drill down um and then Co come along and I was I was already starting I mean this is after your episode and Rogan had come out so I'd already realized I needed to start to prioritize sleep in a different kind of a way and then Co comes along I like well I just see what happens I guess and I started to get myself a morning routine that was unnecessarily elaborate and then I over the last what four four and a half years since that came along my natural wake time now is 7: a.m. if you don't put an alarm on I will get up at 7: a.m. I will go to bed at the moment I'm going to bed at like 7:00 p.m. or 8:00 p.m. which I need to have a chat with you about yeah but uh I will get up at 7:00 a.m. and I don't know I I don't know how much of it you know the chronotype thing the night owl early bird or something in between although useful and Powerful I worry will be used by a lot of people to justify their poor or obsessive sleep habits in whichever direction that they kind of want to rationalize that they should take it that say so natural I understand that absolutely I mean I was somebody that had Stockholm Syndrome from his own industry you know I I like the the whatever the prison guards had become my friends uh because I did what I needed to do in order to be able to survive in the world that I was living in but liberated from that free from that for a full four years right where I was no longer having to do this I was actually incentivized to maybe get up a little bit early because I could train and then prep and do the episodes and so on and so forth oh well it seems like my body works in a different way uh so yeah very fluid in that regard yeah and I think you know you so we definitely need to have a discussion if you're going to bed that early because I I'd love to see your sleep efficiency nevertheless I think what that what that teaches us is much like sleep deprivation you don't really know that you are sleep deprived when you're sleep deprived your subjective sense of how well you're doing when you are not getting sufficient sleep is a miserable predictor of objectively how you're doing with insufficient sleep you the analogy you could use as a drunk driver at a bar they've had you know three or four pints they've had a couple of shots they pick up the car keys and they say I'm fine to drive home and you say I know that you think you're fine to drive trust me you're not let me just grab you a cab I'll take your car keys and it's the also the same with your CR your natural chronotype tendencies versus overdriving it and trying to force yourself to be let's say a night owl when you're actually not a night owl I would also say that when when you start to get very regular and you sleep in harmony with your chronotype you start to not need an alarm and that's the other strange thing by the way human beings seem to be the only species that will deliberately deprive themselves of sleep for no apparent good reason and often when people say how do I know if I'm getting enough sleep one question I'll ask is if your alarm goes off in the morning you wake up but if your alarm didn't go off tomorrow morning would you sleep past your alarm if the answer is yes then it tells me that your body's not done with sleep and no other species does that they just sleep until they're done with sleep but we will naturally terminate that for all sorts of different reasons and so I like the idea that you will wake up no matter what at 700 a.m. it tells me something about your unique biology now my guess is that even if I put you into bed at 2: a.m. you're probably not going to sleep the same duration that you would do otherwise you're going to right exactly because your body has a natural Cadian Rhythm that even when you're sleep deprived it will go on its awesome upswing of a piston activation and wrench you out at 7:00 a.m. so you're getting closer to understanding what your biological rhythms are at least at sleep offset talk to me about the relationship between timing and regularity because it seems like those two are inin ically linked some people might have even confused it that how how important is it to get regularity if we're getting enough of it like sleeping during the day but staying up at night you already mentioned kind of dampened it a little bit for the night owls to say you know it's not your fault and so on and so forth but I imagine that there is some predictive power for mortality for people that are waking and sleeping more aligned with when the Sun is up when the Sun goes to bed etc more aligned if they're sleeping in harmony with their chronotype okay so if evening types are sleeping like morning lcks their sleep quantity is shorter their Sleep Quality is far worse and that's the reason why they have higher rates of mental illness psychiatric conditions higher rates of interes higher rates of obesity higher rates of um hypertension stroke and heart attack so you can see that the consequences of figh back against that biology now it can also work the opposite way too if you've got a morning type that's sleeping like a night owl which rarely happens in society because Society is so biased Club prom toward exactly but you are the archetypal example what happens there is that you are going to bed late and you will necessarily you will still be short slept now the night owl that's getting forced to sleep like a morning tide is going to struggle to sleep on the front end cuz they're not ready for sleep your problem is the opposite you are going to bed far later than you would normally naturally like to do and you will fall asleep ever so quickly the problem is you want to get your 7 to nine hours and sleep later into that morning but you're awake at 7 that was less of a problem when I was younger again this whole thing sort of started when I started to get regularity it was like um I don't know I was a an MMA fighter from a sleep perspective and sort of sometimes ground and pound and sometimes standup game and other times it was Brazilian jiu-jitsu whereas now I've just pivoted into one particular type so I think um giving myself a little bit more structure has resulted in a kind of lock in with my sleep that I didn't have before I was able to shift that window around and again maybe it was not too dissimilar to um squeezing down sleep so that you get sleep efficiency everybody that's a shift worker that's listening to this or most of the people that are shift workers cuz I would imagine if you couldn't deal with it if you weren't if you were insufficiently sleep flexible when it comes to moving around your shift work you would have lasted a couple of years and being like I can't keep doing this it's just going to kill me um so yeah again we're very adaptable at least for me uh we're very adaptable I had a full uh intellect DNA uh genetic screen done which was the super uber Platinum everything everything everything nothing came up for uh sleep a bunch of stuff for sort of dopamine EP Nory uh but nothing really came up for sleep so that was kind of interesting to me so I guess a question I've got what happens to all of the cues the r and the t uh as we age over time what what starts to get manipulated and changed in terms of all of those as we grow up as we get older yeah bloody great question um the first two cues get much harder it's much harder to get the same amount of sleep that you did in your 30s 20 or 40s when you're 60 70 or 80 and this is one of the myths in sleep people used to think well Ultra adults need less sleep and if you look they'll on average get maybe six six and a half hours of sleep what we Now understand is that older adults still need the same amount of sleep as they did when they were in their 40s the difference is their brains simply can't generate the sleep that they need and I've always been perplexed by that mentality of people just saying well older adults get less sleep so older adults need less sleep that's the equivalent of saying well older adults have weaker bones because older adults just don't need bones that are as strong in later life no we don't say that we treat them with calcium and resistance training to try to maintain that bone density why don't we take the same mentality with sleep so firstly quantity gets much harder it's harder to generate the sleep and we know why because as we get older just like our body deteriorates our brain also deteriorates the problem is that your brain does not deteriorate in a homogeneous manner what I mean by that is some parts of your brain rapidly deteriorate or at least more rapidly than other parts of the brain and when we've mapped that what we call Brain atrophy and you can almost play a movie now where you look at it across decades and you can see these beautiful morphological changes in the brain the two two are is that or at least one of the main areas that generates your deep non-rem sleep is right here in the frontal lobe right in the middle called the medial prefrontal cortex that area is the epicenter for the generation of deep sleep and that degrades most rapidly when we get older so unfortunately the Aging brain is a sleep dependent aging brain it's especially um sort of ravaged by the process of chronology relative to other parts of the brain so that's the first issue the second is quality and quality is here coming back to you are nice and continuously asleep for most of the night versus you're awake you're asleep you're awake you're asleep or you're awake for long periods of time that is much more like age related sleep if I were to show you sort of the what we call the hypnogram of sleep which is what you see on your sleep trackers it looks time of night along the horizontal axis you got this different sleep stages and you go on this beautiful roller coaster ride REM nonre but then if you look at the Aging brain you've just got all of these kind of like a dolphin going up surfacing for wakefulness all the time it's fragmented sleep poor quality of sleep part of the reason is because the the release of melatonin is not in this standard beautiful where melatonin Peaks just before you go to sleep stays high and then drops down low you just get this really flat profile of melatonin as you get older secondly you've got the Sleep generating the Deep Sleep generating brain regions deteriorating so you can't stay in deep Sleep you surface in these lighter stages where you're more vulnerable to being woken up and then the the other sort of component of of age related sleep decline comes on to the aspect of your chronotype you are you are given your chronotype at Birth but it's highly aged dependent in terms of where you're sleeping on the clock face so as let's say a six-year-old we all wanted to be awake with the adults at the weekend and try to stay awake and we would try and try but you know I just remember at 9:00 being kind of like lifted up to bed because I'd fallen asleep used to annoy the living daylight out of me so there even though I'm mostly a neutral I'm kind of like an 11 to 7:30 kind of guy there I still had my neutral chronotype but as a child my neutral chronotype was sort of 9 to 6: a.m. uh in the morning and then as I got older I moved forward in time and I found my adult sweet spot but then per your question as you get older in late life now you start to regress back and you become more childlike you want to go to bed earlier and wake up earlier it's the reason that if you go to Florida you know where you've got a lot of retirees you've got the early bird special where people now eating at 4:30 you know they finished their their meal they're home by 8 and they're in bed by 9:00 because they've regressed but even if you take you know 180 year olds in Florida you'll still get a distribution of some people wanting to go to bed at you know 8:30 uh p.m. others more close to 10: p.m. there still the variability of morning types and evening types it's just that where that morningness and eveningness sits on the 24-hour clock face gets dragged around across the lifespan I know that's a complicated way but does that make some sense absolutely yeah yeah it makes complete sense you might have heard me say that I took my testosterone level from 495 to 1006 last year and one of the supplements I used throughout that was tonat Ali I first heard Dr Andrew humanman talk about the really impressive effects that tons of research was showing which sounds great Until you realize that most supplements don't actually contain what they're advertising 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sleeping positions it's really interesting that people say I'm a back sleeper I'm a side sleeper that's not really true you will typically sleep in almost all of those positions throughout the night it's just what is the dominant position and when people say I am a x sleeper or Y sleeper you're just talking about what you typically do more often relative to the other positions more people are side sleepers than front sleepers or back sleepers about 60% of people are most often Sid sleeping position doesn't matter with probably two exceptions although one of them has an asteris which is I don't want to scir Monga the first is definitive if you are snoring if you have sleep apnea or undy if you know anyone who is snoring and they have not been tested for sleep apnea go and get them tested or if you are go and get tested it's real easy to figure out if you're a snorer or not download an app I have no association with them it's called snore lab snore lab Android Apple you open it up you hit record you place the phone down by your bedside it listens to your snoring and then at the end of the night you can see the amount of snoring and it grades it from quiet moderate loud and epic and you see these RoR shocks throughout the night the worse still you can then go and tap at any moment in your night and you can listen to yourself gasping for breath and snoring because snoring what happens when you snore is that the airway starts to partially collapse and when it starts to partially collapse like a straw that gets bent sort of you start to get these fluctuations these Eddies in the airway and that's the sound of that's the partial collapsing of the airway when the airway collapses completely the straw goes flat effectively that's when you stop breathing entirely and you can be there for 15 20 seconds and and your blood oxygen saturation just starts to plummet and at some point your brain brain stem which picks up the ratio of the gases in your bloodstream between carbon dioxide and oxygen says break glass in case of emergency wake him up we we've got to wake him up and that's the moment where you hear and you gasp and you're back up again as a consequence you're never going into deep sleep you stay in those shallows of sleep now mild sleep apnea if you have these what we call apnea events and apnea is a word it's beautiful um pinea is breath the from a Latin derivative anything in medicine that has the word a before it is usually the absence of it you know arhythmia um the absence of a normal rhythmic heart apnea is the absence of breath and Mild sleep apnea is you having maybe 5 to 15 of the events per hour that's how we grade it for each hour of sleep how many of these events are you having mild sleep apnea let's just call it 10 events and you're asleep for eight hours imagine if I were to come in and say tonight Chris I'm going to come into your room and for the entire night maybe 80 times throughout the night I'm going to come in and I'm going to throttle you around your throat to the point where your oxygen saturation drops below 80% do you think you're going to feel good by tomorrow morning the answer is no but so many people are living with undiagnosed sleep apnea we think at least 80% of people who have sleep apnea are undiagnosed right now and that will put you in an early grave is snoring the same as sleep apne no it's not you can have snoring and it will not classify as sleep apnea you still want to understand why you're snoring but nevertheless you can just get a very simple home test in fact you can look at your risk for sleep apnea already go online and type in the uh the search term stop Dash bang questioner stop bang questioner and again it takes probably two minutes to fill out and it will give you a risk Hazard ratio of How likely is it that you have sleep apnea and it correlates very well with an atome sleep apnea test so it's a good quick proxy I love snor laab though that's another great way to frighten yourself into understanding what's exactly happening um so all of which to say I think I I'm forgetting how we got here but nevertheless sleeping positions sleeping position is one of those situations where when you are lying on your back you are allowing yourway the direct access to this thing called gravity and when gravity is present with back sleeping it's far easier to pull that straw flat shut so that's the why we typically don't like people with sleep apnea sleeping on their back the old school approach gsh when I was coming up to sort of start to treat was or to at least get you away from a back sleeping position was you would ask the gentleman usually the more heavy set you would ask them find a t-shirt from your wife usually smaller and get get that t-shirt that has a pocket on the breast and then I want you to wear that tight t-shirt back to front and then I want your wife to take a tennis ball before you sleep and put it in the pocket and every time you roll over it's so uncomfortable that you train yourself out of back sleeping wow and so that's the way that's the old SCH is that um so why do we have preferences for sleeping position is this chronotype is this just habitual can we train ourselves out to being usually based on your skeletal ergonomics and how you want to sleep it's also in part driven absent of your body based on your mattress mhm and so that's why you know having a mattress that's at least supportive enough where you don't get that banana Boe because if you are a front sleeper and you're sleeping on a poor mattress then all of a sudden you just get this every night this bending of the spinal cord and you're lying there man just say okay today for 8 hours I'm going to have you compressed into this banana shape lying on your front and then at the end of that 8 hours get up and you know do 10 Jumping Jacks and feel great not so much so you've got to be mindful of the position so I would say sleeping on your back if you're a snorer not so great there is some evidence that sleeping and I'm going to forget which side it is now I'm trying to think of my anatomy but sleeping I think it's on your left side based on how your gastrointestinal system is working leads to a greater degree of gird which is gastric reflux in other words getting heartburn and just get reflux interesting so that's the the second one though really that I was going to mention is um sleeping on your front or on your back may not necessarily be ideal because what they found is that during sleep and this quick tangent I'll come back to it but another one of the new functions of sleep is brain cleansing that when we go into sleep your brain essentially has this sewage system that kicks into high gear and it washes away all of the metabolic detrius that's been building up across wakefulness because from a biochemical perspective wakefulness is lowlevel brain damage sleep is your sanitary salvation and two of the pieces of metabolic detrius that that sleep system will cleanse your brain of are beta ameloid and Tow protein which are the two culprits that underly we believe the Alzheimer's disease Cascade and what's interesting is that when you are sleeping on your side these are animal studies they found that that cleansing system is more efficient than when you're sleeping on your back or your front and what they did was they they showed this in rats and in mice and then I was watching this I was at a conference they started to show you pictures in the wild of every single animal sleeping what was common across all of them no matter how they contorted their body the common ingredient was that their head was always on one side or the other as if that was the natural sort of tendency the predeliction of how sleep was optimally designed and they argue that the reason for that is because that's when you get greatest optimality of flow of this what we call the glymphatic cleansing system now I would say that I haven't seen strong replication of that nor have I seen any evidence that that's true in human beings human beings are very odd species are head is tilted 90° relative to many others think about a giraffe a donkey think about a dog a cat their head is lifted up in line with their spinal cord when we went from being quadrupeds to bipeds one of the things that had to happen because we were walking on all fours with our head out like a dog if you then stood up on your back legs but kept the head in that same position all you're doing is looking getting very deep interesting clouds so our head tilted down 90° and so that means that our ER ergonomics of the head and the cranium may be very different to animals so I think the jewelry is out and I don't think that's any good reason for you to start worrying about oh my goodness I've got to get my head to the side and if I'm not if it's down on the pillow or I'm on my back don't worry about that is there anything else to say on snoring people that snore why we snore and then sort of progressing through that to treat sleep apnea I would simply say that coming back to being insufficiently slept and that mood disregulation and you not knowing what you the true self actually was is ever more true in untreated sleep apnea patients and I remember we were doing a study with one group and we started to treat these individuals now there are numerous new treatments out there if you have mild sleep apnea you may not need one of these masks these nasal pillows which are called CPAP machines CPAP and it stands for continuous positive airway pressure this little nasal pillow pushes and pressured air up your nose and it acts like a an airway splint to keep the airway open so it doesn't collapse now if you have severe sleep apnea I know that these machines can be invasive although people like ResMed are have really great machines now the old school kind of mask fighter pilot Tom crw those were tough to live with now they're much better nevertheless I would say even if you feel as though you're not you're struggling to sleep because of this kind of pipe that's coming off you that's still far better than you sleeping without it and having the horrific oxygen desaturation and minimal Sleep Quality that you get otherwise so nevertheless if you have mild sleep apnea you now have these um mandibular augmenting devices so it looks like a sports gumu top and bottom but it's hinged and what it tries to do is move the lower jaw forward by just a couple of millimeters and what's fun is that you can do this test at home lie on your back and just sort of lie there and start making the snoring noise so I can make the snoring noise and then just try to move your jaw forward it's actually much harder to snore wow and it's a tiny change anatomically in the jaw but it can make a vast difference so now these new mandibular devices are out there there's all sorts of new ways there are also some people obviously rightly don't wish for this there are more invasive surgeries where you'll put a neuros stimulator that stimulates the airway forces it open and that saves you from having the CPAP machine and some people end up permanent CPAP machine yeah it's a permanent sleep app machine so there are lots of great ways to treat it what about snoring what about reducing snoring something that's presumably more common than sleep apnea yeah so there I would probably go to a mandibular device speak to your dentist if they don't know about go find a dentist who does they can make up these devices and most of them are covered by Insurance you can buy them on Amazon make sure that you just look at the star ratings and make sure it's rated by at least a couple of 500 600 people and then believe the rating and you've got to get a bit used to it and you know I've I actually about three or four years ago um because I would track ruthlessly every night my snor lab I could start to see a little bit of snoring coming on now that's just my age as we age you know just like the rest of your body it becomes a bit saggy my muscle tone isn't what it used to be and so I started to see signs of very mild sleep apnea now I wasn't in anywhere close to the region of needing to be treated but because I know so much about sleep I don't want to live a shorter life nor do I want to live a life with disease so I just bought myself one of these devices I ended up then um having a a great dentist friend who specializes and we actually got the the proper device custom device yeah but you can buy them on amaz you put them in hot water youy downard and they're actually not too bad as if you can tolerate them for smaller people who don't have Jaws like my jaw and certainly your jaw you know it's going to be a bit you know tougher you know my wife very slim refined woman you know she's probably not going to be able to tolerate it because the jaw mass is just not sufficient so you've got to be a I'm not trying to say it's a one- siiz fit all for everyone but for those who can if you have some mild snoring it will clean it right up it's very impressive in other news Shopify Powers 10% of all e-commerce companies in the United States they are the driving force behind gym shark and skims and aloe and neonic that is why I partnered with them look you're not going into business to learn how to code or build a website or do backend Inventory management Shopify takes all of that off your hands and allows you to focus on the job that you came here to do which is designing and selling an awesome product best of all the award winning support is there to help you every step of the way so you can upgrade your business and get the same checkout we use at newtonic with Shopify right now you can sign up for a $1 per month trial period by going to the link in the description below or heading to shopify.com slod wisdom or lowercase that's shopify.com wisdom to upgrade your selling today let's talk about sleep in relationships I think uh two people trying to sleep together wonderful pairing they're so in love everything's great and yet the one of the best predictors for their lifespan their health span their mood their emotional regulation the way they feel the next day the achievement of their goals their memory the fact that they're not going to fall asleep at the wheel and die uh wonderful that's my next book right there Chris Williamson wonderful Partners in waking terrible Partners in sleeping talk to me about the relationship between sleep and relationships yeah there's some really great research on this um Pioneer in this field is Wendy Troxel wrote a great book um and what we find is that if you survey people and you ask do you sleep in the same bed together one out of four people will say that they do not sleep in the same bed and if you then survey them anonymously be because there's such a stigma associated with not sleeping together about one in three couples will say I wake up in a different location than this bed that I went to sleep in with my partner so in other words they got up during the night and they just went and they got on the couch and yeah exactly so so it's certainly it's certainly a common practice and it's increasingly so this idea I think poorly named which is this idea of asleep divorce to prevent a real one and I'm not suggesting again here that it is a one-size fits all it's absolutely not some couples can sleep together and they sleep really well and they have a preference for that what's interesting though is that if you measure them objectively you always see that when couples sleep together versus when couples sleep separately their sleep is always objectively as we measure it with sleep trackers or you know polysomnography in the laboratory it's always worse when they're sleeping together on average than when they're sleeping separately however if you ask them subjectively what do you think of your sleep they'll say Well about half of them will say I actually feel my sleep is much better quality when I'm sleeping with my partner versus when I'm not some of that has to do with perhaps the societal bias that they think they have to cleave to others it's about safety that they just feel safer and others it's just more intimate but what we have definitely found is that it's if you start to undersleep a male if you short sleep them and if you look at the average data they could be in bed let's say 7 hours with a partner they could be down to around 5 and a half hours because of the Sleep disruption if you put a male healthy male in their 20s on 5 hours of sleep for five nights they have a level of testosterone of someone who's 10 years older than them so and you see equivalent impermanence in female reproductive Health folicular stimulating hormone lutenizing hormone progesterone these are all critical sex hormones that promote Superior libido drive and it also promotes Superior sensation and sexual pleasure during the act of intimacy so firstly when you're underslept and again this is not a one siiz fit all but for those that it's not working for the stigma in society is that if you're not sleeping together you're not sleeping together but in fact the opposite seems true because you repete your sex hormones we also know that for every one hour of sleep that a woman gets an extra hour of sleep that a woman woman gets her desire to be intimate with her partner increases by 14% wow now if you think about the latest libido drugs for women things like fi those will improve libido by about 23 to 24% that's a pharmacological brute forcing agent but here 90 minutes of sleep one hour of sleep and you're you know you're getting there so all of a sudden you know all the guys now are probably saying calling their girlfriends or their wife honey we need to go to bed an hour yeah should we get into spend an hour and let's sleep in come on let's have a um so so there's certainly a a superior benefit when you are sleeping well as a couple your physical component of intimacy is improved we also know that when couples are sleeping well uh from a female perspective at least you get by way of those sex hormones you get greater vaginal lubrication which leads to higher pleasure during sex and you get greater sensitivity of the genitalia for both man and woman in terms of the intimacy the other component though is the psychological component when couples are not sleeping well for example when they are sleeping together firstly their empathetic sensitivity is blunted secondly as a consequence they end up butting heads more in the relationship and furthermore because they prefrontal cortex which is the kind of higher order reasoning logical area of the brain that's the one that goes first in terms of sleep deprivation it's the same one that is there designed to do conflict resolution so you are you are in enfeebled as an organism to have a co-opted relationship that's emotionally mature and designed to be part of a team versus adversarial and combative and so shorter nights greater fights that's what data starts to demonstrate then you can ask well okay if I design if I decide to to sleep in separate rooms how can I firstly approach that with my partner and how can I design it the first thing I would say is approach your partner with curiosity and a non-binding agreement go to your partner and say look what have you ever thought about us maybe trying to sleep in separate locations so we sleep better so we're better together as a consequence would you be open to just saying look for the next two weeks we try sleeping apart and if we agree that it doesn't work we just go back to sleeping together would you be open to that idea so you make it non-threatening you approach from a level of curiosity and you don't make it binding that from this point forward this is what we're doing then how do you design it what we most of us miss by sleeping together is the bck ends of sleep because in between we're largely non-conscious so you can say look if before we go to sleep I'm just going to come into your room and we're just going to have a kiss and a cuddle and we're going to do what we're going to do at the front end of sleep and then whoever wakes up first you can go through to the kitchen make the coffee and the person who was waking up second just text your P it and now now this is you know utopian world where no one's rushing out the door to go to work but if you have the chance then just text your part and say hey I'm awake come in give me a cuddle give me a kiss and that way you get what you wish for which is the buck ends of sleep of intimacy cuddling and all of those good things but you still get to sleep apart what is it that's happening when people sleep together that's causing the disruption for the most part it's usually two things it's the it's the territorial non-conscious fight for the top surface called the cover right okay yeah the kind of tug of war and the second is the distribution of disturbance along the base of the bed which is I'm tossing and turning and you therefore may not even remember that I woke you up but my movement still train going past outside and it correct yeah and you roll over you're back into shallow sleep and then the other person has rolled over and now that was just at the time and they're adjusting themselves just at the time that you fell back asleep after you were the one who caused it and now you're awake again so firstly there's the non-conscious physicality of top and bottom sort of um surfaces being moved around and then the other is snoring it's the other you know if you ask a lot of usually women because now women get sleep apnea and men get sleep apnea it's just that it's probably at a rate of about 3:1 ratio men getting sleep apnea it's about the opposite for insomnia far more women have insomnia than men it's not to say that men don't have insomnia High neuroticism it's usually because anxiety disorders are about tce as common in women than in men and anxiety just as we spoke about is one of the principal underlying mechanisms through which we understand this thing called insomnia okay did you see on Reddit quite a while ago that famous couple sleep study they did where they ended up with the twv solution yeah what do you make of that because I've had a number of friends I have one friend who I'm not going to name I have two friends one friend who a year ago actually it was done on the show it was George so George um fully committed to this having read that study on Reddit and he had the classic partner is great but [ __ ] we really the sleep is is lower quality than it should be and he was very much prioritizing it Allah Dr Walker um and he pivoted to a 2v solution and yeah do you want to explain a two V solution just for folks who two du two two du covers on the top of the bed uh there couple who had maybe using an aura ring or something Sim attract their sleep the single best determinant of the wife's good night sleep was the husband being in the bed the single best determinant of a bad night sleep for the husband was the wife being in the bed and for for clarity I think it was the same it was more of a decrease in Sleep Quality for the man as being on the period was for the woman uh so that was the sort of rate extent of yeah yeah exactly the the rate of impact and they tried everything lots of different solutions they didn't want to go to a twoed solution so they went to a to dovas solution which presumably is as you said fixing the top surface there no longer a chug of w because it's two separate uh surfaces to play on so I guess is there not first off there must be companies I look at all of the eight sleeps and the you know the the Helix mattress and stuff like that uh an extra extra wide bed that's got maybe some sort of segmented um you know the honeycomb thing that kind of portions off in the Middle with a two Vas I mean how big does a b have to be before it's one bed that is essentially two do you know what I mean have you looked at solag the real estate territory we're talking about here at some point getting wi it's just an entire bedroom that's one mattress yeah exactly it's a soft play area for for parent keep your bedroom chitchat to yourself Chris what do you think what do you think about the two solution have you looked at that has it ever been replicated and then what about um Solutions maybe people don't have sufficient bedrooms in the house to be able to move to two what what can people do to make sleep together better uh yeah yeah I actually think the two solution is a great one in fact if you look there's um Equinox hotels uh the chain uh principally in New York right now if you go in they're highly optimizing sleep and I'm just start to have conversations with them to to see if I can help them with that they already do this where the king bed will have it's dressed in essentially two separate suit of you know your sheep they've got sleep on them all as well right they've got the cool mattress don't know if they have at sleep yet but certainly they yeah they probably I'm sure they do but they will they've already figured this out and it kind of a genius move but there's a more extreme version of that and it's called The Swedish method and it sounds highly salacious just turns out that this was a method pioneered in Sweden which is simply that you get two twin beds you put them together side by side so you're still sleeping essentially next to each other but there is complete separation between church and state as it were yeah and therefore the bottom and the top is segregated rather than the tuve where the bottom is common duv is split and this way with the Swedish method you do top and bottom wow which sounds very a little bit it does sound very Swedish um anything else I'm so glad you're not cutting that part anything else to say on uh sleep and relationships um I would say that certainly sleep affects sex meaning that when you are getting sufficient sleep it can promote a greater degree of physical intimacy and pleasure sex also impacts sleep though and what they've what we found um we in the Royal Way of the Sleep field is that sex that is associated with orgasm ends up producing about a 70% Improvement in subjectively reported Sleep Quality regardless of time of day regardless of time of day it's higher in men than in women so women it's about a 64% Improvement in men it's about a 72% Improvement but it's still you know demonstrable now for some people listening maybe you don't have a partner so but all is not lost because it turns out that masturbation associated with orgasm results in about a 50% Improvement why in part of it is probably because of certain other social bonding hormones like Pro well probably if you look at some of the data there is probably vasor press in for men MH and then if you look at that sort of the the classic hormone of bonding which you have you spoken about oxto oxytocin before yeah so oxytocin that's more so in females than in males men is so fascinating and it's oh don't get me yeah and I started to speak to Peter tier you know because he used to use it for all sorts of sleep related reason but those hormones typically are released by way of pro-social activity now when you're by yourself you don't get that added benefit so there is something about and I think what's happening with orgasm is that you're very sympathetic you're very fight oflight you're getting very activated your heart is racing but then after afterwards it's that kind of cigarette moment in the movies where all of a sudden you're just spent and you go all the way over into the parasympathetic quiescent State and you're kind of done and that's the state that you need to be in so firstly I think from a hormonal and a nervous system perspective that's why sex by way of orgasm is beneficial the benefit of couples or you know at least more than one person producing that added benefit from 50 to 70 is probably because of the proo hormones but nevertheless you can still get you know 50% of the way there so in terms of adding sleep credit you know you're making money hand over it's a good making money hand over fist but maybe I wouldn't say that let's not talk about fist um so you mentioned there about nicotine but the cigarette after sex uh caffeine you know one of the most common uh stimulants that I think 80% 90% of people use on a daily basis yeah it's the second most traded commodity on the surface of the planet after oil so it tells you everything it's the larest it's the largest drug experiment that's repeated on the planet every single day wow what is there to know about sleep and caffeine probably I think most people now through idiots like me understand some of its temporal Dynamics what I mean by that is it's halflife caffeine has a half life of about 5 to 6 hours which means after about 5 to 6 hours 50% of that is still in your brain which means it has a quarter life of 10 to 12 hours for the average person so drink a cup of coffee at midday perhaps a quarter of that caffeine is still in your brain at midnight it's highly dependent however on your sensitivity which is determined by a specific enzyme that enzyme is a what we call a cytochrome p450 it's a liver enzyme and it's a variant on a gene that's called the cyp1 A2 Gene um and uh which is just you know word spaghetti at this point word salad but simply variations in that Gene means that you are either quick at ing the caffeine or slow and everyone knows what type that they are and I'm pretty slow too I am a caffeine sensitive individual but nevertheless just keep that in mind that in terms of caffeine having that temporal Dynamic I would say the dose and the timing make the poison try to cut yourself off after about probably four cups of coffee maximum three is probably really where I would draw the line but again it depends on your sensitivity that's not where it stops though because even if you're one of those individuals that says look I can have two espressos after dinner and I fall asleep fine and I stay asleep that may be true but the caffeine will actually keep you out of the deeper stages of sleep and what we've we did some studies where we gave you 200 milligrams of caffeine which is a hefty you know drip big whack sort of yeah cup of coffee after after dinner and that robbed you of about 15 to 22% of your deep sleep and to do that I would have to add about 12 years of your to your life so I could age you by a decade in terms of your Deep Sleep Quality by just having you know two espressos after dinner the other thing about caffeine is that it will fragment your sleep so it will litter your sleep with these Awakenings and just like alcohol which does the same but by way of a different mechanism caffeine is going to reduce the quality of your sleep non-consciously because those are Awakenings are so brief you never commit them to Memory so you wake up the next day you feel lousy but you don't remember waking up so you don't put two and two together that said though I've actually changed my tune on on coffee I would absolutely say for anyone for whom they like coffee absolutely drink coffee and the reason is because if you look at Coffee the health benefits associated with coffee are astronomically numerous and remarkably robust statistically furthermore perplexingly for someone like me if you list all of the benefits that it's drisking in terms of diseases and you stack up what sleep will do in terms of drisking all of your disease States it's almost a onetoone match so people are coming along to me and saying well can you square that Circle for me how I don't understand how that can be true the answer is that the Coffee Bean contains a whopping dose of antioxidants and because we're so deficient in our antioxidant consumption because we're deficient in our whole food dietary intake in this Modern World The Coffee Bean has been asked to carry the Herculean weight of all of our antioxidant needs so no wonder it looks like drinking coffee is associated with health benefits it's not the caffeine it's the antioxidants case in point if you look at the benefits that decaffeinated coffee produces it's the same wow so it's not the caffeine it's the Coffee Bean I uh looked at the whoop urine review last year it's actually just come out recently uh and I haven't haven't been through it and they talk about your behaviors and what's been related between your behaviors and your sleep and your recovery and your strain and so on and so forth but they also have aggregated anonymized and aggregated the data from all of the other whoop users the number one predictive behavior for a good night's sleep was caffeine the number one predictive behavior for a good night's sleep was caffeine so is there a uh method or would you ever uh encourage somebody to use caffeine in terms of its timing to help bring you into land from an adenosine perspective uh so that you sleep more easily so that your latency is reduced or whatever from all of the data there's nothing to say that you should advocate for it as a sleep aid I think there's some data to say it may be equivocal that at least moderate doses of caffeine have any effect on your sleep the problem with some of that data is that it's associational so it could be that people who are drinking coffee are people who also are very thoughtful because they can so yeah healthy user bias they're the same people who are probably drinking two cups then they're going to the gym they're exercising sleep is fantastic sry exercise is fantastic for sleep but that's the interesting thing about the whoop data though because that is a relatively I would guess homogeneous group of people all of whom have got a wearable they're tracking lots of things and even within because these are behaviors done by different or the same individual on different days a within subject design is what we call it sort of longitudinal within subject Y and so the other possibility is that that it it's still on days when you're drinking caffeine are days when you are more fatigued more fatigued this is why we need a scientist to help me pick this apart okay so that's sleeping caffeine what about sleeping alcohol yeah drink lots of it it's fantastic stick for your sleep said like a true brein um it's right there on our passports alcohol is probably the most misunderstood sleep aid that there is out there alcohol is in a class of drugs that we call the sedatives and sedation is not sleep but when you have a couple of night caps in the evening you mistake the former for the latter and if I were to show you the electrical signature of your sleep with alcohol versus without you would see how different it is it's not the same that that alcohol will actually it pushes you into what looks like deep slow wave sleep but it's kind of the more the faster slow brain wave activity so it's sort of the more less nutritious of those deep slow brain waves but it's simply sedation the second problem with alcohol is that like caffeine but through a different mechanism by way of acting on the sympathetic fight or flight branch of the nervous system it will make you wake up more times throughout the night and once again they're so brief that you don't usually commit it to memory the other thing is that because of that sleep fragmentation that principally is happening in the first half of the night this is why on your sleep tracker when you know I'm if I look at my aing data I mean I don't typically drink but even if I have you know a glass I get hit not just with this another thing I'm going to tell you about REM sleep I lose a good amount of my deep sleep and it turns out that it's really the fragmentation of your sleep early on in the night when the alcohol concentration is highest when your liver and your kidneys have not had the chance to metabolically clear it and when you get fragmentation in the first half of the night you're not getting your deep sleep and as a result there's a great study that demonstrated that um alcohol after dinner one glass decreased the amount of deep sleep and as a result produced a 50% drop in growth hormone release 50% I mean I don't know what you'd have have to age an individual by and to get them to have a 50% drop in growth hormone but so there are it's consequential it's not epiphenomenal just because you don't get deep sleep you may say well so yes and so what what's the consequence of that lack well one is that you don't get your growth hormone release for reparation and repair but then the other thing about alcohol people love me don't they saying all this someone once told me when we listen to you you're like your personality is like the greatest prophylactic known to man oh you're the fun police thanks for yeah exactly yeah God if and that goes together already with my blood of seric Personality anyway nevertheless alcohol also is very good at blocking your REM sleep and it turns out it's not the alcohol it's the metabolic byproducts of it particularly the alahh tides and it's the alahh that will essentially act like a sort of jamming up of the cogs of the gears of the generation of REM sleep so you become REM sleep deficient this is the reason that people will sometimes say God you know we we had two or three bottles of wine last night when with friends came over at the weekend and then I slept in late CU we went to bed late and I was having these crazy dreams just wild crazy dreams what's happened there is that firstly REM sleep comes mostly in the second half of the night you get most of your deep sleep in the first half of the night if you're sleeping later into the morning that's the REM sleep Rich face is part of your sleep cycle so your brain has a different taste preference for what it wants to eat from the finger Buffet of the Sleep menu at night early in the night all it wants to do is Feast on deep sleep very little REM as you go through into the second half of the night it likes to switch its taste preference to REM the further you sleep later into the morning the more REM sleep you get if you want to increase the amount of REM sleep one of the things you can do is just sleep half an hour later into that morning and you'll start to get more REM sleep but what alcohol will do is it will start to block the amount of REM sleep that you've been having for most of the night your brain is so clever though this sleep is so strongly conserved across biology across philogyny that sleep we emerged as I said with living organisms and has stayed there it's one of the most preserved behaviors that we see in any living organism and it's preserved at the level of the stages too so your brain what I mean by that is it's understanding how much REM sleep you Chris should have had across the night when you've had a few too many drinks and it keeps a clock counter of how much room sleep you should have had and you've not obtained and finally by those late morning hours on the Saturday when you've slept late your liver and your kidneys have finally excreted all of the alcohol so in the last hour or two of sleep your brain gets the REM sleep it will have normally obtained plus it tries to get back that which it's lost and it's called a rem sleep rebound effect and that's why you have really intense dreaming and you have these really crazy bizarre experiences does your brain get back all of the REM sleep that it lost no it doesn't it can only accumulate about 50% of the Deb so you will still be REM sleep deficient REM sleep it turns out if you want to say G give the head-to-head challenge which is more important non-rem versus REM well I'm going to firstly tell you that all stages of sleep are important different stages do different things at different times of night but the ultimate test of what's more important is presumably death how quickly do you die when you don't have one versus the other they did a series of studies back in the 1980s that will never be replicated again because I think they were just you know so barbaric they started to sleep deprive rats to the point when they died and what they found is firstly that rats will die as quickly of food deprivation as they will of sleep deprivation sleep deprivation will kill you just as quickly as no food about 11 days in the rats then they said okay let me now selectively just deprive the Rats of deep sleep so they still get REM sleep or they get deep sleep and we remove REM sleep and when they looked at that the rats died from REM sleep after about 20 days mhm so REM sleep was you know still lethal REM a lack of REM sleep was still lethal non-r sleep they still died but they died after about 60 days so in other words rats will die quicker from REM sleep deprivation than they will from deep non-rem sleep deprivation we all predicted the the opposite in those studies why because I told you that non-rem sleep was the original OG in terms of The evolutionary course of sleep it was the first stage of sleep so surely the first stage of sleep that emerged in the course of evolution would be the fundamental Elemental most important the opposite was true great study then back at at Harvard and what we find is that a lack of sleep short sleep as I said short of your sleep short of your life and it's sort of a it's a it's a decaying curve which is that you know the the less sleep that you have the the higher and higher your death risk but let's come back to that 7even to 9 hours of sweet spot because something odd happens when you get past about 9 you're death risk does not keep going down it goes back up as if more sleep after 9 hours is deathly and people have said well that's proof that sleep can actually kill you if you look at the data at least one of two things is happening in those studies when you get sick what is the first thing that you typically want to do sleep exactly and it turns out that the reason is that your immune system has a very adaptive Network that when you get sick it Brute Forces a set of chemicals to induce you into more sleep because it knows that the Swiss army knife of Health the best thing that it has to combat disease and sickness is this thing called sleep so it drives you to sleep more and so what was happening in those studies is that whatever the disease was sickest people were sleeping sick people were sleeping more like an unhealthy use of bias and it looks like artificially more sleep is killing you the people that were sleeping 9 hours more night what there was something underlying that was causing them to it was too powerful for sleep to overcome despite sleep trying the other reason is because of Sleep Quality versus quantity typically what we find is that people who have really bad Sleep Quality stay in bed for far longer and Sleep Quality also predicts all cause mortality so as a consequence it looks like people when they say what time did you get into bed what time did you wake up that's how they measure the the the amount of sleep as it were poorly as it is those people who are in bed for 10 hours died sooner and the reason is not because they were sleeping 10 hours it's because they were trying to get back more sleep because the quality of their sleep was so bad that they had to stay in bed for longer and therefore poor quality of sleep masquerades as longer quantity of sleep being bad for you but to come back to it the Harvard study then looked at how much of different stages of sleep people were getting across the lifespan because they were able to do this with fancy sort of technology and what they found was that when they put non-rem sleep again in the same statistical model with REM sleep REM sleep beat out deep non-rem sleep in humans to predict your all cause mortality and here it wasn't this reverse shape J shape like total sleep deoration sorry like total sleep duration which is you know once you get past 9 hours it starts to hug back up no with REM sleep the less and less that you had the worse and worse your mortality risk it was a linear relationship and so across animals across human beings REM sleep seems to have been if you want to do the math which I wouldn't argue for anyone to do if there is one stage of sleep that's mortality more important than the other it would be REM sleep which is also the reason maybe to raise caution regarding alcohol and then maybe THC talk to me about CBD THC it's been marketed for a while separately and together as Solutions what's the truth behind it so THC and CBD I think they've gone through a real Evolution THC for the most part I think the data is fairly robust it's just not going to be your friend when it comes to sleep it is very clearly helping people for fall asleep faster and I think that's something that we can come back to in a second the problem with THC first is that you build up a tolerance and a dependence on it a psychological dependence and what happens is that when you stop using THC for sleep not only do you go back to the bad sleep that you are having because of the dependency you typically have a withdrawal and your sleep is even worse as a consequence and if you look at the number one reason why people fail in their attempted abstinence from smoking weed it's because they can't tolerate the insomnia so they fall off the wagon and they go right back to using again because they've built up both a physiological and a psychological dependence so that's the first issue is just the really bad insomnia in fact it's part of the Cannabis withdrawal syndrome set of features in what we call the dsm5 which is the diagnostic and statistical manual of mental disorders it's basically the psychiatrist handbook if you look at um cannabis withdrawal syndrome right there at the top is insomnia and that's a it's you're just feeding yourself a future his or future event in your history of insomnia when you try to withdraw and you typically will go back the second problem with THC is that it's very potent at blocking your REM sleep again and we've spoken about REM sleep both as as a mortality feature REM sleep is critical for creativity learning and memory it's also essential for your emotional and mental health but we often think of dream sleep you know it's it's such an active state that we think of it as purely for the brain it's REM sleep is for the body men and women both release their Peak levels of testosterone when you're in REM sleep and so REM sleep is essential but you're depriving yourself of it with THC and a really good case and point here um is that when people stop using teing when they've been smoking weed firstly they'll start to say I just I just don't dream or I don't remember my dreams anymore then all of a sudden when they stop using it they will say once again like that late morning Saturday morning with the alcohol they will say God I'm just having these crazy dreams now I never used to dream at all the reason is because the brain has built built up such a chronic death of absent REM sleep that finally when you stop smoking weed it comes back with a vengeance because you've been trying to sort of get it but you can't and the roadblock is finally out the way and boy do you start getting REM sleep again so THC I right now I just don't think there's good evidence for although I'll com well I come back to it now in one of the two ways if you look at some of those studies though and youve really got to kind of dig deep into them and look at all of the ancillary the supplemental materials in the science paper something funny happened when I was reading the literature if you looked at they they always classify people's level of sleep at you're in these sleep studies it's just one of the things that we always measure just like we measure your brain waves we measure your sleep apnea if you look across when people were dosed experimentally with THC the sleep apnea started to decrease and in some of those studies decreased statistically significantly which would argue that THC May potentially be have something beneficial to say about being at least an adjunct to sleep apnea therapy now I am not going to Advocate based on the downsides that come with th in terms of your sleep that it should be used but nevertheless you shouldn't throw the baby out with the Sleep bath water here what is it about THC that is beneficial to reducing the respiratory disturbance associated with sleep apnea I think we need to figure that out because there is there are too many studies where that seems to be an anecdotal result in the data now is it because it it prevents the relaxation response of the the Airways so that they stay more taught and resistant against the collapse is it about the release of neurochemicals that are there to stimulate the nerves to keep the I've got no idea but I do think it's a really interesting kind of story that's yet to be told what about melatonin other sleep supplements that people are probably quite heavily relying on interesting I don't I mean you'll know this being from the UK but Americans may not that melatonin something you can just buy in CVS here is kind of hard to get prescription for in the UK uh drugs like uh zadam uh ambient uh the you do not I mean you need to be like [ __ ] Insomniac for weeks and weeks in order for your doctor to step in pharmacologically and help you with your sleep in the UK it's very much not a thing that your GP would ever do uh but some people from the UK can get a hold of melatonin in some way or another especially a lot of people in America are using it uh and other supplements the magnesiums of the world what the alins what do you sort of come to think about here yeah I think the first thing to note is that if any of these supplements or any supplement stacks that are out there that promise you the Royal Road to you know resplendant sleep if that if they really were doing what they claim the drug companies would have been all over them 20 years ago and would find analoges and would have been making billions of dollars from them the fact that they've left them to the Wayside tells you a lot about really what their efficacy is and the drug companies are ruthless but you know it it it took George Lucas I think something like 30 or 40 years to amass about 4 billion in profit from the Star Wars franchise took ambian 21 months to do that so they know that these drugs if they are out there and any molecules like these supplements if they are good sleep aids they will be very strategic melatonin I think over here it's so easily purchased you go down you know any grocery store and in the health food section there's this big purple subsection and that's the Melatonin section and you've got you know 10 milligram 20 milligrams I've seen 50 milligrams firstly 5 milligrams 10 20 milligrams these are what we call Super physiological doses meaning that they are levels of melatonin that your body would never naturally release far higher than your body's natural tendency so the fear here although there are some studies that people have argued this is not the case but the fear is just like testosterone replacement at some point your testes if you're exogenously injecting will just stop producing innate testosterone and once they stop they don't restart the worry is the same with your pineal gland which is going to release melatonin that if you keep exogenously giving your brain vast amounts it says well you're giving it to me so I don't need to produce it anymore and once it stops does it ever restart there are some data where they looked at um an individual who was blind and the reason that they were looking at this individual is because when you're blind and depending on the level of blindness if it's at let's say the level of the retina or the optic nerve you don't receive light signals so you don't get the light to reset your Cadian Rhythm so you're bouncing with your sleep all over the place it's very difficult for these patients so what we typically do is we give them exogenous melatonin to at least feed them the signal of melatonin Darkness at night to try to regulate their sleep and they did a study where they were tracking the Melatonin of this individual and they were giving exogenous melatonin and then they stopped and then looked to see did that individual stop producing their own natural melatonin and the answer was no so people say well that's a good and it was about a 30-day experiment other people I think have looked across about six weeks of dosing and when they stop the people keep producing it and some people have argued that's the evidence then that we don't have to worry about that the problem is most people don't use melatonin like that they've been using it for three or four years so we don't know and it could be perfectly harmless the second concern about melatonin is that it's a hormone that regulates the timing signal for when you should sleep it doesn't participate in the generation of sleep itself so melatonin is like like the starting official at the 100 meter race it brings all of the Sleep races to the line and Begins the great sleep race but it doesn't participate in the Sleep race itself that's a different set of chemicals and compounds so that's why when people have done what we call metanalyses where you get all of the individual studies looking at melatonin and sleep and you put them all together in the same big statistical bucket and you ask what's the overall effect melatonin only improved the speed with which you fell asleep by about 3.9 minutes which is not that much more relative Placebo and it only improved your sleep efficiency by about 2.2% so again largely trivial now I think however despite touting that those statistics I think there is a subset of people for whom melatonin is sleep generating and therefore melatonin is not just the starting official it's also one of the racers and we don't yet understand why I think one of the ways that m tonin could be a sleep generating agent and we this brings this will bring me back to CBD in a second is that melatonin can make you cold melatonin has the ability to produce not hypothermia don't worry about that but it will drop your core body temperature a little bit and it turns out that we do need to drop our brain and core body temperature by about 1° C to fall asleep and stay asleep it's a reason that it's so hard on those summer nights when it's brutally hot and you've got no air conditioning you can almost not fall asleep despite how tired you are in a warm room but in a cold room you typically can sleep it's always because the cold room is at least taking you in the right temperature direction for good sleep as melatonin in some individuals may be mildly hypothermic and move you in that direction so I think that's I I'm fascinated by that and I want to pick that apart but for most people firstly it's not going to move the needle that's the Reon that no one no doctor has ever prescribed melatonin for people with insomnia um you have to have a Cadian disruptive clinical syndrome causing the insomnia to receive melatonin that's where it can be helpful the other thing about or two other things about melatonin if you go go down that purple aisle now a large part of it is dedicated to Pediatric melatonin for kids and what we know is that melatonin is a bioactive hormone we did some work and we were looking at um great scientist Craig canapari at Yale um and we spoke with the FDA about this admissions to the hospital for melatonin poisonous overdose have increased by 53% in the past 10 years which is a stunning statistic now granted melatonin for the most part is a largely inert compound in terms of its safety profile but the worry with the Pediatric component of melatonin nowadays from the Sleep Community is that studies done back in the 1980s '70s demonstrated that in juvenile male rats essentially male rats going through adolescence when they were given higher doses of melatonin it stunted their testicular growth and it caused testicular atrophy so imagine if I came along to a PTA meeting a parent teacher association meeting and to the parents and the teachers I got up there and said tonight I'd like you to start dosing your child with bioactive hormone and I'd like you to dose them with a magnitude that is far higher than their bodies would ever naturally release and it's a hormone that will also disrupt their reproductive gonadal development and I'd like you to do this every night for the next couple of years who's with me and and you get taken off stage rather you know rapidly and again I don't mean that that's hyperbolic in terms of an example but I do think we need to be a bit more thoughtful certainly about melatonin pediatric populations the final thing about melatonin it's now being replicated they did a study originally where they looked at at least 20 different brands off the shelf of melatonin and then they tested based on what it said on the bottle versus what was inside the capsules what it turned out was actually what you were swallowing swallowing was anywhere between 83% less than what it said was on the bottle to 464 per more oh [ __ ] hell right that 50 that 50 milligram capsule has become a monster it's a wild west you don't know what you think because it's not regulated by the FDA over here wow and what was even worse is that within any one vendor the amount of variability from one batch to the next the next was just as large so this isn't across even across companies what about other Technologies to artificially boost or improve sleep is there anything cool at the moment yeah I think there is I mean I think there are you know CBD I think is actually one of the the potential contenders in this category of new emerging Technologies pharmacologically CBD I think is is we still don't have enough data I think the problem with CBD is that it is dose dependent if you look at the data squint your eyes because there's not enough and you make a non-scientific kind of guesstimation anything less than about 25 milligrams seems to actually be wake promoting whereas anything that's about 50 milligrams or more may actually be sleep promoting even though it's the same drug compound same compound so you get what's called a dose dependent response and it's bodal meaning that it's the Goldilocks phenomena you know not to little not too much just the right amount and let's then entertain that you and I sit here in another 5 years time there's been lots of work on this and CBD now is a sleep aid at the right dose the question then is how is it doing that because for me as a scientist to entertain its causality I at least want to understand mechanistically what it's doing to be a plausible parsimonious explanation for CBD I think it's actually at least two different Roots like melatonin CBD is really quite hypothermic it will get rats cold when we dose them the colder their core body temperature the faster sleep will arrive with them the deeper the sleep that comes after the second however I think is an indirect mechanism I think now there is very good data even human brain Imaging data that CBD is what we call anxiolytic which it reduces down your anxiety it takes you out of that phight oflight branch that we've been talking about it reduces cortisol levels the emotional centers in the brain called the amydala they are turned down in terms of their volume of kind of cranked activation by way of CBD so in other words that kind of tired but wired phenomenon is potentially going to be Medicated by CBD CBD isn't necessarily generating sleep it's simply removing what is blocking your brain's natural ability to generate the sleep that it could do if only it could try to reduce the anxiety that's getting in the way and when I say anxiety here I'm meaning the physiological biological anxiety within the body that's I think what CBD is potentially doing to get you into good sleep so new technologies I think CBD is an interesting one but then we come on to an area that I've been doing a fair amount of work in over the past eight years or so which is the augment the artificial enhancement of human sleep because what I started to realize is that you know I can come on lots of podcasts I can give you the scientific data but in truth there's only so much I can do to get people sleeping the same amount that I would wish them to sleep so the next question would then be well could I create technologies that act like a zip file for sleep that I can compress sleep into six down from eight now I think that that's you've got to that I think it's a dangerous thing because I think it's hubis because it took Mother Nature 3.6 million years to put this thing called the 7 to9 hour sleep necessity in place sleep is the most idiotic thing that you can conceive of you're not finding a mate you're not foraging for food you're not reproducing you're not caring for your young and you are vulnerable to predation on any one of those grounds sleep should have been strongly selected against in the course of evolution if Mother Nature had found some magical zip file solution to compress 8 hours of vulnerability nonsense down to six guaranteed she would have done it it and the fact that that it that hasn't emerged and then I come along and I say to you oh Chris I'm going to be you know some you know scientific genius who comes along with the compression zip file for sleep you know good luck take care we are starting to get there with some things though one of the things that we developed was an electrical brain stimulation device so we've moved from Pharmaceuticals to electral because if you want to change sleep sleep is an electrical phenomenon it's an electrophysiological State it's brain wave activity it's electrical activity and if you want to speak in the currency of the brain you should deal in the same currency which is electricity so we developed something called a transcranial direct current stimulation tool which is a fancy way of saying I put a headband on and I insert a small amount of voltage into your brain it's so small that you typically don't feel it but it has a measurable benefit to your brain wave activity and people had been doing this approach where they measure your sleep in the laboratory and they're starting to look at these deep slow brain waves and then using this electrical stimulation device they're going to try to act like a choir to a flagging lead vocalist and by way of measuring it they can try to predict where the next stroke of midnight is coming on the top of that brain wave and they hit you with a pulse of electricity and they try to amplify the size of those brain waves and they can and in doing it they almost double the amount of memory benefit that you get from sleep the problem is when we go to sleep we take things off we don't put things on so you're expecting me to have a headband device with all of these wires and I'm going to sleep with it and then there's going to be some crazy computer in your study that's kind of you know measuring your brain wave and it's trying to temporally estimate when that's a disaster it was never going to happen so what we took the approach of is that when you stimulate the brain and you stop stimulating like a drug in the system it still has a blast radius of a benefit and when we do 10- minutes version of stimulation it lasts in terms of its effect on the brain for about 2 hours and it was that deep sleep that I said comes in the first half of the night and mostly in the first two hours so I knew I had this window of opportunity to capture to go after deep sleep so instead what we did was we applied this headband and as you're brushing your teeth when you're taking your makeup off you you're stimulating the head or you're lying in bed for 10 minutes and then what happens is that you take the headband off and it's almost like um it's a good analogy would be a child on a swing the the static and The Swinging the feet nothing is happening you as the parent you've got to come along and you got to start swinging them but when you give them enough momentum at some point you stop and they keep swinging so I was trying to essentially get the brain swinging so that when it went into sleep it would generate bigger or a better analogy would be I'm trying to fertilize the the so I'm trying to electrically fertilize the soil of your prefrontal cortex so that when I take it off and you start sleeping you germinate more powerful deep sleep brain waves because I've electrically fertilized the so have you tested this in the lab so we've tested it now multiple times and we were able to we've published uh data on it already we then ended up realizing look if I'm going to get this out to the public despite me being a p iCal scientist I've got to make it a company and move it out we got Venture back Capital that was just when covid hit and we were trying to do human testing where we were putting you know nasal theists up people's noses to measure their breathing and Co you you know so we the we had the kind of caboose but on kabash anyway one of those we slowed down but we were able to get enough data that at least confirmed to me that it had efficacy we've released a first gem product now again I'm not some I I never want to be the George Foreman grill of sleep you know I never want to Hawk this stuff so you you can kind of look around what's it called it's called somni so if you just go to the website stim science the company is stim science stimulation science um stim science.com you'll find it take what I say with a grain of salt it's gen one if it were up to me I would wait at least another 10 years get another 10 million hours of data before I as a scientist felt comfortable that's the reason I'm not the CEO because people will have already done this long before me so we've got a first gen product out there second gen is coming I think probably the end of q1 2025 I we've now done lots of systematic studies um we've looked at it on the basis of insomnia it seems to be even more efficacious for the more severe your insomnia symptoms are I was worried it would be the opposite the harder the problem the less potent the solution it seems to be the oppos opposite um it does seem to benefit young and old but I would say that in the especially old individuals we're finding it harder to drive the brain into sleep with the stimulation device we now I think have some good new Solutions in terms of how we stimulate the brain to overcome the age related problem so it's not all good news and um but certainly the duration of sleep and the efficiency of sleep improve and the speed with which you fall how long do you have to have it on for about 10 minutes wow it's interactive thing because we'll also do um bone conduction for sound so you have a whole app experience you do the app and what's different in our method versus others who are trying to do this is what's called it's a Clos loop system because the stimulation I need to co-opt my brain into sleep is slightly different in terms of its frequency in other words what how I'm stimulating your brain in terms of the kind of the brain wave pattern my stimulation frequency sweet spot is different to yours not by much but just enough that if I tailor it to your unique frequency snowflake like as if versus standard stimulation tools out there are like going to your blooming Dales and you just grab a suit off the rack and it doesn't really fit you quite well this version is the saval r suit I tailor it unique to your physiology and that turns out to make night and day night day difference Christ walk it makes a big difference statistically in fact we almost get no benefit at one size fits all stimulation and we were doing that for about two years and getting no data and I didn't want to release the product cuz you know I don't want to sell snake oil if my mother is buying a device that promises a good sleep and it's $400 that I'm not going to sleep well at night if it's total snake oil so we just weren't going to release and then we realized now we've got to find a unique stimulation pattern so what the headband does is not just stimulate it records it's an input output device and we start with a short session where I measure your resting brain wave activity and then we do an a sort of an AI calculation where we rejig the stimulation for your frequ in Reverse yeah we reverse engineer it and now we know what to stimulate you at and then if we see your brain waves change even across the 10-minute session we're constantly adapting it to what we call a staircase method very cool so that's electrical stimulation is One path I think I'm now interested in others the next one is kinesthetic vibration if you see a parent with a child who's not sleeping well typically you know a grandmother will just pick the child up in their arms and they'll start to do what start to rock the child you know you think about you know a a Manger rocking the manger or parents with their child they'll put them in the car and anything that's repetitive kinesthetic is enough to induce sleep so they did this great study Sophie schwar at the University of Geneva it was wonderful borderline SNM they got a mattress frame and they dangled it on these big chains from the the ceiling so the bed frame was suspended on these chains and all of a sudden it feels like you know candle wack on the nipples timey up timey down type stuff and then what they did was they inserted an arm against the side of the the bed frame that had this rotation and it would rock at a very slow frequency in fact it would rock only once every 4 seconds was a really slow rock and the reason they were doing that is they were trying to mimic the super slow brain wave frequencies that go go up and down maybe just once every second maybe once every two seconds Ultra slow brain they were trying to mimic that and sure enough by rocking you at this gentle frequency it increased the amount of those deep sleep brain waves and these additional burst of brain waves that ride on top of them like Surfers on the on a wave called sleep spindles and the combination of those two we know are important to hit the save button on new memories for what we call memory consolidation and sure enough after the sleep on the rocking mattress it ended up boosting the amount of memory by about 20% and some of their replication Studies by about 10% you think 10% but if I were to say to one of my students you know okay look you got uh you know 65% on your exam do you want an extra 10% oh my goodness that's a grade point you know in so it's not it's not a trivial amount so I think this and then they've done these really great studies in in fruit flies where they started to just vibrate the surface and these fruit flies just conked out and there something about the kinesthetic motion and then what they did was really clever you could say well is it something to do with the tactile sensation of feeling like you're moving or is it really what we call the vestibular system the sensation of movement so in these fruit flies they were able to inactivate the vestibular mechanism ISM in the fruit flies so the fruit flies could no longer sense movement and they vibrated them and they just stayed awake so it absolutely is something to do with the vestibular system that is assisting with sleep so I think that's a fascinating area that you know these new mattress companies you know there are a couple of them bright BR yte is doing this um eight sleep has you know the ability to now you know it will vibrate you can tap on the side of the bed and it will vibrate you know what if and take by the way I think eight sleep is a is a fantastic um product I was using it for years beforehand now together with myself Andrew huin and Petra tier we joined the The Advisory board so again full disclaimer take what I say with a grain of salt just like I speak about aing because I'm an adviser there too I would say though that these mattresses may now be able to create some kind of Ripple approach and so we're starting to play with this technology in the lab where we're trying to do um just lateral ripples to see if we can actually manipulate you I was at a conference um at what's called um the the section of the advanced um sort of science agency here DARPA which is part of the Defense Agency and they were had this really interesting technology for um special operatives to navigate them through based on the trajectory through a particular kind of um scenario where they had to go and find a kill and they couldn't use radio communication cuz that would give the game away but they were able to insert this device into the ear that would stimulate the vestibular system and tell them left right forward back so then I was thinking well hang on a second if I'm Rippling the bed or I'm swinging it you know all of a sudden my girlfriend and my wife is probably thinking jesz you know it's a bit too much too soon you know we we were fly pedestrian in what was going on in the bedroom now you're swinging the mat you know go easy I don't like that but what if I could not even stimulate your mattress which could disrupt some someone else all I need to do is have this air device and I'm going to fool artificially your brain into thinking that it's being rocked by way of stimulating the vestibular system and off you go to sleep so that's another sort of method that I'm really interested in and there's good evidence for probably the next one is um acoustic and there's now I think this Emer wave of acoustical which is acoustic manipulation of the brain early studies from groups in Japan like Yan from Germany uh Yan bornes group they were just simply trying to do sounds that would these tones that would go at the frequency of the slow brain waves and they just started playing them as you were falling asleep and just kept playing them and they were ignorant of whether your brain waves are going up or down and it did seem to improve the amount of deep sleep just passive tone playing at this this frequency of about once every second or less then they got a bit clever then they started to measure the brain waves in the laboratory and they would try to hit the brain with a a tone right at that strike of midnight like we were doing with electricity and sure enough you boosted the brain wave the problem was if you did it about three or four times in a row the brain fought back and it resisted the tone and in fact it started to decrease the amount of deep SLE brain waves so you've got to be a bit careful why would that happen it's probably because the brain has a protective neural mechanism to prevent too much synchronous brain wave activity synchronous brain wave activity when it gets out of control is called epileptiform brain wave activity which causes a seizure so you've got to be you know you have to be thinking about these things so I think but there is I think now devices out there that are doing vibratory stimulation and part of the brain stimulation device that we have now is a bone conduction system too where we can also vibrate you as well as electrical stimulate you because so you're doing both so I'm doing both because when it comes to sleep for a commercial device now as a scientific device I want to pass them out separately and I want to understand them distinctly but when it comes to the you know boots in the ground and the trenches I'm going to throw the kitchen sink at this too so if I can do Acoustics and electrical I'll do it it's so cool all of this technology is so sick and uh yeah I wonder what's going to happen I wonder what's sort of coming next and obviously you know such a Reliance on Pharmaceuticals sort of leaning in and and people manipulating all manner of different different things internally you mentioned insomnia there have you looked at um chronic fatigue syndrome is that part of your remit at all fatigue sounds like tiredness sounds like sleep is that something that you ever you guys ever cross over with um we we've done a little work in it and it's different and I think what's happening with chronic fatigue is that there is here we're talking about a m metabolic problem which is it's about energy balance that there's something going on with a metabolic regulation of the system that causes this overall sense of malaise now how that plays out with sleep all we simply know is that chronic fatigue syndrome results in fragmented sleep and poor quality of sleep which in some ways is counterintuitive because all of us if you've ever gone out you know on one of you know I cycle a for a bit if I've on one of those you know Century rides and you know back in California I like to do it in the summer cuz I love cycling in the heat by the end of that day I come home and it's like working in the fields for eight or nine hours I just know that night I am going to have the most rightous sleep of my life because I'm just so fatigued I can feel it in my body that's a very different physiological State I believe than chronic fatigue syndrome mine is acute fatigue syndrome chronic fatigue syndrome I think is probably a very different biological Cascade and that's probably pushing you into more perhaps a higher kind of chronic cortisol state where you're all of a sudden fighting against sleep rather than promoting sleep I think it's different fascinating you said earlier on as well about dreaming I want to kind of get into dreaming what is it why do we do it how does it work explain to me yeah dreaming is when you think about it absolutely bizarre because last night everyone listening yourself included as long as you slept you all became flagrantly psychotic and before you reject my diagnosis of your nightly psychosis I'll give you five good reasons firstly when you slept and you started to dream you started to see things which were not there so you were hallucinating second you believe things that could not possibly be true so you were delusional third you became confused about time and place and person and in Psychiatry that's what we call being disoriented fourth you had wildly fluctuating emotions and we describe that as becoming emotionally labile your pendulum like you're all over the place and then fifth you woke up this morning and you forgot most if not all of that dream experience you're suffering from Amnesia if you were to experience any one of those five symptoms while you're awake you'd probably be seeking psychiatric and psychological intervention but for reasons that now we're starting to understand it's a normal biological and psychological process so if it's if it's prevalent and it's consistent what is it functionally doing for us now you've got to be very careful because dream dreaming for the most part is principally associated with REM sleep so how do I put a scalpel scientifically between simply conflating any function of REM sleep let's say hormone benefits for testosterone and saying no separate from REM sleep separate from the stage of sleep from which dreaming emerges show me that dreaming above and beyond the state from which it comes from which is REM also has its own separate functional benefits and that was hard to do for a long time and now we know that there are two benefits of dreaming independent of necessarily having REM sleep although it is beneficially supported by the physiology of REM sleep the first is that dreaming provides a form of overnight therapy dreaming is emotional first aid because it's during dream sleep at night that dreaming acts like a nocturnal soothing bomb that just takes the sharp edges off those difficult painful experiences so that you come back the next day and you feel better about them and what REM sleep dreaming is doing is essentially it's divorcing the emotion from the memory experience because what makes a memory emotional is that at the time of the experience you had this whole visceral emotional reaction and that wraps the memory with this emotional blanket but what dreaming does is it goes in there and it divorces the emotion from the memory it strips the bitter rind from the informational orange so that you wake up the next day and you have a memory of an emotional event but it's no longer emotional itself you don't regurgitate the same intensity of visceral reaction that you did at the time of the experience and so that's why we think dreaming provides a form of it's emotional convalescence and the quintessential disorder that we've studied that this process seems to fail in is PTSD post-traumatic stress disorder because when you speak to those patients what they will tell you is I can't quote unquote get over the event what they mean is that every time that they relive the memory let's say it's the war veteran they're walking through the supermarket car park a car backfires and instantly they have a flashback to the trauma memory of the detonation of the land mine and what they're describing to you is the they have not stripped the emotion from the memory it's still bound to the experience it's not coincidental that one of the diagnostic features of PTSD is repetitive nightmares and what we've done is put forward a theory that in PTSD because they have two higher levels of a stress related chemical called noradrenaline in the brain they are not able to do the elegant trick of stripping the emotion from the memory so what happens the next night the brain comes back and says look sleep please I've got this highly charged emotional trauma memory please do your trick of divorcing the emotion from the memory and it fails again because of this two high levels of a stress chemical called nor adrenaline and so it becomes this repetitive almost like a broken record and it perfectly fits the feature of repetitive nightmares you cannot receive a diagnosis of PTSD without having sleep disturbance or repetitive nightmares so the what so then you can ask well so then in normal REM sleep why is it doing that REM sleep is the only time during the 24-hour period where our brain shuts off this stress related chemical called noradrenaline the sister chemical in the body everyone has heard about it's called called adrenaline upstairs in the brain it's noradrenaline and noradrenaline does lots of things but one of the things it does is it gets released in rude amounts when you undergo one of these emotional experiences it's the thing that plants the red flag on the memory and says to the brain this is priority this was emotional this is important and so it it's useful to prioritize what gets Remembered in the brain but it's only useful to tag the memory initially as important it's not useful to hold on to the emotion and dream sleep provides that form of the emotional detox so we I presented this data a conference this theory that dream sleep strips the emotion from the memory because dream sleep is the only time when the brain has this perfect therapeutic chemical cocktail of shutting off noradrenaline and the Brain actually has the emotional memory centers reactivated during dreaming so you can reactivate the emotional memories but you process them in a quote unquote safe neurochemical environment but in PTSD they'd already measured levels of noradrenaline in the cupos spinal fluid and found that they were excessively high no wonder they couldn't strip the memory the emotion from the memory and I was presenting this and then in the afternoon session a psychiatrist came along from um Puget Sound he worked within the VA the veterans system and he was treating patients with PTSD and they most of them had high blood pressure so he was treating with a treating them with a generic drug called prasin and the drug it turns out cuz it's the VA it's cheap it's generic it crosses the blood brain barrier so it goes up into the brain and he was perplexed because his patients were coming back to them and their blood pressure was a little bit better but they started saying to him I'm not having the nightmares anymore and my symptoms are getting better so I had a theory that was in search of clinical data he had clinical data that was in search of a theory and it was one of those kind of hair on the back of your neck moment standing up race to him afterwards said look I've got to catch a flight back down to Berkeley I'm going to fly you down next week we need to go out for dinner we need to speak about this we started speaking about it he did um clinical trials um it then became the only um VA approved medication for PTSD there have been some failed replications with that medication I'll I'll tell you that right now but nevertheless it is usually one of the firstline medication treatments now for PTSD Veterans for for nightmares so that's the first benefit M of dreaming um I would say that you can then argue well how do you disentangle that from just REM sleep that they're getting rosling cartright who's now passed away great sleep researcher back in the 1980s was looking at her um patients she was treating psychologically who had going through really tough experiences bereavement divorce course and they were very depressed and around the time of those events she was measuring their dreams getting dream reports and then she did a follow-up study one year later and about half of those patients had gained remission in terms of their depression they'd got better the other half had not so she then went back a year previous and looked at the dream reports and split them on the basis of those who ended up getting remission and improving versus those who didn't both of those groups were getting REM sleep both of those groups were dreaming that was not the difference the difference was that those people who got remission at the time of the event were dreaming about the experiences themselves those people who had REM sleep who were dreaming but didn't dream of the events that they were experiencing did not gain remission in other words it's not just sufficient to have REM sleep it's not even sufficient to dream you have to be dreaming about the difficult things that you're going through in order to get that overnight therapy benefit so that to me was a demonstration that it's something about the act of dreaming above and beyond the stage of sleep does that makes some contorted sense the second benefit of dreaming is very different it's creativity and enginuity because during deep sleep deep nonr sleep that's when the brain takes the new memories that you've formed and it cements them it sets them like Amber like a fly trapped in Amber into your brain it cements them into the architecture so that you don't forget so deep sleep hits the save button on individual memories but memories that sit like isolate Islands in your brain are largely useless because that's the old laptop your laptop was even better at storing individual pieces of information than your brain ever was but you're far more intelligent why because you don't just simply have isolate pieces of information your brain richly interconnects them together that's the difference between knowledge which is remembering the facts versus wisdom which is knowing what it all means when you put them together that is the purview of REM sleep REM sleep takes those new memories and it acts almost like group therapy for memories everyone get a name B badge and it forces you to now speak to the people not at the front of the room that you think you've got the most obvious connection with you've already done that when you're awake seeking out the obvious obvious connections dream sleep forces you to go and speak to the people at the back of the room that you think you've got no association with whatsoever it turns out that you do it's a distant connection but it's a powerful one nonetheless because when you start to fuse things together that shouldn't normally go together but when they do cause marked Advance is in evolutionary Fitness it sounds like the biological basis of creativity that's what dream sleep is doing it's almost as though you wake up with a revised mind Wide Web of associations and it's during dream sleep and the act of dreaming itself that we it's almost like memory pinball you take what you've learned bang and you shoot it up into the cortex and you start bouncing it around and you test out what the connections are but the way the algorithm works during dreaming is different than wakefulness wakefulness is the Google search gone right you type in you know modern wisdom into the Google search and the first page All About You fantastic stuff you go to page 20 and it's about a field hockey game in Utah and you think Bloody what how but if you read about it all of a sudden you think oh that's clever I can see why that's associated it's a diff it's a now you can have a thousand of those every night that are completely useless but all you need is one of those to make that advanced leap that's the novel difference between 2001 and Space Odyssey where they're banging bones around and then all of a sudden one of them realizes Christ this thing is actually a weapon it's not just a bone what does it mean if we keep dreaming about the same situation or the same person people that have sort of consistent dreams with consistent uh characters or scenarios in yeah repetitive dreaming and repetitive nightmares some of it we think from the PTSD literature is about trying to reprocess emotion and emotional experiences and something maladaptive short circuits that so you keep trying to reprocess that's one Theory the other is that we we don't know if necessarily that's your brain simply trying to prioritize the memory circuit and it's saying that every night I want to etch and score that memory into the sort of the the neural circuit glass of the brain ever more strongly because it's important so one Camp is it's maladaptive and it's a process failed the other is it's adaptive and it's just simply telling your brain pointing you to saying this is the important stuff we're going to memorize it more I would say that for people who are undergoing sort of repetitive nightmare because we used to have no real good uh treatments for it now I spoke about pricin as one way that we've done this with ptsc patients but there's now actually a very effective psychological treatment for nightmares and it's called um I image rehearsal therapy or IRT for short and it comes back to we made a discovery back in uh 2003 what we found is that when you form a memory that memory is fragile and when you sleep the brain fixates it so it's now stable and it's set and it's hardcoded into the brain however we then discovered that when you come back the next day if you recollect if you reactivate that memory again it opens that memory back up to being fragile and susceptible to being molded and changed and you think well why would you go through the act of cementing it only to basically kind of UND do that cementing process think about a memory system think about a Word document I type in the word document and then I hit the save button which is sleep I come back the next day I double click on the word document and I can't edit it it's I I want it to be flexible and your brain has that ability so the brain every time you recollect a memory you open it back up to change and then you modify it and then you sleep again and you reconsolidate the memory this the took advantage of that so it had individuals who had repetitive painful nightmares and with a therapist they simply rehearsed the the trauma dream now during the rehearsal every time they brought back that memory to mind by definition it opened up that memory to being edited and with the therapist they would convert the ending so let's say that I was in a horrific car accident and I was the break failed and I went straight through the The Junction and I got sideswiped and it was a horrific car accident well now instead I'm coming up to the light and I'm hitting the brake pedal and in this new sort of rehearsal they say well then you just reach down cuz it's a manual car and you just grab the handbrake and you pull it and gradually the car decelerates you move it to the side of the road and you avert the rewriting the memory and you rewrite the memory and then you get them to sleep and now it Recon Ides the updated version and you have to do that though multiple times so you set the new scenario which is a neutral scenario you have them rehearse it every day you set a timer they do this and then over time you morph the memory and you now rewrite your history and as you're doing that night after night what happens to the trauma dreams the frequency of them decreases in proportion with the frequency of you repeating that every day Absolut Ely brilliant memory Dynamics so cool so cool Matt I feel like I could speak to you all day we need to we need to bring this one into land at least for the first one uh you're so great and like I said before you genuinely made a huge change the probably the single biggest lifestyle change that I made was after your first episode on Rogan so however long I live is at least in part due to due to yourself well I stand on the shoulders of all of my colleagues I think I did a pretty bad job when I first came out at communicating science I think I was I was untrained I was dictator tutorial I was absolutist not because I wanted to be that way that's not my natural ilk it was just because I saw so much suffering Happening by way of a lack of sleep steaming in with authority sounds like a nice way to fix that right exactly and I was so passionate about it I came across as almost adversarial I probably caused as much insomnia by way of my TED talk you know was called sleep as your superpower or something and people were saying it should have been called sleep or else dot dot dot you know and I feel bad about that but so I would say I'm now I'm a little less bad as a scientific communicator but really all I'm doing is communicating the science of all of my colleagues I'm just in the privileged position of being like a true academic the the the idiot with the bonjo her style and the bad accent who's trying to communicate sleep science but if I've done any of that work it's simply because I've communicated the science of others and for their efforts I'm immensely grateful thank yeah Matt I appreciate you until next time mate next time take care thank you very much for tuning in if you enjoyed that episode you will love my fulllength conversation with Dr Andrew hubman just here come on press it