World No.1 Sleep Expert: Magnesium Isn’t Helping You Sleep! This Habit Increases Heart Disease 57%!
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World-renowned sleep scientist Dr. Matthew Walker argues that magnesium supplementation often fails to improve sleep because most forms, such as magnesium oxide or citrate, do not cross the blood-brain barrier and therefore cannot directly influence brain processes required for sleep production; instead, they merely create expensive urine unless one is already deficient in this mineral. While there is some evidence supporting Magnesium L-threonate, Walker emphasizes that lifestyle fundamentals like regularity, caffeine management, alcohol avoidance, digital detoxing an hour before bed, and dimming lights offer orders of magnitude better results than supplements. He also highlights Ashwagandha and phosphatidylserine as more effective alternatives for managing the "tired but wired" phenomenon by reducing cortisol levels and shifting the nervous system from a fight-or-flight state to a quiescent parasympathetic one, noting that while magnesium may relax muscles indirectly via the vagus nerve, it is not a primary solution for sleep onset or maintenance issues. Walker introduces the concept of "sleep banking," debunking the old myth that weekend catch-up sleep can fully repay a week's worth of debt; instead, new data from Walter Reed Army Institute shows that building up a surplus of sleep credit beforehand acts as a safety net against future deprivation, reducing cognitive impairment by approximately 40% during periods of unavoidable short sleeping. He explains that while the heart benefits significantly from weekend recovery regarding cardiovascular risk reduction, other systems like the immune system and blood sugar regulation do not rebound after catch-up sleep. Furthermore, he details the four pillars of great sleep—regularity, timing, quality, and quantity—and illustrates how the final hour in bed is critical for maximizing REM cycles, which are essential for memory consolidation and emotional processing, urging listeners to stay in bed until they feel naturally sleepy rather than adhering to a rigid wake-up time. To address insomnia specifically, Walker advocates breaking the associative link between lying awake in bed and anxiety by implementing the "20-minute rule," where individuals leave their bedroom if sleep does not occur within 20 minutes to engage in dim-light activities like reading or listening to podcasts until feeling sleepy again. He warns against looking at clocks during night awakenings, as this reinforces a conditioned response that specific times are for waking up rather than sleeping, and suggests techniques such as guided meditation, box breathing, body scans, or vivid mental walks—like imagining walking the dog in high detail—to distract the mind from itself without inducing sleep paralysis. He also notes that while true crime documentaries might seem relaxing to some, they may harm deep sleep due to their violent content, whereas stories similar to bedtime reading for children can effectively soothe adults by getting them off their own thoughts. Finally, Walker discusses a new class of FDA-approved medications called DORAs (orexin receptor antagonists), including suvorexant, lemborexant, and daridorexant, which differ from sedatives like Ambien by targeting the orexin system in the brainstem to dial down wakefulness rather than simply sedating the cortex. Clinical studies indicate that these drugs not only improve sleep efficiency but also facilitate the glymphatic system's ability to flush metabolic toxins like beta-amyloid and tau proteins, which are linked to Alzheimer's disease, a cleansing function that Ambien actually inhibits by 30% to 40%. Despite their efficacy in promoting functional, restorative sleep, these medications face barriers such as high out-of-pocket costs of up to $400 per month and limited insurance reimbursement or availability outside the United States. Walker concludes by sharing a personal story about his wife and Clive Wearing's profound amnesia to illustrate how taking partners for granted is common but preventable through mindfulness, urging listeners to prioritize sleep as it fundamentally alters gene expression affecting immunity, cardiovascular health, and emotional regulation across 711 genes.
Read the full video transcript
Here's the problem with magnesium
supplementation [music]
when it comes to sleep. The first thing
to note is that most forms of magnesium
don't cross the blood brain barrier and
sleep [music] is produced by your brain.
So, how can something that doesn't get
into your brain affect brain process?
All you're doing is creating probably
expensive urine.
However, there is one form of magnesium
that seems to have some evidence in
favor of [music] it, which we can speak
about, but it doesn't stop there.
There's so much new evidence that we
have, including this myth of 8 [music]
hours, my fear about giving melatonin to
kids, why you keep waking up in the
middle of the night, and the invention
of the first new class of sleeping
[music] medication that I actually
favor, and most people are not aware of
it. Okay, let me write this down.
Matthew Walker [music] is back. And the
world-renowned sleep expert and
neuroscience professor is sharing brand
new research to combat [music] the sleep
loss epidemic and help you get the
perfect night's sleep. As a society, we
have struggles with sleep at night due
to many reasons, but no one teaches us
this stuff, and it's things like, say
you go to bed at 11:00 one night, 1:00
a.m. the next night, then 10:30 p.m. the
next night, and it's remarkable how many
people do this. But studies have shown
that you are statistically 49% more
likely to prematurely die versus those
people who were most regular in terms of
going to bed and waking up at the same
time. And worse, they had a 57%
cardiometabolic disease [music] risk
increase. What the Science really
teaches us that there are four pillars
of good sleep. And [music] then there's
this incredible new study looking at
sleep banking. And this is remarkable
for people who are facing a sprint at
work or a medical doctor about to go on
call for the next 40 hours, new parents,
and we can go through all of that. But
if you were to push me to say the three
[music] most impactful things that you
can start doing tonight to start
sleeping better, it would be
I see messages all the time in the
comment section that some of you didn't
realize you didn't subscribe. So,
>> [snorts]
>> if you could do me a favor and
double-check if you're a subscriber to
this channel, that would be tremendously
appreciated. It's the simple, it's the
free thing that anybody can do to help
us here to keep everything going in this
show in the trajectory it's on. So,
please do double-check if you subscribed
and thank you so much because in a
strange way, you are you're part of our
history and you're on this journey with
us and I appreciate you for that. So,
thank you.
>> [music]
[singing]
>> Dr. Matthew Walker.
Here in front of me, I have these cards
which I'm going to reveal a bit later,
but these kind of hold what you consider
to be the four pillars of great sleep.
But you also spend much of your
professional career just studying the
brain generally to understand human
performance and how we can
change our lifestyles and also introduce
some of these new sort of treatments to
improve how our brain performs. I want
to talk about all of that as well. But
to start, for anyone that is unfamiliar
with you and has been hiding under a
rock,
how do you summarize who you are
professionally,
the sort of academic references you're
drawing on, and the experiences and
research you've done so that the viewer
listening at home
understands the full world that you
operate in, study, and have experienced.
I am a neuroscientist by trade, but my
specialty is sleep, the effects of sleep
on the brain and the body, and I've
probably spent about the past two
decades trying to understand exactly
why do we sleep?
Because 50 years ago,
the crass answer to the question, why do
you sleep? was the following. You sleep
to cure sleepiness.
Which is the factuous equivalent of
saying, well, you eat to cure hunger.
No, you don't eat to cure cure hunger,
you eat to support all sorts of
physiological and biological benefits.
But now, and this is not due to my
research, this is all of the incredible
colleagues whose sort of shoulders that
I stand on,
we've now had to upend the question.
We now have to ask, is there any major
physiological system in your body, or is
there any operation of your mind that
isn't wonderfully enhanced by sleep when
you get it, or demonstrably impaired
when you don't get enough? And the
answer now seems to be, no, we there is
no such system, even down to the level
of your DNA.
Your sleep and how you are sleeping or
not sleeping will change the very DNA
nucleic alphabet that spells out your
daily health narrative.
And we can see it all the way up to
society. Sleep can change the fabric of
society, can change how we interact with
other people, it can change our belief
systems, it can change how lonely or
sort of hyper-social we are. So, to your
question, I'm a sleep scientist by
trade, and I suppose my mission has been
trying to reunite humanity with the
sleep that it seems to be so bereft of.
We had a fantastic conversation last
time and my audience
valued it tremendously. I know that cuz
we we often survey our audience and we
we get to see some of the the back-end
stats. And this conversation about sleep
is particularly personal to everybody
listening because when we surveyed our
audience ahead of this conversation
today, about 75 or 80% of the Diary of a
CEO audience struggle with sleep for a
variety of different reasons. So, we
actually asked them, a thousand of them,
their questions to ask you today. But
also, the other reason I really wanted
to chat to you is the science of sleep.
I mean, as is the way of science, is
always evolving. We're learning new
things and even since we spoke last
time, there is new sleep science which
we're going to talk about today. And one
of those particular things we're going
to talk about is going to be
demonstrated using
this jar.
>> [laughter]
>> Because I always want to know what the
updated sleep science is so that I can
be a better sleeper because I agree with
everything you said about how
foundational sleep is in my life.
I and um I didn't know this at the start
of my career. I didn't know this even a
couple of years ago, 5 years ago, I
didn't know. I thought sleep was one of
those things you could just
take it or leave. Yeah. I mean, and it's
not your fault in so many ways because
if you didn't know what I know, you
would just think, well, when I sleep, my
body is dormant and my mind for the most
part is blank. So, is it so catastrophic
to lose, you know, an hour or two of
sleep? And you know, you have to then
think about from an evolutionary
perspective,
it is such an idiotic idea
to sleep because when you're sleeping,
you're not finding a mate, you're not
reproducing, you're not caring for your
young, you're not foraging for food, and
worst of all, you're vulnerable to
predation.
So, on any one of those grounds, and
especially all of them as a collective,
sleep should have been strongly selected
against in the course of evolution.
And my point is that, and it's often
been said that if sleep doesn't serve an
absolutely vital set of functions,
plural, then it's the biggest mistake
the evolutionary process has ever made.
And we now realize it didn't make a
spectacular blunder. But really, I guess
to the point of it is
sleep is not a passive state. It's an
incredibly active state both in the
terms of the brain and the body. And so,
you uh should not feel sort of, you
know, remiss or ashamed that you didn't
value the importance of sleep because
firstly, as a subjective sense, you just
think, well, my mind was offline for a
while.
Second, we also know that we don't teach
the importance of sleep in education.
And doctors themselves, you know,
there's a great study and they what they
found is that medical doctors across, I
think it was about 11 different
curricula around the world, they will
only receive about 1.2 hours of
education on sleep. But it's a third of
their patients' lives.
So, there's
a collection of sort of almost perfect
storms that have happened to keep
society ignorant of the importance and
the value of sleep. I think that's why
we often so shortchange it, together
with also something terrible, which is
stigma.
That people are so proud to say, well,
I've been eating really healthy the past
couple of months or, you know, I've been
going to the gym, you know, three times
a week consistently for the past year.
No one is ever going out into society
and saying, you know, I I've been
getting 8 and 1/2 hours of sleep
consistently every night. Because if you
did, people would say, really?
And there's a there's a slight edge to
the really, which is that if you have
time to sleep,
then you must not be busy. And if you're
not busy, you must not be important.
So, can you do me a favor and for the
listener at home, can you tell me
what the different groups of people
that are listening to this conversation
right now are seeking? From the extreme
end being
sleep apnea, I get no sleep, I'm an
insomniac, to the other end where maybe
they're looking for marginal performance
gains. Like, what are the what are the
cohorts of people you see and the
reasons why they're so interested in
your work? They listen to your podcast,
they read your books. What are the
cohorts? Firstly, we have the collection
of people who have insomnia.
Those people who have other sleep
disorders like sleep apnea, which we can
speak about. There's another disorder
called restless leg syndrome. It's a
terrible disorder where your legs start
to feel as though they've got this sort
of creepy, crawly feeling and you've
constantly got to massage them and move
them. It's a terrible disruptor of your
sleep. All of these disorders are
markedly undiagnosed, by the way. And
then you've got another collection of
individuals who they don't have any
sleep disorders, but they are either
doing things that will dismantle our
sleep. So, either they're taking on
things into themselves like alcohol,
caffeine, THC that aren't the sleep
helpers, even though sometimes they
think they are.
And then you've got perhaps the internal
things that will prevent you from
sleeping well, things like stress and
anxiety. And then you've also just got
life itself that can get in the way.
And then moving from the sleep disorders
realm to the uh I don't have a sleep
disorder, but I'm probably not doing it
right, {quote} {unquote}, when it comes
to sleep. Then you've got the people who
are obsessed about getting it right, and
they are the bio-optimizers,
this sort of the, you know, the
bio-hackers. And then you've also got, I
work with a lot of high-performance
individuals who are really trying to
just scratch out those last couple of
percentages, either at in business or
often we're working with professional
athletes. These are the people for whom
two or three percentage point changes
can be
tens of millions of dollars, or they can
be the difference between standing on a
podium at the Olympics or not. And so,
this is is a broad collection of
wonderful characters.
And since we last spoke, is there now a
lot of new sleep science and
understanding as it relates to sleep
performance and these three categories
of sleep deficient, sleep disorders,
lifestyle factors, and then the
optimizers?
Yeah, I think there's there's a broad
collection of new evidence that we have,
but maybe let me come on to the middle
group. You know, I used to say that for
people who were deficient in their
sleep, that sleep wasn't like the bank.
That you can't accumulate a debt. Oh,
here we go. Okay.
So, what we can see here is that the jar
used to be full.
Full of sleep credit when you're
sleeping well.
And then during the week, I'm short
sleeping. So, maybe I'm only getting 5
hours a night. So, I'm constantly going
into debt. So, I'm losing all of this
wonderful sleep credit, and my system is
building up this collateral debt.
And then we used to think that sleep was
not like the bank, that once you've gone
into debt, unfortunately,
the lid is closed, and even at the
weekend, if you try to pay it back,
you can't put back credit into the
system.
However, there was a study published
from what's called the UK Biobank, which
is this incredible data set. It's
revolutionary. And they studied in this
particular research paper over 90,000
individuals.
And what they did was they essentially
split them down into those individuals
who were short sleeping during the week,
and then short sleeping at the weekend.
And they compared them to those
individuals who were short sleeping
during the week, but then long sleeping
at the weekend. They were doing catch-up
sleep. That's me. And that's so many
individuals, it turns out. If you look
at the data, it's it's remarkable how
many people do this this catch-up sleep
behavior.
But what was amazing is that in the
people who were short sleeping during
the week, but long sleeping at the
weekend, they had a 20%
reduced cardiovascular disease risk
relative to the people who were short
sleeping during the week, but also short
sleeping at the weekend. Now, to be
clear, both of those groups had a higher
cardiovascular disease risk than people
who were sleeping sufficiently during
the week and sleeping sufficiently
during the weekend. So, I'm not saying
that it's a completely free lunch, but
for the first time, we realized that at
least one system, major organ system in
your body, is like the bank, which is
that if your heart
at the weekend,
you can
just keep
putting credit back,
and your system doesn't suffer as much.
For your heart? For your heart. Okay.
But again, many of the other major
physiological systems don't show that.
So, work by people like Kenneth Wright
at the University of Boulder, Colorado,
he's shown that your immune system
doesn't rebound after long sleep at the
weekend, your regulation of blood sugar,
your cognitive ability. So, that's
one way in which I've changed my mind
regarding sleep and the bank.
But there's a very different new set of
data that has changed my mind completely
about this idea of sleep and the bank.
Now, what we've just discussed here is
to say, I went into debt,
and then I was hoping to try and pay it
off with credit at the weekend. So, the
jar represents the debt that you have,
the sleep direct. Yeah. And what I'm
trying to do is force more coinage
in at the weekend
to see
if I can offset the debt that I created
and get back to net net neutral by the
end of the weekend. Now, it turns out
you can't do that. Even if you sleep for
as long as you want, but here's this new
remarkable data. It came from Walter
Reed Medical Army Institute, a
researcher called Thomas Balkin. And
what he was interested in was flipping
the direction of the question.
Not if I go into debt, can I pay back
with credit,
but what if I know in future I'm going
to face a debt, an upcoming debt,
can I do sleep banking? Oh, so if I've
got a big thing coming up where I'm
traveling across the world and I know
I'm going to be sleep deficient, can I
sleep a lot before it to create a
What would the financial analogy be?
>> the financial analogy would be, let's
say that we're coming up to Christmas.
Yeah. And you're going to spend lots on,
you know, presents and all sorts of
stuff. So, I know that in October and
November, I'm going to tighten my
financial belt. I see.
>> So, that when I go into the sort of
Christmas period and I'm spending a lot
more money, my bank account isn't hit as
hard. I don't go into as much of a sort
of a debt situation because I've built
up credit.
>> So, you can create sleep savings.
Correct. It's a sleep saving system. So,
essentially, you know,
what he was able to do,
not
just put
the jar to full,
but he was actually packing in
even more
so that you almost got this wonderful
overflow of sleep. How did he know?
He didn't. It was the experimental
hypothesis.
And And but how did they prove it? So,
what they did is that they woke you up
to a period when you're going to have
two or three nights of either no sleep
or marked sleep reduction.
And in the week beforehand, with these
army cadets, instead of being limited to
8 hours of time in bed, they were able
to get 10 hours of time in bed.
And they could sleep all that they want.
And so, they went from probably an
average of about 7, 7 and 1/2 hours of
sleep to about 8 and 1/2,
almost 9 hours of sleep. So, they were
extending their sleep duration.
And so that they had built up this
buffer. It's almost like a sort of a a
sleep safety net that's in place, so
that when you go into the tumble of
sleep deprivation,
you're sort of almost bolstered and
you're lifted higher, and therefore your
degree of impairment that you suffer
under conditions of sleep deprivation is
significantly less if you banked sleep
beforehand versus those people who were
just sleeping normally
and then face the deprivation. They went
down much further in terms of their
cognitive and mental performance. So, he
gave them challenges and tasks to do
Correct.
>> in two different groups. One group had
sleep savings saved up from sleeping
well the previous week, one group
didn't. That's right.
>> And they performed remarkably different.
So, both of them were impaired relative
to a sleep rested person. Okay. However,
the people, it's sort of, you know, how
how much of a drop in your cognitive
performance do you suffer? And what he
found was that people who had built up
this credit, this savings account of
sleep in the days in the week
beforehand, they suffered about 40% less
of an impairment relative to the people
who had not created any savings plan.
Now, they weren't in debt, they were
just net neutral. But boy, did they drop
quickly.
Whereas those people who'd had some
cash in their sleep credit system,
they didn't fall anywhere near as far.
But this is remarkable for people, like
you were saying, who are facing, let's
say, if I've got a sprint at work, or
I'm a medical doctor, and I know I'm
about to go on call for the next 40
hours, you're in military aviation, all
of the new parents, all of these
circumstances are places where now we
know, athletes are a great example, when
we work with athletes, people like
Michael Grandner have demonstrated that
athletes sleep terribly, typically, the
night before a huge performance. No
matter, you know, of course, they're
nervous. Mhm. But what you can do is you
can have them bank sleep in the days
before when they're not as nervous, and
therefore their performance doesn't
suffer as much, even though they know
they're going to be deprived. Sleep is
so important, isn't it? And I think
everybody now knows that because of
people like yourself, or really, you
know, you were the real pioneer in
pushing this subject into the world. I
remember when you first went on Joe
Rogan's show, the amount of my friends
that sent me that episode and then sent
me your book was just staggering. It was
like that was the catalyst moment, I
think, in society for the mainstream to
really start talking and caring about
sleep. However,
there's still so many people struggling
um
because of all the factors that you
talked about when we were talking about
group two, who have those lifestyle
factors, the stress, the psychological
factors, the trauma, etc., etc.
What can we give them,
those people, the people that really,
really struggle? Maybe they haven't got
a disorder, we'll come to the people
with sort of sleep disorders later, and
we'll talk about optimizers. But what
what is the new information or advice
that we can give them
that will help them once and for all
sleep 8 hours a night and get their life
back?
If you were to push me to say what are
the three most
impactful things that you can start
doing tonight to start sleeping better,
it would be the following.
Digital detox. Okay, let me write this
down. Digital detox, okay. And what does
that mean? One hour before bed,
try to limit
activating social media engagement,
email,
and text messages that are going to
trigger you. It's fine to listen to a
podcast, you know,
>> [laughter]
>> You heard it here, folks.
Right from my mouth. But it's also good
to like and subscribe, would you say? I
would say that, you know, like and
subscribe and then just click here so
that you get the latest notification.
You get that bell, just click on the
bell icon so that you
>> [laughter]
>> So, it's not a problem of blue light. A
quick aside, we've been taught this myth
of the blue light effect. Yeah. From
devices and it really is a myth because
an incredible Australian researcher, a
guy called Michael Gradisar, has almost
single-handedly
changed the the what I think of as being
the zeitgeist for a while after a very
influential paper, which is a great
paper. And what they showed was that one
hour of iPad reading before bed
ended up impairing your melatonin. It
disrupted sleep. It reduced the amount
of dream sleep and even after they
stopped reading the iPad, the blast
radius impact on your dream sleep lasted
a week. It's almost like the drug needed
to get washed out the system. That even
when you you'd stop using technology for
an hour before bed,
the impact of that technology, even
though you'd stop using it, could still
be seen in the echo of sleep disruption
for a week later. It was a very
influential study in a very prestigious
channel. When was that? A while ago?
That was probably about 10 years ago.
But then Michael Gradisar, this
incredible Australian researcher,
started to say, "Well, I can't replicate
these findings."
And what he was discovering is that it's
not the blue light that's the problem.
Now, the blue light will change aspects
of your melatonin and melatonin is a
hormone.
It simply tells your brain and your body
when it's night time, when it's time to
fall asleep. It doesn't participate in
the generation of sleep. Melatonin is
like the starting official at the 100-m
race. It brings all of the racers to the
line and it begins the timing of the
race, but it doesn't participate in the
creation of the race itself. That's a
different set of chemicals.
>> It doesn't make you go to sleep.
>> It doesn't make you And if you look at
what we call meta-analyses, where we
gather together all of the individual
studies on a topic and we put them in a
big statistical bucket, what they found
is that melatonin will only improve the
speed with which you fall asleep by
about um 3.4 minutes and it will only
increase the efficiency of your sleep by
about 2.2%. So, not much more than
placebo.
Um so, melatonin is
it it's Now, the placebo effect is the
most reliable effect in all of
pharmacology. So, you know, maybe no
harm, no foul. I would say, and don't
forget I will come back to the three,
but when it comes to melatonin, be
careful. More isn't always better.
And you run the risk of
confusing your morning brain
into a dense nighttime fog. And what I
mean by that is
10 mg or 20 mg of melatonin is what we
call a supraphysiological dose, which
again is just a fancy medical term to
say it's a size of magnitude of
melatonin that your body would never
naturally release. It's far greater.
So, melatonin is the signal of darkness
and normally by the morning hours, our
natural release of melatonin has stopped
and you're down to zero levels again. In
the morning? In the morning. So, you
wake [clears throat] up and your body no
longer has the signal of melatonin
saying it's night, it's night, it's
night. But if you've dosed yourself with
10 mg or 20 mg of melatonin,
you run the risk of saying, "Well, yes,
I know it
quote unquote knocks me out." But the
problem is in the first, you know, three
or four hours of the waking morning,
you're struggling because you're in this
fog of a hormonal melatonin, a hormonal
signal saying it's still pitch black.
Now, it's not. It's bright light
outside, but your body is fooled into
thinking it's pitch black because you've
dosed yourself too high and no wonder
you're reaching for two or three cups of
coffee in the morning.
So, what what dose of melatonin should I
be taking? Somewhere between probably
about 0.1
to 3 mg. And do you advise melatonin for
people?
Yes, in two conditions. The first, or
circumstances I should say. The first is
when you're going through jet lag.
Wonderfully helpful, but timing is
critical. You need to create that sort
of that artificial signal of night
because let's say that you and I here in
Los Angeles, we're both going to fly
back to London tomorrow. And London is
eight hours ahead. So, we fly overnight,
we arrive in London and then that first
night, let's say we decide to go to bed
or I decide to go to bed in the hotel at
midnight. The problem is here in Los
Angeles, on my body clock, it's still
4:00 p.m. cuz London's eight hours
ahead. So, my melatonin is not going to
rise for probably another six or seven
hours. So, I need to artificially hijack
my melatonin system and tell my brain,
"Oh, no, it's not 4:00 p.m.
It's instead, it's midnight." And so
there, under conditions of jet lag, very
helpful. The second is if you have a
circadian rhythm disorder. Let's say
that you're someone who has a an
advanced circadian phase. What that
means is you're someone who really can't
get sleepy until 3:00 or 4:00 in the
morning and you would prefer to be
sleeping throughout most of the day. So,
you you're almost nocturnal. Is that a
genetic disorder? And yes, it's a
genetic disorder in part.
>> How many people have that?
Probably 1 to 2% of the population have
a very severe
advanced circadian phase disorder.
But there, melatonin can also be helpful
because once again, their melatonin part
of their problem is that their melatonin
is very delayed. So, they don't get the
signal of "Oh, it's night" until maybe
4:00 in the morning. You and I, we start
to get our signal of melatonin,
depending on our chronotype, by
somewhere between about 9:00, 10:00, or
11:00 p.m.
They may be delayed by five hours. So,
if we can give them melatonin, we can
artificially try to fool their brain
into thinking it's actually earlier in
their biological rhythm. So, they sleep
earlier and they're more in sync with
the rest of society. How does someone
know if they're that type of person, if
they have that disorder? Is there
There's not a way to test, is there?
Well, what we typically do is we will
bring you into a laboratory and we will
measure your innate levels. So, we will
shut out sort of all windows, all clock
faces are gone, and we just let you run
your natural rhythm. Mhm. And they have
the same rise and fall in melatonin,
just like you and I do. Except where
it's doing that rise and fall of
melatonin on the 24-hour clock face is
radically different. Okay. For you and
I, it's, you know, 9:00, 10:00 p.m.,
11:00 p.m. at night when we're starting
that melatonin crescendo. For them, it's
4:00 in the morning. So, we can measure
it. It's not in their minds, it's not
their choice. It's a biological edict.
Are you concerned that melatonin is
becoming more and more popular as a way
to solve
lifestyle issues
that have caused sleep impairment?
Because I'm seeing loads of You know,
I'm an investor, so I see lots of
companies now pitching me different
products that have melatonin in them as
a sort of day-to-day sleeping
supplement. I think I'm really torn.
I've been on both sides of this argument
and
I'm cautious about it for two reasons.
The first is in pediatric populations
here in the United States. Pediatric?
>> Yeah, so the people's use of melatonin
in kids is increasing. So, in pediatric
populations, it's
increasing exponentially. And in fact,
if you go down the sort of the
supermarket aisles here in America,
often if you go into sort of the the
health sort of food section, there's
this big purple section. That's the
melatonin section. And a large
proportion of that is there dedicated to
gummies for your children with
melatonin.
And
there was a study that was published
about three years ago that showed here
in America, over the past 10 years,
there has been a 503% [clears throat]
increase
in poisonous overdose admissions to
hospitals of melatonin in the past 10
years. 503%
increase.
So, firstly, we've got to be a bit
careful. The second reason is that
melatonin is a bioactive hormone and
it's also involved in reproductive
development. And there were studies done
back in the 1970s, I think, where they
were looking at juvenile male rats,
which is to say male rats who were going
through adolescence.
And they were dosing them with high
amounts of melatonin. And what they
found is that that stunted the
development of the testes, of the
testicles, and it caused testicular
atrophy. Now, these were very high
doses, but we've got to be a little bit
careful. We think We say, "Well,
melatonin's a natural hormone, so
anything natural is safe." Melatonin
overall, in terms of its safety profile,
is very safe. It's actually a very good
antioxidant.
But you've got to be careful because
things like, for example, testosterone
supplementation in males, what we know
is that if you're injecting
testosterone,
after a while, after maybe 18 months or
so, the testes themselves will stop
producing their own testosterone. And
even if you stop the administration of
the exogenous testosterone, the
injection, the testes never return their
function of producing testosterone.
Now, we don't have any evidence yet that
that's the case that if you keep taking
melatonin at high dose, your body, the
fear would be, shuts down its own
natural production of melatonin. I've
seen no evidence of that. In fact, I've
seen evidence to the contrary that even
after about 6 months or even 12 months
in certain small cities, when you stop
melatonin, the production starts again
naturally. It seems fine. Problem is,
people haven't been taking melatonin for
just 12 months. They've been taking it
for years.
We've got no idea what happens after
years. That was my hesitation when the
first time someone offered me melatonin
is from doing this podcast and speaking
to smart people like yourself, I've come
to learn this sort of principle that if
you start making something for your body
in terms of a hormone, if you start sort
of
consuming something externally, like
testosterone, your body will say, "Fine,
I don't need to do this." It will try
and return to that level of balance
where the quantities in your system are
maintained, which means it kind of
learns to shut down. And I always think
about the case of testosterone cuz men
know that if we start injecting
testosterone, then we're going to have
to pretty much do it forever. Yeah. Um
if we want the those levels to be the
same. Yeah, that's the worry is that
there are no free lunches in biology and
usually if you fight biology, you
typically lose. There's always a
trade-off. And so when my friends often
like talk to me about like these miracle
things or this thing or take modafinil
and everything will be fine and da da da
da da. I go, "Yeah, but what's the
trade-off?" And I get most concerned
when they say there isn't one. Cuz then
I go, "Shit, we don't know it."
>> [laughter]
>> Yeah. You've got to be careful because
absence of evidence is not evidence of
absence. Mhm.
Be very careful when you're
doing that deal with with your
physiology. So, to come back to the sort
of the three things, the first thing we
were mentioning is digital detox and
don't worry about the blue light.
Worry about light in general. I'll come
on to that cuz that's the second. But,
Michael Grandner, as I was saying, what
he found is that the blue light doesn't
really disrupt your sleep.
It's a combination of first, these that
we use are attention capture devices and
they are designed to fleece you of your
attention economy and they do it
ruthlessly well. They've spent tens of
millions of dollars designing these
products to do that.
So, what happens is that these devices
become hugely activating.
And as a result, they essentially will
be a mute button on your sleepiness. So,
you could be there, you get into bed,
it's 11:00 p.m. You think, "I am so
tired. I was falling asleep on the the
the couch watching television." And then
you get to bed, you start going on to
social media, and then you start
doomscrolling, and then you get into
this what we call bed rotting, where you
just sit there. And now you look at the
clock and it's no longer 11:00 p.m. It's
1:00 a.m. And you've just done sleep
procrastination. Now, it turns out that
it's yes that that these are attention
grabbing devices that will mute your
sleepiness.
But, you have to be of a certain
personality type, he found. Not all of
us are vulnerable to this sleep
disruption of devices. You have to be
someone who is perhaps neurotic, someone
who has high impulsivity, or someone who
is perhaps high anxious. If you are of
any of those kinds, you should be really
careful about your use of technology in
the bedroom. Now, for me to, you know,
sit here and say, "Look,
put your phone in the car in the garage
and that way, you know, that's what I
would love because
what we've learned to do in this modern
era is the first thing when you wake up.
What is it that you do?
No no comment.
>> [laughter]
>> What about you?
It's just you and I, Stephen.
Um I grab my phone before my eyes are
even open. And what happens is this sort
of small tsunami of anxiety washes over
you because as soon as you unlock the
phone, it's everyone else's agenda for
your day but your own. And it's a
terrible way to wake up. Have you ever
had the experience where you've got to
wake up for an early morning flight and
it's a critical flight? You know that
that night is not going to be a good
night of sleep. It's going to be a
shallow kind of sleep. It's what we call
anticipatory anxiety. You are
anticipating an anxious event in the
morning.
And studies have shown that when we
create this anticipatory anxiety, the
amount of deep sleep that you have drops
significantly. You don't sleep as well.
And therefore, if we just do this little
sort of version, this LITE version of
the morning flight, which is we know
that when we go to bed and we put our
phone down, we know that when we wake up
every morning, we're just going to open
it up to that hit of anxiety every
morning. No wonder our sleep can start
to get shallow.
Now, I'm not going to sit here and say,
"Well, don't take your phone into the
bedroom because the genie is out the
bottle and no matter what I say, it's
not going back in anytime soon." And a
friend of mine, Michael Grandner, has
got this beautiful
uh framework where he says, "You can
take your phone into your bedroom. It's
fine.
But, you can only use your phone
standing up. Oh.
>> [laughter]
>> What's his name? Um Michael Grandner.
He's from Brooklyn.
>> his own business.
And and what happens is that you you're
there and you think after about 7 or 8
minutes, "Oh, I'm just I'm just going to
have a bit of a sit down here." As soon
as that phone goes away. So, I would say
that digital detox is the first friend
that will really help your sleep. The
the second is regularity and we'll come
on to regularity when we speak about,
you know, what really makes for good
sleep.
If you were to only do one thing,
not three things, but just one thing, go
to bed and wake up at the same time no
matter whether it's the weekday or the
weekend, regularity is king. Okay, so
that's the third pillar. That's correct.
Regularity. Okay.
And then I have
the T for timing. Correct.
Which we'll go through these.
Quantity, which we've talked a little
bit about already, and quality.
Correct. So, when I looked at the
science, for me, I created this
framework of the four macros of good
sleep. You've heard of the three macros
of food, macronutrients, fat, protein,
carbohydrate. To me, there are four
macros of good sleep and it's QQRT.
QQRT. And it stands for
quantity,
quality,
regularity,
and timing. And think of it less like
pillars, but the four legs of a chair.
And if any one of these becomes
unstable, the chair will topple over.
So, I'll probably start with the one
that people have heard me bang on about,
which is quantity. 7 to 9 hours. This
myth of 8 hours is nonsense. It's a
wonderful range, 7 to 9 hours.
And what we know is that using that
sweet spot of 7 to 9 hours, when you get
less than that, the shorter your sleep,
the shorter your life. [ __ ] Short sleep
predicts all-cause mortality. Now, we
say that this is the minimum of 7 hours
of sleep and some people have argued,
perhaps correctly, that look, if you
look at these mortality curves, there's
not much of a percentage difference
between sleeping 6 hours versus the 7
that you're telling me is minimum. So, 6
hours is just fine. So, all of this
nonsense and rhetoric is is is silly
from you.
And I think they made a conflation
because
7 hours
is the minimum amount of sleep that you
need to survive
because the way that we quantify what
minimum is is based on whether you die
or you don't prematurely.
The amount of sleep that you need to
survive is different than the amount of
sleep that you need to thrive.
And people will conflate the former with
the latter. So, you've got to be careful
when people are sort of touting on
social media that say, "Well, no, but
look, you there's not much difference
between my sort of survival rate on 6
hours versus 7 hours."
You may have a just as much of a long
life, but the quality of your life will
be very different. So, that's quantity,
7 to 9 hours. And is that does it change
for parents, by the way, because I've
met so many parents that seem to be
functioning better than me and they've
got four they're having like four or
five hours sleep. Did evolution not give
parents any leeway or anything when they
have kids that suddenly their brain
changes and now they can survive with
less sleep? The evidence doesn't suggest
that once you go through parenthood, you
get some magic sort of, you know,
immunity shot that makes you, you know,
resilient and not vulnerable to a lack
of sleep. And in some ways, you could
argue because we used to, you know, live
as a collective tribe and we would share
duties, at that point, you know, mother
nature doesn't really worry too much
about you now
because you've already procreated and
you've passed on your genetic code. So,
you are now the the sort of the, you
know, the not particularly well, you
know, cared for individual through
evolution. It's your offspring that gets
So, it sacrifices you
in a way. I mean, that's what we see in
the animal kingdom. Did you see that
documentary about the octopus? Yeah. It
it was just I mean, I thought it was
beautiful documentary, but um The TLDR
for anyone that hasn't seen it is once
the octopus and I'm going to completely
butcher this, so please ignore.
Um once the octopus has given birth,
it dies. Basically, it doesn't move out
of that hole and it dies. Is that rough?
Well, I don't know if if it dies, but
its level of of active life I searched,
"Does the octopus die after
reproduction?" And it says, "Yes. Female
octopuses die after their eggs hatch.
After laying eggs, a female stops eating
and devotes all of her her energy to
protecting and oxygenating them until
they hatch. Once they do, she dies
shortly after. A process called
semelparity,
meaning they reproduce only once. This
death is triggered by hormone changes
from the optic gland similar to
mammalian pituitary glands.
And males die shortly after mating as
well, usually within a few months.
That is wild. In some ways it
it's tragic and it reminds me I'm so
glad that I'm not an
>> [laughter]
>> But but coming back to it. So, for
there doesn't seem to be some, you know,
magic cloak of invincibility that you
put on when you go through parenthood.
Certainly what we know is that the
number of individuals who can survive on
6 hours of sleep or less and show no
impairment in either their brain or
their body, rounded to a whole number
and expressed as a percent of the
population, is zero.
So, quantity matters, but it turns out
that we got it wrong in thinking that
was the only thing because
then came quality. So, QQRt. Quality is
defined in sleep science as two things.
The first is something that your sleep
tracker will measure, which is the
continuity of your sleep, meaning do you
sleep in one or two nice long bouts
throughout the night? That's good
quality of sleep, nice continuous bouts.
Versus your sort of sleep is very
fragmented by all of these awakenings,
that's very poor quality of sleep. And
the way that you can measure it in your
sleep tracker is just by looking at the
app and there'll be something called
sleep efficiency. Sleep efficiency is
defined as the following: of the time
that you're in bed, what percent of that
time is spent asleep? And what we like
to see is you north of 85% or above. So,
this is kind of like the users guide to
sleep trackers.
What I want to see is 85% or more. If
you're less than that, we need to have a
conversation. That's number one good
quality of sleep. The second, which is
what sort of what these trackers can't
really do, but I can do in the sleep
laboratory when you look like a
spaghetti monster cuz I put electrodes
all over your head,
>> [snorts]
>> I can measure the quality of your big
deep slow brain waves of deep non-REM
sleep.
And that is a second measure, the power
of those big slow brain waves. That's a
second measure. And quality seems to be
as predictive as quantity
in making a difference not just to your
all-cause mortality, but quality even
more than quantity when it comes to
mental health has been showing the
biggest signal.
So, again, it's not that quantity
doesn't matter. You do have to get
sufficient amounts of sleep. But
quality, as much as quantity, should be
paid attention to and I haven't said
that enough.
The next is where we came to in our sort
of three things that I was saying. The
first is digital detox. Then the next
thing I said is regularity.
This is somewhere where I've also
changed my mind on. I've doubled down on
regularity. There was a study that also
came out of that same data set that I
described. It's called the UK Biobank
data. And now they didn't look at 90,000
individuals, but they looked at 60,000
individuals.
And they decided that they were going to
compare and split them into quartiles.
So, the most regular
to the second most regular
to then sort of the third most regular
and then the final was those who were
the least regular. And what does regular
mean in this context?
>> Good question. Highly regular
individuals plus or minus 15 minutes in
terms of going to bed and waking up at
the same time. In other words, a total
wiggle room of 30 minutes. Oh, okay. So,
if I'm always going to bed at 9:00 p.m.
and I do that 5 days in a row, I'm
regular timing really.
>> So so it's it's regularity in terms of
when you're going to bed and waking up.
So, it's you're right, it's timing in a
way, but I'll come on to why there is a
separate key for timing in just a
second, but regularity here was okay,
plus or minus. So, let's say you go to
bed at 8:45 p.m. one night and then 9:00
and then 9:10 p.m. and then you're back
to 8:00. That's beautiful tight timing.
I like that. Whereas the those people
who were least regular, they were 90 to
120 minutes disparate. They were going
to bed, let's say, at 11:00 one night
then 1:00 a.m. the next night then they
were going to bed at 10:30 p.m. and then
they were going to bed at 12:30. They
were all over the map. So, what they
found was that those people who were
most regular versus least regular, they
sort of compared the extremes of these
two,
those people who were most regular had a
49%
relative decrease in all-cause
mortality. So, they were 49% less likely
to prematurely die than those people who
were least likely to die. They had a 39%
cancer mortality risk reduction.
Great. They had a 57%
cardiometabolic
disease risk reduction.
So, that was stunning that regularity
was incredibly powerful as a predictive
signal of your different forms of
mortality.
That wasn't the best part of the paper,
though.
They'd also measured quantity as well as
regularity in these same individuals.
So, then they decided to say, "Well, I'm
going to take our measure of quantity
and regularity and we're going to put
them both in the same statistical bucket
and do a Coke-Pepsi challenge to see
which one wins out in terms of
predicting all-cause mortality." We all
bet in the sleep field, at least I did,
it was going to be quantity. I was
wrong.
Regularity beat out quantity in
predicting all-cause mortality and by
quite some margin. Now, that doesn't
mean that you can now go away and say,
"I'm going to start sleeping 4 hours,
but incredibly consistent 4 hours." You
need both quantity and quality, but
goodness does regularity seem to carry a
massive signal. So, the coming back to
those three things, I would say digital
detox, just go to bed and wake up at the
same time.
And the final thing is light. In this
modern world, we are a dark-deprived
society.
We get what I call junk light at night.
So, you've heard of junk DNA? Well, we
get junk light at night.
We don't need all of this light and it
fools our brain into thinking it's still
daytime outside. So, no wonder as a
society, we have some struggles with
sleep at night. Now, that's due to many
reasons, stress, too much caffeine,
alcohol, THC, but excessive light is one
of the easiest things that you can do.
So, for the next 7 days,
just do me this experiment,
if you can,
set an alarm 1 hour before your normal
bedtime. When that alarm goes off, turn
off and I I do this myself, turn off
almost all of the lights in your house.
When you say all of the lights, do you
mean the little red light on my smoke
alarm or No, that's fine. But, you know,
so my wife and I, 1 hour before bed,
almost all the lights. We've got sort of
this little set of this sort of light
that goes around the television, the
back of the television, so it kind of
looks like the television's cool and
illuminated.
I will set that down to about 5%
of brightness
and all of the rest of the lights out.
So, you can kind of just still see some
illumination, so I'm not sort of, you
know, looking desperately uncool in
in front of it when I'm tripping over
things cuz it's complete black, you
know. Then start cooling the house or
the room as best you can to around about
67-68°
Fahrenheit or about 18° Celsius. We can
speak about temperature, but just do
this experiment for the next 7 days. 1
hour before bed, the alarm goes off, you
switch off all of the lights
and ask the following question, do you
feel sleepier? Is it soporific? Does it
make you feel more sleepy
as a result? But don't stop there. What
you've gone and done is the first
positive experiment, which is you've
gone from the no intervention, lights
are on, to then the Matt's intervention,
which is now the lights are off for 1
hour before bed. Don't just ask, "Is my
sleep better when the lights were out
for 1 hour before bed?" Once that 7-day
period has finished, go back to doing
what you were doing before, which is
keep all of the lights on and ask
yourself, "Did my sleep get better when
I did the intervention and did my sleep
go back to being worse when I stopped?"
Because I'm trying to teach you
bidirectionality in the experiment. Does
that make some sense? Yeah, so you get
to
get to basically do an AB test. Correct.
You get to see both sides of the
equation and with that, it's more proof
positive than just one direction alone
cuz who knows, it could just be a
placebo effect.
So, regularity, coming back to it, is
critical. So, we've talked spoken about
QQR, quantity, quality, regularity. On
the
um
regularity
>> regularity point, why? What's going on
in our brain that's making it from a
hormonal perspective or other that's
making it important for us to sleep at
the same time? It's a bloody great
question. People don't respond to rules,
they respond to reasons not rules. So,
let me try and explain the reason behind
the sort of the rule. When it comes to
regularity, we have something called a
circadian rhythm that we've spoken
about. And there's a clock that sits
inside of your brain, deep in the middle
of the brain. So,
we have, it just turns out,
a brain here.
Lovely. Okay. So,
we've got one of these hemispheres here
and then I'm just going to take out what
we call the subcortical sections. So,
these are the areas that are below the
subcortex. So, here is the brain. So,
this is the front of the brain, the back
of the brain, top of the brain, and
here's the brain stem. And it turns out
that right in the middle of the brain,
right here, is an area called the
hypothalamus.
Now, here, this structure here, this is
the thalamus. This is the sensory gate
of your brain. So, all of your five
senses, sound, touch, taste, smell, they
all flood into this gate called the
thalamus. And then the thalamus will
decide whether it sends those sensory
signals up to your cortex. And when it
sends the signals up to your cortex, you
start processing them and you become
consciously aware of the external world.
Now, as we're falling asleep, just as an
aside, what's interesting is that this
gate, the sensory gate, the thalamus,
once we start to fall asleep, the gate
will close shut.
Now, your eyes are technically still
seeing, your ears are still hearing,
your tongue is still tasting.
But because the gate of the thalamus,
the sensory gate, closes shut, those
signals that are coming into your brain
are no longer sent up to your cortex, so
you stop perceiving the outside world,
which is just simply a different way of
saying you've fallen asleep.
Now, the hypothalamus, you've heard of
hypo sort of hypertension or sort of,
you know, hypothermia, that means lower.
So, here's the thalamus. This area here
is called the hypothalamus.
And it's a tiny structure, but within
that structure contains a nucleus. And
that group of cells, the nucleus, has a
fancy term and it's called the
suprachiasmatic nucleus. But the
suprachiasmatic nucleus is your master
24-hour clock.
Every cell in your body has a clock
inside of it.
But this is the master clock. It's like
Lord of the Rings, there's one ring to
rule them all. Well, there's one clock
to rule them all.
And here, in the suprachiasmatic
nucleus, you get the 24-hour rhythm of
being awake and being asleep, being
awake and being asleep. How does your
brain keep quartz-like precision 24-hour
clock time? How does it do that?
The way it does that is that it uses
signals such as light and dark.
>> From your eyes? From your eye.
And so, when light comes through the
retina,
it tells the hypothalamus it's daytime
and therefore you should be awake. And
its rhythm starts its awesome sort of
upswing. And temperature can do this,
and feeding can do this, all sorts of
different things. But for the most part,
light is the principal governor that
essentially acts like electrical, I
should say, photon fingers that pops the
wristwatch dial out and resets it
precisely to 24 hours every single day.
Because if you're left in the dark with
no signals of light, your clock isn't
precise. It drifts to about 24 hours and
15 minutes, so you start going forward a
little bit every single day. If you go
into a cave, and people have done this
experiment. The thing that keeps it
precise is light.
So, you need light to keep a beautiful
24-hour rhythm.
One of those things that's under the
control of your 24-hour rhythm is your
sleep-wake cycle. What if I'm doing
exercise? Exercise is a wonderful
entrainer of your circadian rhythm, as
long as you're doing it at the right
time.
So, if you're starting to exercise at
3:00 or 4:00 in the morning,
that's not good, because that's an
activity signal that's going to confuse
the brain into thinking it's the active
period, which is normally, because we're
a diurnal species, the day.
And it's the same thing, coming back to
my point of regularity,
using light as the best way to help with
that regularity, because light,
if it's artificial at night, fools your
brain into thinking that it's daytime
still outside. I mean, is there any such
thing as non-artificial light? I mean, I
guess with the sun, but I mean, is there
a type of light that I could use at
night, like candles or something? Or
Yes, below 30 lux Right.
>> is not going to necessarily do you a
disservice. Probably below 50 lux. Now,
lux, l u x, is just a measure of light
intensity. And you can download on the
App Store a free lux meter. And if
you're an idiot nerd like me, you're
going all over the house at night and
you're sort of putting it in different
locations. You're seeing, "God, God, is
there any kind of white spots here
where, you know, the lux is too high?"
But you need to drop that that lux. By
the way, it's a great way, if people
want to say, "Look, my REM sleep is
deficient. How can I get more REM
sleep?" There was a great study where
they did something similar to what I'm
telling you now.
90 minutes before bed, they turned down
the lights to below 30 lux and they
pulled out all of the blue light.
And just that trick of dropping the
lights down 90 minutes before bed, below
30 lux, making it warm, yellow light,
increased their REM sleep by 18%. Wow.
It's a huge margin. So, no need for
pharmacology. But to your question, why
is regularity
important? Well, I told you that light
is one of the signals that can create
regularity. It turns out that your
behavior
is another thing that will tell your
brain. So, meaning, when you go to bed
and wake up at the same time,
it acts like an anchor. It anchors your
circadian rhythm and it tells you,
almost like a scene in a movie, this
scene is now complete, a new scene
starts. This scene is complete, a new
scene starts. So, every time that you're
going to bed at the same time and waking
up at the same time, you are feeding the
suprachiasmatic nucleus, the master
24-hour clock in your brain. You're
feeding it signals of regularity.
And when it feeds on signals of
regularity, it improves the quantity and
the quality of your sleep.
Your circadian rhythm likes consistency.
It likes regular signals. When you feed
it signals of light, of activity, of
waking up, going to bed,
you improve the quantity and the quality
of your sleep. That's the reason behind
the underlying rule. So, having a TV in
your bedroom is a terrible idea then,
because if
on that behavioral point, if I'm getting
in bed, but then I'm staying up for 3
hours watching Netflix, my brain is
going to be quite confused about like
the behavioral pattern of what what I'm
doing in my life.
It's not going to associate the bed with
sleep, it's going to associate the bed
with movies. That's one of the problems
that we call it's called conditioned
arousal, which sounds a lot more
salacious than it actually is. It's a
term that we use in sleep medicine,
which may explain insomnia. So, with
insomnia, let's say that the first time
you go to this thing called the dentist
and you get in the chair and it's kind
of cool, you're reclined back and, you
know, you think this is fine. But then,
after about 14 or 15 visits,
when you get into that chair, you are no
longer looking forward to getting into
that chair, are you? Why? Because you've
learned the association that being in
that chair typically leads to a bad
outcome.
>> [laughter]
>> Now, the same thing is true with the
bed. If you start associating the bed
with anything other than sleep, and we
give you a pass in terms of sex,
sleep and sex, anything other than that,
you start to learn that this thing
called my bed is this place where I'm
awake, where I work, where I eat, where
we have conversations, where I watch
television. And so, you know, if I were
to and I'm going to I'm stealing Michael
Grandner's point, but if I were to say
to you, "Bed, sleep, bed, sleep, bed,
sleep, bed, sleep, bed,
sleep." Okay, if I were to say, "Bed,
scroll, bed, eat, bed, work, bed, sleep,
bed, TV, bed."
You've confused. Yeah. Because there's
no predictive signal. You've never bound
an association. Now, the way this works
to your disadvantage in insomnia is the
following.
The insomnia event that begins the
insomnia is typically not the thing that
maintains the insomnia. So, let's say
that I
um had I experienced a really difficult
bereavement
and that triggered a form of insomnia
where I couldn't sleep because of the
bereavement.
Gradually, the bereavement
is not the thing that's going to
maintain my insomnia. It's because every
time I have been going to bed over the
past month,
I have not been sleeping. I've been wide
awake in my bed. So, now, because your
brain is such an incredibly associative
device, it learns the association that
my bed is the place where I'm always
awake.
And what do we then do? We need to break
that association in insomnia. So, what
we do is we say the 20-minute rule. If
you've been in bed for about 20 minutes
and it's just not happening for you,
don't worry. Don't listen to idiots like
me that doom and gloom and disease and
sickness and one bad night is not going
to be a problem. It's just not. So, just
say, "Look, tonight is not my night. I
am not, however, going to lie in bed
awake, because very quickly my brain
starts to learn the association that my
bed is the place where I'm wide awake."
And you need to break that association,
so go to a different room in dim light,
just read a book, listen to a podcast,
whatever it is. And the rule of thumb is
the following. Only return to bed when
you are sleepy.
And so, there's no time limit. And that
way, you gradually relearn the
association that my bed is the place
where I always get consistent sleep,
because otherwise, it's the dentist's
chair. You walk into your bedroom
and you look at your bed and it's your
nemesis. And you convince yourself, even
before you get into bed, "I'm not going
to sleep, because that's the place where
I always don't sleep." And by the way,
if you suffer from the 3:00 a.m.
awakenings, my first question is, "How
do you know it's 3:00 a.m.?"
And that's your first problem. Looking
at the clock does two things. It makes
you more anxious. Yeah. And second,
because your brain is such an incredibly
associative device,
you start to then decide that 3:00 a.m.
is the time when I need to wake up. If
you keep looking at the clock, you keep
reinforcing that 3:00 or 4:00. And sleep
at 3:00 in the morning is like trying to
remember someone's name. The harder you
try,
the further you push sleep away. Sleep
is something that happens to you. It's
not something that you make happen.
And so, at that moment, the best advice,
if you don't want to get out of bed, is
do any one of the following.
Meditation.
Just do a guided meditation. You can
download apps. Next, if it that's not
your thing, that's okay. Do box
breathing. You know, you can sort of
inhale for five, hold for six, exhale
for seven. There's all sorts of
different numbers, but you can do
breathing exercises. The third, if you
don't like that, is a body scan. So,
close your eyes, start at the top of
your head, feel as you know, do I have
tension in my forehead? Do I need to
relax it? What about my neck? Do I need
to move through your body and gradually
go down? How are my shoulder blades
feeling? I just relax down into the bed.
And gradually down into the chest, into
the
move through and just relax.
If none of those things feel fun, the
next thing you can do is take yourself
on a mental walk. There's a great study
from my university at the University of
Berkeley, California.
And we didn't do the study, Alison
Harvey did it. By the way, counting
sheep,
bad idea. Makes your sleep worse. It
turns out. Why is that? Because well,
with every kind of little bleating
cotton wool ball with a strange look on
its face that leaps over the fence that
you're counting, you're reinforcing
every minute of sleep that you're not
getting, and it seems to make matters
worse. But what she found was that
there's an alternative. If you think
about a walk that you know in great
vivid detail. So, for me, it's going to
be walking the dog. So, I go over to the
shelf, I open the door, is it the red
lead or the I'm going to go with the
blue lead today. So, I clip the dog in
with my right hand, I open the door with
my left hand, I take a left down the
stairs, I look It's that level of I want
you 4K detail
in terms of granularity.
And what's common about every method
I've just described, meditation, box
breathing,
sort of body scan, going on a mental
walk, all of these things have in common
that you get your mind off itself.
In that particular example, where she
asks you to vividly think about a
journey that you know, what did she find
in the study? What she found is that
that increases the speed with which you
fall back asleep Uh-huh. significantly.
Because, as I said, it it's so, you
know, her work to me demonstrated that
it it is so like that name, because
the moment I stop trying to remember
someone's name,
what happens?
You remember. I remember it.
And so, when you do these types of
exercises where you're getting the mind
off itself,
the next thing that you typically
remember
is your alarm clock going off in the
morning.
Is this why people listen to very vivid
sleep stories, and why I listen to
serial killer documentaries?
Serial killer documentaries,
true crime documentaries, I should say.
That's a bit more
uh nice to palate.
I don't know of them. My suspicion is
that they may be doing your deep sleep a
disservice. Anything Stick up for me in
the comments.
>> [laughter]
>> If you listen to true crime to fall
asleep, please write it below in the
comment section. If you find it
subjectively wonderfully pacifying
and calming,
and there is not death, I know I'm being
>> maiming, blood, and limbs being
distributed at high velocity all over
the scene, I would say it's great. But
if it looks like a Quentin Tarantino
movie or sounds like one,
may be harm and foul, rather than
helpful.
>> just in my ears.
>> But yes, so,
you know,
we forget that, to the best of my
knowledge, the meditation company called
Calm, now I have no affiliation with
them. They were doing somewhat well,
but what they realized is that they
wanted people to sort of meditate in the
morning. When they used looked at their
usage statistics, people were meditating
in the morning, but then there was a
huge swath of usage right before bed.
People were self-medicating their state
of insomnia. And then, through a stroke
of genius, they realized,
when we were young, we used to love
falling asleep to our parents reading us
a story.
Why is that any different when we become
adults? So, they created sleep stories,
and they went from struggling as a
company, I think, to becoming the first,
or one of the first, billion-dollar
valuation health companies out there.
They became a unicorn.
And now they can they've got, you know,
people like, you know, Matthew
McConaughey, they've got Harry Styles,
and then occasionally they've got a
you know, an unfortunate British sleep
scientist with a bad voice, but you can
listen to these sleep stories, and they
are wonderfully soporific. Why? Because
they get your mind off itself.
We we talked earlier on about melatonin,
and there are other supplements which
people talk a lot about. One of the ones
that's become really popular
is magnesium. I've heard ashwagandha,
and I've heard magnesium a lot. Yeah. Is
there any efficacy to these? Are these
Are these useful?
The first thing I would say is that if
you're suffering from sleep problems,
and you're looking to supplements,
you're stepping over dollars to pick up
pennies. Okay.
What you need to do is think about the
fundamentals.
Regularity.
Watch your caffeine intake.
Make sure you're not drinking too much
alcohol.
Get regular, dim down half the lights,
digital detox. Any one of those, but
especially all of them combined, are
going to get you log orders of better
sleep than reaching for the
latest supplement bottle of whatever it
is. The second thing to say is, think
about it from a logical standpoint. If
there were really some supplement that
promises to be the Shangri-La of all
resplendent sleep at night, the drug
companies would have been all over it
decades ago.
To put in context, it took George Lucas,
I think, about 30 years to amass
something like 4 billion in revenue from
the Star Wars franchise. It took Ambien
22 months.
That's how big a business sleep pharma
is. Ambien's what? A sleep pill? Ambien
is a sleep pill.
Magnesium, if you dig into it, and I I
did a deep dive about 3 years ago,
because I I kept hearing it, too, this
magnesium, magnesium. The first thing to
note is that most forms of magnesium,
magnesium oxy oxide or magnesium
citrate, most of these forms of
magnesium
don't cross the blood-brain barrier.
And sleep is produced by your brain. So,
how can something that doesn't get into
your brain affect
brain process number one? There is one
form of magnesium that seems to have
some evidence in favor of it. It's
called magnesium L- threo nate. But if
you look at the literature, where did
this story come from?
It turns out that about 30 years ago,
they started looking at people who had
disrupted sleep, and they would assess
their blood work. And what they found is
that some of those people were magnesium
deficient.
And when they supplemented them with
magnesium, and they became magnesium
normative, their sleep got better.
But that's very different than saying,
look, you and I were currently magnesium
normative,
and then dosing myself with high volumes
of magnesium, am I imagining that that's
going to make my sleep better? The The
analogy would be, let's say I develop
this incredible new oxygen saturation
machine,
and you say to me, well, but Matt, my
blood oxygen saturation right now,
looking at my device, tells me it's
98.6%.
It doesn't matter how fancy or good my
machine is, I'm not going to get you
past 100%. You're already at ceiling
level. Mhm. And that's the problem with
magnesium supplementation. If you're
magnesium normative, all you're doing is
creating probably expensive urine
at that moment in time.
Now, there may be an indirect benefit of
magnesium
in that it does seem to relax muscles.
And when the body is in a state of
relaxation, it sends a signal of
relaxation back up a branch of nerves
called the vagus nerve that goes up to
the brain and signals to your brain
you're starting to relax down, and you
get the state of quiescence. And that's
very helpful for sleep. So, magnesium
may still have an indirect benefit on
sleep through its relaxation kind of
policy that it instantiates in the body.
But overall, magnesium
is not really moving the needle, if you
look at the studies.
Ashwagandha
is different. Ashwagandha and another
compound called phosphatidylserine.
Phosphatidylserine
and ashwagandha, both of these
supplements seem to help do one of two
things. They either ratchet down the
fight-or-flight branch of your nervous
system, and they can also reduce the
amount of cortisol that the body is
releasing.
That's important, because
I see a lot of people coming to the
sleep center where I'm at, and they have
what I call the tired but wired
phenomenon, where they come to me and
they say, I am so tired. I am so so
tired, but I'm just so wired emotionally
and from a nervous perspective that I
can't fall asleep. And let's say that
you've done let's say, you know, an
on-stage event, and it's incredible.
You've got that on-stage buzz, you come
off stage at 11:00 p.m., and normally
you'd be fast asleep, but you know you
are so wired, it doesn't matter. You are
tired as tired as can be, but you're so
wired, you can't fall asleep. That's the
fight-or-flight branch being switched
on, and you just can't fall asleep. You
need to push it back off.
Phosphatidylserine and ashwagandha will
both push you back over into the more
quiescent, what we call parasympathetic
nervous system branch. That's good.
However,
they also will reduce cortisol, and
cortisol is a wake promoting hormone.
Cortisol is fine. We it gets a bad rap.
You need to have your cortisol start to
spike a few hours before bed and it
helps with the waking up process. It's
wonderful. Every day we have a cortisol
spike that starts happening before we
wake up. It's one of the things that
helps us wake up and then it builds us
to this beautiful crescendo mid morning.
Where you should be awakened
not needing caffeine. And it drops
before bed. And then it starts to peak
in a sort of middle early afternoon and
in fact usually peaks at late morning
hours I should say and then it will
start its awesome sort of down swing.
And what you see is that right before
you go to bed cortisol should hit its
lowest point, what we call its nadir,
its lowest trough. Mhm. What's
[clears throat] interesting by the way
just as an aside is that insomnia we can
classify usually as at least one of two
different types. There's actually
multiple but let's just say there are
of those multiple there are two types.
One is called sleep onset insomnia, I
can't fall asleep. The other is sleep
maintenance insomnia, I can't stay
asleep.
When they've looked at people's cortisol
on a 30 minute by 30 minute basis on the
24 hour clock face, we go through just
what we described. Just before we wake
up we get this rising cortisol, it peaks
late morning and then it drops down and
right before bed our cortisol is almost
at its lowest point.
With insomnia patients they show exactly
the same thing, a beautiful rise
in the late morning hours. It starts to
come down but then you see two
anomalies.
Right before bed it goes back up.
And then in the middle of the night even
when it's starting to rise it will have
this abnormal spike right in the middle
of the night too.
And what we believe is that that may in
part explain sleep onset insomnia.
Cortisol should be coming down and
should stay low right before we go to
bed but then it jumps back up in
insomnia patients. I can't fall asleep.
And then it continues to stay low
throughout the first half of the night
but then it also spikes in insomnia
patients. I can't stay asleep.
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We were talking about regularity, timing
and all these things and quality and
quantity.
But one of the things I learned from
your work is that that last hour is
potentially the most important hour of
me being in bed. And I I say this in
part because my my girlfriend she would
wake she'd have about six six hours six
and a half hours sleep. She sleeps very
very well, perfect sleeper. But she'd
always get up really really really
early. And
in part that was because of the the
guilt that I talked about. But I had a
conversation with her about the guilt
and I said, "Just stay in bed as long as
you need to stay in bed. Like just have
that extra eighth hour." And in part
that's because I learned that
the further we go in sleep, the more REM
we're getting. Yeah. Okay, can you
explain that to me with these four
blocks? Why that last hour is
particularly important and why we
shouldn't be jumping out of bed or why
we should be using certain sleep devices
to wake us up when we're at the end of
that last hour of REM. Absolutely. So
here we have the four blocks of sleep.
So when we first fall asleep we go into
light non rapid eye movement sleep stage
one. This is the stage of sleep that if
I wake you up out of it you say, "I
wasn't sleeping." Mhm. Now you it's just
that you're just in that transitional
phase, this beautiful liminal state
between the windows of wakefulness and
true sleep. So this is your bridge
between the waking world and the sleep
world and it doesn't last for very long,
maybe just 10 or 15 minutes at tops.
Then you get into the workhorse of
sleep. This is stage two non REM sleep.
50% of your night is spent in stage two
non REM sleep. I don't like the word
light non REM sleep. I've often used it
but it's not really it's we do a lot of
cognitive processing in stage two non
REM sleep. It's good stuff. It's not
just the stage that you have to go
through from sort of you know deep non
REM sleep to go back to stage two in
order for you to get to REM but I'll
come to that. So we have fallen asleep
10 minutes.
>> Yeah.
Now we're in stage two non REM sleep.
We'll stay there for about 15 or 20
minutes. Then if it's [clears throat] in
the first couple of hours of the night
we go down into the very deepest stages
of deep non REM sleep. This is where the
brain wave patterns slow down
but the brain waves become incredibly
big. Huge big powerful slow brain waves.
This is where you get an enormous amount
of restoration recovery of many of your
major physiological systems.
So physical recovery. Physical recovery
but mental too. Yeah.
It's during deep sleep that you take
newly minted memories that you've
learned and you hit the save button on
those memories so that you don't forget.
Deep sleep essentially is going to
future proof the information that you
just learned today.
It transfers information from a short
term storage vulnerable reservoir to a
more permanent long term storage site.
It's during deep non REM sleep when we
have this communication. So think of
those deep powerful slow brain waves
like long wave radio station when you
used to tune into a radio station in the
car.
You get huge ability for information
transfer across long distances across
huge paths in the brain. It's amazing.
So we've gone from light non REM. Then
we go down into deep non REM. We'll stay
there for about 15 or 20 minutes. Then
we'll start to rise back up again. We'll
go back into stage two non REM sleep.
Wait, we've gone from one two three to
two. Yes. So we've gone Think about it
more
almost like a roller coaster ride. So we
go from light non REM
and then we go down into stage two non
REM. Then we go down into deep sleep and
then we're going to rise back up into
light stage two non REM sleep. We're
going to stay there and after about 70
80 minutes you're going to pop up
and you'll have a short REM sleep
period. Oh okay, like this.
>> And this is beautiful. So this is what
we call a hypnogram. I'll put this on
the screen for anyone. Lovely. So what
I'm describing here is this roller
coaster ride. So we've fallen asleep,
light stage one non REM. Go down into
stage two. Then you go down and you have
a heavy period of deep non REM slow wave
sleep stage three.
And then and that's what you see on your
sleep tracker is deep sleep. This is
light sleep. This is deep sleep. Stage
two non REM sleep, light sleep, stage
three non REM sleep, deep sleep. But
then you'll start to climb back up and
then [clears throat] you may pop up and
you'll have a short REM sleep period
here after about 70 or 80 minutes. So
you'll have about 10 minutes of REM
sleep
and then back down you go again. You go
down into non REM sleep and then up into
REM. Down into non REM sleep and you'll
go up into REM. Down into non REM sleep
and up into REM.
So what's interesting however is that
the ratio of non REM to REM changes. Now
there's a myth out there and it's a bit
of a problem.
We humans have a 90 minute average non
REM to REM cycle. So we go down into non
REM sleep and then up into REM sleep
every 90 minutes. Then we go back down
into non REM sleep and then up into REM
sleep. So we go down into non REM sleep
and then up into REM in this 90 minute
cycle.
The problem is that
it's on average 90 minutes. It ranges
from 70 minutes to up to 120 minutes
from one individual to the next. So you
know these devices that you may have
seen tried to sort of you know
entrepreneurship, they say, "I'm going
to wake you up at the ideal moment in
your 90 minute cycle so that this thing
that sits on my bedside I tap it when
I'm the lights go out and then it's
going to go on its 90 minute cycle and
it's going to figure out the perfect
moment to wake you up." It's nonsense.
Because my sleep cycle may be 75
minutes, yours may be 105 minutes. It's
got no idea cuz it's using a hard coded
90 minute cycle. It's it's in some ways
nonsense.
But we go down into non REM sleep and up
into REM sleep every 90 minutes. What
changes however is the ratio of non REM
to REM within those 90 minute cycles as
you move across the night such that in
the first half of the night the majority
of those 90 minute cycles are comprised
of lots of deep non REM sleep and very
little REM sleep. But as you push
through to the second half of the night,
now that seesaw balance shifts over and
you spend much more of your time in REM
sleep in the second half of the night
and particularly just as you said in the
last two hours of the night. Why is this
consequential? Well, just as you said
and you spoke about for your girlfriend,
let's say that you know I normally go to
bed for argument's sake and I'm not
saying this is the ideal time but I go
to bed at midnight to make the math
easy, and I wake up at 8:00. But
tomorrow, I've got to catch my flight
back home. So, I'm going to wake up 2
hours early. So, I'm going to wake up at
6:00 rather than 8:00. I've lost 2 hours
of sleep. So, how much total sleep have
I lost? Well, I've lost 25% of my total
sleep, 2 hours of my 8 hours, 25%. Well,
yes and no. I've lost 25% of my total
sleep,
but I may have lost
50, 60, 70% of all of my REM sleep. Why?
Because REM sleep comes in the second
half of the particularly those last
couple of hours of sleep. So, that's why
it's not just academic that you
understand the sleep cycle relationship,
but it's also pragmatic because it can
impact the amount In fact, the easiest
way, if people said, "How can I get more
REM sleep?"
I would say, "Just sleep 15 minutes
later into the day than you normally
would do, and you will
disproportionately bias yourself towards
getting significantly more REM sleep."
And why does REM sleep matter?
REM sleep is a brain state, firstly,
that is incredibly active. In some In
fact, some parts of the brain,
particularly if I were to show you these
deep emotional centers of the brain, as
I pull this brain apart,
so, we've got these sort of deep
emotional centers in the brain that sit
and in fact, they sort of they're more
just underneath in here tucked in inside
just next to your brain stem at the top
of it. And these emotional centers are
called the amygdala, and you have one on
the left and one on the right side of
your brain. That part of the brain,
together with a memory structure that
runs alongside it called the
hippocampus, those two parts of the
brain form what we call the limbic
system. And you may have heard of the
limbic system, so the emotional centers
of the brain. Those can be up to 40%
more active when you're in dream sleep
than when you're awake. Dream sleep?
Dream sleep is rapid eye movement sleep.
>> REM sleep? So, REM sleep is the stage
now It depends on how you define
dreaming.
If you define dreaming as any mental
activity reported upon awakening, then
you dream in all stages of sleep, light
non-REM sleep, deep REM sleep. So, what
would What would that sound like? Well,
if I woke you up and said, "Steven, just
tell me what was going through your
head?" And you said, "Well, I was just
thinking about the next time you're
going to come in and wake me up." That's
just a dream thought.
What Most people think of dreams as the
dreams that we have from REM sleep, from
rapid eye movement sleep. That's why we
call it dream sleep. Dreams from rapid
eye movement sleep are florid, they're
narrative. In fact, last night when you
fell asleep and you went into dream
sleep, you became
incredibly psychotic.
Excuse me.
Now, before you reject my diagnosis of
your nighttime psychosis, let me give
you five good reasons. When you went
into dream sleep last night, you started
to see things which were not there. So,
you were hallucinating. Second, you
believed things that couldn't possibly
be true. So, you were delusional.
Third, you became confused about time,
place, and person. So, in psychiatry, we
call that being disorientated.
Fourth, you had wildly fluctuating
emotions.
Something that we call being emotionally
labile. You're all over the place.
And then, how wonderful, you and I, cuz
I'll include myself now as being
psychotic, you and I, we both woke up
this morning and we forgot most if not
all of that dream experience. So, we're
suffering from amnesia.
If you were to experience any one of
those five symptoms whilst you're awake,
you'd be seeking some degree of
psychological help. But for reasons that
we're only now understanding, it seems
to be a normal biological and
psychological process. So, what are the
reasons? Why do we dream? We dream for
at least two different reasons. The
first reason is emotional first aid.
REM sleep is what I've defined as
overnight therapy.
And it's during dream sleep where your
brain takes difficult, painful emotional
experiences,
and it acts like a nocturnal soothing
balm, and it just takes the sharp edges
off those difficult, painful
experiences, so that you come back the
next day and you have a memory of an
emotional event, but it's no longer
emotion You don't have that same
visceral regurgitation of of that same
emotional charge.
Why is REM sleep able to do this
overnight therapy, this deep
potentiation? Why is REM sleep able to
sort of strip the bitter emotional rind
from the informational orange, as it
were?
The reason is the following.
Dream sleep, REM sleep, is the only time
during the 24-hour period where the
brain shuts off a stress-related
neurochemical called noradrenaline.
Now, you've heard of the cystic chemical
downstairs in your body called
adrenaline. Well, upstairs in the brain,
we don't have adrenaline, we have
noradrenaline.
REM sleep is the only time
where it's completely shut off.
And what we put forward as a theory
called overnight therapy where your
brain
has, as I told you, these emotional
centers and these memory centers, the
emotional centers, the amygdala, the
memory centers, the hippocampus.
You reactivate those structures when you
go into dream sleep.
So, your brain gets the chance to
reactivate and replay and reprocess
emotional experiences. However,
it's doing it in a {quote} and {quote}
safe neurochemical environment because
that stress chemical of noradrenaline is
completely shut off. So, it's the ideal
neurochemical therapy
for stripping the emotion from the
memory.
And we put forward a theory that perhaps
the quintessential disorder where this
fails
is PTSD.
Because when you speak to those
patients, not only do we see that their
REM sleep is disrupted,
when you speak to those patients, they
will say, "Look, I just can't {quote}
and {quote} get over the event." What
they mean by that is
the war veteran who's now going to the
supermarket and they come outside and
they're in the car park and the car
backfires and they instantly have the
flashback to the the sort of detonation
on the military field.
And what's happening there is that the
brain has not stripped the emotion from
the memory. So, every time they relive
the memory, they regurgitate that same
emotional reaction. Mhm. So, no wonder
we proposed that the brain then comes
back the following night and says,
"Look, I'm sorry, sleep. I still got
this trauma memory. Can you do your
trick of stripping the emotion from the
memory?" And it fails again. So, in the
next night, it comes back and says, "I'm
sorry
to bother you, but I've still got this
emotionally charged memory. Please do
your trick of stripping the emotion from
memory." It fails again. This sounds
like the broken record of repetitive
nightmares that we see in PTSD.
Why could this be happening? Levels of
noradrenaline in the brain in patients
with PTSD are too high.
And I was at a conference some years ago
where I was presenting this theory. We
just presented this theory. It was a
theory, and it was in search of data.
And it turns out at the same conference,
it was one of those incredible moments
you get hairs on the back of your neck.
There was a psychiatrist from Puget
Sound, which is just outside of Seattle
on the West Coast of America,
and he had been treating his war
veterans in the Veterans Administration
with a blood pressure medication called
prazosin.
Now, it turns out that prazosin, it's a
generic drug because it's the Veterans
Administration, so it's cheap, and it
crosses the blood-brain barrier.
When prazosin gets into the brain, one
of the things that it does is shut down
levels of noradrenaline. Why was this
interesting? What he was perplexed by is
that he was saying, "I'm giving this
blood pressure medication to my war
veterans with PTSD.
It's not helping too much with their
blood pressure, but they're all coming
back saying, 'All of those repetitive
nightmares, they're starting to go away,
and I'm sleeping better and I'm feeling
better.'"
What he had done was inadvertently
treated their high levels of
noradrenaline, which were preventing the
brain from kind of stop dropping those
levels of noradrenaline down and
processing the emotion from the memory.
It was too high in those PTSD PTSD
patients, but by treating them with this
drug, he'd inadvertently brought the
levels of noradrenaline down during REM
sleep.
And then, it ultimately became one of
the only prescribed medications in the
Veterans Administration for repetitive
nightmares.
Because why? The brain had finally got
down into a {quote} and {quote} safe
chemical state because noradrenaline was
too high, but he treated them with this
drug. So, he had data that was in search
of a theory. I had a theory that was in
search of clinical data, and so, I raced
to him after he gave his presentation. I
said, "I think I know why you're finding
what you're finding." I flew him down to
Berkeley. We spent all day together,
went out for dinner together, and as I
said, ultimately, he went on to do
clinical trials in it. It's not a
cure-all for everyone, by the way. It
doesn't work for everyone.
But And I would say that there is now a
better treatment for nightmares if
you're suffering from nightmares,
and it's called image rehearsal therapy,
or IRT.
And it works through an incredible
mechanism of memory that we actually had
discovered about, gosh, 20 years ago
now, called memory reconsolidation.
So, when you learn information, it would
be Oh, let's take a Word document.
Wouldn't it be staffed if you opened up
a Word document, you started typing in,
you know, all this information, you hit
save, and then you come back tomorrow,
and you double-click on the document,
and Word has shut you out. You can't
edit the document. That's a really bad
information storage system. It's a bad
idea.
Your human memories are just like this.
You form new memories, then you sleep
and you save them.
But when you come back and you
reactivate that memory, when you recall
a memory,
you bring it back into this opened-up
state. It's like double-clicking on the
memory, and the memory becomes fragile
and malleable once again, so you can
update and edit that memory. And then
the next night you resave it. It's
called reconsolidation. So, the first
night I save it, that's consolidation.
Then I reactivate it, I modify it, and
then the next night I reconsolidate it.
So, coming back to nightmares, it turns
out that you can do this with trauma
patients who have nightmares caused by
trauma. For example, let's say that you
got into a horrific road accident,
and you went through your brakes failed,
you went through the red light, you got
T-boned. It was just traumatic. It's all
traumatic.
And what you do with the therapist,
because you're having these repetitive
nightmares of reliving that same car
crash every night,
you work with them and you tell them the
dream. You recall the dream actively out
loud. But then, working with a
therapist, what you do is you modify the
outcome. So, instead of me saying the
brakes failed, now in the new scenario
with your therapist, you say, "Well, you
look down and there's a manual handbrake
in the car." So, you realize that you
can actually just gradually start
applying the handbrake, and you bring
the car to a safe halt, and you go to
the side of the road, and there's no
accident. And what you're doing is
you're reopening back up that trauma
memory, and you're rewriting
the narrative.
And then you sleep, and you update that
memory. And by recalling and rewriting
the memory each and every waking day,
you end up dissipating the severity of
your trauma nightmare every single
night. And it's called image rehearsal
therapy for nightmares. It's incredibly
powerful. It's probably more powerful
than the prazosin drug that I spoke
about.
And I'm guessing
people don't sleep and also have
nightmares for a variety of reasons
relating to trauma generally. Ah, it's a
good question perhaps, which is in some
ways
what's the difference between a bad
dream and a nightmare? Mhm.
>> [clears throat]
>> Because all of us will have bad dreams.
Bad dreams are usually things that
happen infrequently. Maybe you have them
once every month, every couple of
months.
>> Yeah. The definition of nightmare
disorder is that you have to have these
dreams frequently, maybe at least twice
a week.
They have to wake you up
out of your sleep, and you have vivid
recall.
Plus, it has to cause you some kind of
daytime distress, where you're not
feeling good about the day. It's causing
you mental anguish. And furthermore, if
it starts to lead to hopelessness
or a sense that your life is not worth
living, you absolutely need to go and
see someone. And here's what we've
discovered about nightmares.
Short sleep duration, not getting enough
sleep, sleeping less than 6 hours,
predicts by about 100 to 150% higher
percentage chance of you having suicidal
thoughts,
attempting suicide, or tragically
suicide completion. That's bad sleep.
It turns out that nightmares,
so if short sleep has a 150% higher
likelihood of suicidality,
having nightmares has an 800%
higher likelihood of suicidal tendencies
associated with it. Now, we don't think
that nightmares are causing suicidal
tendencies.
That's not what we believe. We believe,
however, that nightmares, much more than
disrupted sleep, nightmares seem to be
the canary in the coal mine. Nightmares
are this distress beacon that leaks from
our electrical static of sleep at night,
and it is incredibly sensitive to your
suicidal tendencies, your suicidal
attempts, and as I said, suicide
completion as well.
Nightmares are a biomarker. If you are
having distressing nightmares that are
waking you up,
you need to go and speak to someone
about it. It's absolutely paramount,
because there are good, effective ways
that you can dissipate those nightmares.
I'm trying to understand whether it's a
a malfunction or it's a signal. I guess
it might be both. It's a very good
question, which is is it adaptive or is
it maladaptive? Is it a good thing to
have a nightmare, or is it a bad thing
to have a nightmare?
We don't quite have the answer to that.
But let me come back to I told you there
were two functions of dream sleep, and
we're still in the first one, which is
emotional first aid. And it turns out
that your thinking is incredibly astute.
We believe that at least normative
dreams, not nightmares. Nightmares may
be the system failing, just as I spoke
about in PTSD with repetitive
nightmares.
In fact, repetitive nightmares are so
consistent in PTSD that you can't
receive a diagnosis of PTSD without
having repetitive nightmares. That's how
sort of diagnostic they are. But
dreaming, normative dreaming, even if
they're bad dreams, is beneficial. How
can I make that claim? There was a study
done by a late sleep scientist, a woman
called Rosalind Cartwright,
and she was studying people who'd gone
through a difficult period, let's say
bereavement or a very bitter divorce,
and they had become depressed because of
that experience.
And around the time of the experience,
she was seeing them as a therapist, and
she was having them do dream recall. So,
she was having them create dream diaries
every single night. And then she tracked
these patients for a year. And it turned
out that about roughly half of them, by
12 months later, had remitted from their
depression. They got better. They'd got
past their depression. The other half
were still depressed. So then, she took
that data, and she went back with those
two groups, and she said, "Is there
anything different about their dreams?"
And it turned out that there was. Both
of those groups of people, whether they
could free of their depression or they
stayed in their depression, both of them
were dreaming at the time. Both of them
were having REM sleep. Both of them were
dreaming. What was the difference then?
Those individuals that went on to gain
remission
to their depression and get get better,
those people were dreaming of the events
itself at the time that they were
happening. Whereas those other people
who didn't go on to gain clinical
remission, they were dreaming.
They just weren't dreaming of the
experience itself. In other words, it's
not just sufficient to have REM sleep.
It's not just sufficient to have REM
sleep and be dreaming. You need to be
dreaming of the difficult, painful
experience that you're going through to
gain that clinical resolution. Damn. So,
if I have something going on in my life,
I need to think about it before I go to
bed.
Yes and no. [laughter]
What you have to realize is that
it's taken us,
depending on who you believe, 3.4
million years of evolution to develop
this thing called hominid sleep and
dreaming and REM sleep.
I think that
that evolutionary millions of years
probably understands what the correct
blueprint playlist of dream experience
is and should be for me at night. And
therefore, I don't need to worry about
it. I shouldn't try to force anything.
That's the first function of dream
sleep. Is that it's emotional first aid,
and we've got good data for that.
But there's a second, completely
independent benefit of dreaming.
Dreaming is a form of informational
alchemy.
Dreaming is creativity.
Now, I told you that during deep non-REM
sleep, we take new memories that we've
learned, and we fixate them like amber,
sort of setting a fossil in. And we do
that during deep sleep.
That saves the individual pieces of the
new stuff. Then comes along REM sleep,
which happens after deep sleep,
and the second phase of memory
processing happens. That's where REM
sleep starts to fuse all of the things
that you've recently been learning with
this entire back catalog of information.
And so, you wake up with a revised
mind-wide web of associations that is
capable of divining solutions to
previously impenetrable problems.
So, you know, it's almost
it's like group therapy for memories.
That REM sleep gathers in all of the
information that you've learned during
the day, and everyone gets a name badge.
But unlike the waking, logical
connections that you make already, REM
sleep is like a Google search gone
wrong. That you insert, let's say, diary
of a CEO, and it takes you to page 20.
This is dream sleep. Mhm. And it's about
some field hockey game in Utah, and you
think, "Hang on a second, but how on
earth is that?" Well, there was someone
who had, you know, they'd found a diary
that'd been lost, you know, a long time
ago, and the guy who'd found it was a
famous CEO in the town of this sort of,
you know, Utah as he was watching. So,
it's a distant, non-obvious connection.
But it turns out that that's what
dreaming is all about. It's [snorts]
almost as though we go to sleep with the
pieces of the jigsaw, but by way of
dreaming, we wake up with the puzzle
complete.
And when you start to fuse things that
shouldn't should not normally go
together, but when they do, every now
and again, cause a marked advance in
evolutionary fitness, that is the
biological basis of creativity. It's the
reason that no one has ever told you,
"Look, Steven, you should stay awake on
a problem."
They don't. They tell you to sleep on a
problem.
And in every language that I've inquired
about to date from,
you know, from French to Swahili, that
term, sleeping on a problem or something
like it, exists. My point being is
the benefit, the creative benefit of
sleep transcends cultural boundaries.
It's a common experience of Homo
sapiens.
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What is the uh most important thing we
haven't talked about as it relates to
the personas of those people that are
probably listening right now, and for
the reasons why they might have clicked,
you know?
They're probably looking Again, we have
the optimizers, we have those that have
bad sleep habits, and then we have those
that have real sleep disorders. What is
the most important thing we haven't
talked about that we should have talked
about for them?
It may be the dystopian future. Let's
talk about the dystopian future, then.
>> [laughter]
>> What is a podcast if it does not
contain, at least in this day and age, a
dystopian future? What is the dystopian
future?
Probably the most spectacular discovery
that has happened since you and I last
spoke,
is the discovery of what we call the
genetic short sleepers.
These are individuals who, by way of a
genetic mutation, can survive on as
little as 6.25 hours of sleep, in other
words, 6 hours and 50 minutes of sleep,
and they show zero impairment in the
brain or their body. They can do just
fine on 6 hours of sleep. I know where
this is going. And we have four genes
that we've identified now. The first two
genes, the first one identified was
called the DEC2 gene, DEC2 gene. The
second was called the ADRB1 gene, which
I granted, I know it sounds like the
next Radiohead album, but it's it's not
the next Radiohead album.
And these genes allow these individuals
to get away with an amount of sleep that
normally would cause predictive disease
and sickness, just as we've spoken
about. So, at this point, probably some
people listening are thinking,
I think I'm one of those people.
Just to put it in context,
your the probability that you will be
struck by lightning in your lifetime is
0.0064.
Highly unlikely. The chances of you
having the ADRB1 gene is 0.004.
And the AD BR1 gene is the short sleeper
gene? It's one of the short sleeping
genes. So, in other words, you are
statistically more likely to be struck
by lightning in your lifetime than you
are to have that short sleeping gene.
So, the probability is is is low. By the
way,
why is this the case? Why do they get
away with this? And we've discovered
now, by using sort of genetic
manipulations, we understand why. First
thing is that they have a much stronger
wake drive during the day. So, you and I
and all the rest of our mere mortals
will have these kind of like
oscillations in our consciousness
throughout the day, where we'll have
dips, where we feel a bit sleepy and
we're dragging, and then we'll kind of
get They don't have that. They have It's
like a light switch, like a dimmer
switch. You and I, we may sort of go up
to like 80% brightness when we're awake,
and then sometimes we'll flicker, and
then we'll go down, and we'll have
pretty solid sleep, maybe sort of, you
know, down to 20%, but the lights are
not quite off, you know? Our sleep is is
good, but not amazing. These people have
an all or nothing phenomena. They are
all 100% bright light throughout the
day.
And then, and they can maintain 17, 18
hours of wakefulness, no problem.
And then, when they sleep, they sleep
hard. They have much more efficient
sleep. Remember we spoke about sleep
efficiency, and I wanted 85% or above.
Almost all of their time at night is
spent in solid, stable, sound
sleep. And the depth of their sleep they
have is greater. So, they're awake more
throughout the day. They build up a
stronger wakefulness
>> happens. It's not that I'm against that
idea.
I would love for the burden of disease
and sickness to be reduced, and people
not to suffer from that. And if I could
find a way to do it genetically, I
would.
And you could think about people
arguing, "Well, imagine the productivity
benefits." I mean, huge upside of that.
You know, people are being more
productive, and they're probably
spending more. So, from a capitalistic
society, it's the perfect It's the ad
man's dream. Because when when you're
asleep, it's antithetical to a
capitalistic society. Why? Because
you're neither producing nor consuming.
That's very cynical, and I don't buy
into that, but nevertheless.
So, all of these things would be
markedly better, would they not be, if
we genetically engineered this way? Why
do I fear it?
I know for a fact that as soon as six
becomes the new eight,
everyone starts sleeping four.
And now I'm just in back into the same
battle again. Because six is the minimum
that you need, and they say, "Well, if
that's the minimum, then I'll sleep
four." And when I find the next gene
that allows you to get away with 4 hours
of sleep, then they say, "Well, that's
great, so then I can go down to two."
And it's a form of almost this sleep
currency, you know,
inflation that I'm always fighting a
battle, and at some point, I'll always
be on the wrong side of that battle.
Crazy. These people with this gene
can thrive on 4 to 6 hours sleep without
any negative effects
that most of us would experience.
>> [clears throat and cough]
>> Correct. It's I'm So, you know,
what is going on there? And what we're
seeing is this this incredible density
of sleep, and this
epic drive for wakefulness. They are
more efficient sleepers. They can get
done what you and I take 8 hours to do.
They can do it in six. And I guess you
Is there a way to easily test this? I
guess go to a lab and get
>> Yeah. So, if you've ever done, you know,
I think um you know, all of those
genetic testing kits out there where you
and a lot of them will allow you to
download your raw data. All you need to
do is download your raw raw data and
then there's a company, I think it's
called Prometheus. Again, I have no
affiliation with them. I don't know how
valid they are. But then you upload your
raw genetic data into their model and
then it will list and it will rip it
apart. So normally those genetic
services, they give you a nice PDF and
it's kind of like maybe 15 pages of all
of the the main stuff and it's This
Prometheus is kind of like the, you
know, the old-school kind of scientist
nerdy. They will just give you this kind
of raw just kind of janky, you know,
50-page report.
The interface is terrible, but you can
go in there and you can search to see
you know, what form of the DEC2 gene do
I have or what form of the ADRB1 gene do
I have and it will tell you are you a
genetic short sleeper or are you not?
And you can find out. I've been thinking
a lot lately about
about certain diet states as well and
whether that they have an impact on
sleep. We're talking about circadian
rhythms. So I was thinking about fasting
a lot and also think me myself and Jack
over there are
in ketosis right now. I was wondering if
you
when you think about brain performance
and sleep and different sort of states,
do you think much about fasting or
about ketosis or
Yeah, it's it's a mixed bag if you look
at it. Certainly what you eat will
change how you sleep.
But perhaps more powerfully is how you
sleep
dramatically changes how you eat and how
you dispose of those calories and what
happens inside of your body when you are
underslept.
But So I have lots of cravings when I've
short slept. Yes, you have and there's a
reason why
is firstly two appetite hormones called
leptin and ghrelin will go in opposite
directions. So
they sound like hobbits, I know, and
I've got some Lord of the Rings thing
here, but
leptin is the signal that says to your
brain you're full. Yeah. You're you're
satiated. Don't eat anymore. Ghrelin is
the opposite. It kind of makes your
stomach tummy growl and it says you're
hungry. You're not full. You need to eat
more. When you are underslept, leptin,
which says you're full, stop eating,
that hormone is impaired. It drops away.
So you lose the I'm full signal and
worse still, the ghrelin signal, which
says I'm hungry, that increases.
And so now you have about a 30 to 40%
increased hunger drive. And the final
part of this is that when you are
underslept and taking on board calories,
the way that you dispose of that energy
is different.
Your body has a higher predilection when
you are sleep deprived to disposing of
calories as fat rather than storing it,
for example, as glycogen in the muscles.
Oh, so when I'm underslept, I'm That's
why, you know, you're more likely to get
belly fat. Correct. And what's worse is
that there was a great study where they
looked at people who were dieting
and either getting sufficient sleep or
not getting sufficient sleep. What was
fascinating is that both of those
groups, whether you are well slept or
not well slept, you both lost weight. In
fact, you lost about the same amount of
weight. So you think, okay, so that's
fine. The problem was if you looked at
what you were losing, there was an
issue.
Those people who were dieting but not
getting sufficient sleep, 70% of all of
the weight that they lost came from lean
muscle mass
and not fat. In other words, when you're
not getting sufficient sleep, you keep
what you want to lose, which is fat, and
you lose what you want to keep,
which is muscle.
>> Oh gosh.
Damn, it's important, isn't it, this
sleep stuff? But coming back to ketosis,
by the way, I would say when people go
into a fasted state, usually what we see
is that the sleep gets shorter.
Mhm. And they'll say, I sleep almost
more efficiently. I'll sleep for maybe
just 4 or 5 hours, but I feel more alert
and more awake.
Now, some of that has to do with the
ketosis. When you are calorically
deprived,
the brain starts to realize that
something is wrong because you are
lacking calories. You're going into
starvation. So it drives on a chemical
called orexin. Orexin is a
wake-promoting chemical and it forces
your brain to release much more of this
wakefulness chemical called orexin. So
now when you're fasting, it's easier to
stay awake for longer and your brain
will deliberately stop you from sleeping
as much. Oh. It's not because it wants
you to sleep less. It's because the only
time during our evolutionary past that
we experienced short sleep was when we
were in a caloric deficit and the reason
came comes back again to this idea that
you have to stay awake longer cuz you're
not finding food. Now, your brain
doesn't know you've deliberately decided
to fast, which is a good thing in lots
of ways.
But that's one of the reasons that when
people are fasting, they'll say my sleep
goes to Yeah, mine
>> heck in a handbasket, you know, it's
>> really, really short. So when I'm I'm in
ketosis now and I'm like in on my way in
and my sleep will reduce to about five
five, six hours. My Whoop scores plummet
Yeah. until I kind of come out the other
end, which might take a couple of weeks
and then my sleep scores seem to
stabilize again. But that initial
transition period, it looks like it's
having a physiological shock.
>> It is and it the shock is this chemical
orexin, which is this wake-promoting
chemical, which will force you to stay
awake in a very solid fashion. By the
way, case in point, people with
narcolepsy,
this sleep disorder where they
inadvertently and uncontrollably fall
asleep during the day, they have the
opposite. I'm just telling I was just
telling you that when you are fasting,
your brain dumps out this chemical
orexin to force you awake and you're
wide awake.
People with narcolepsy, when we've
studied their brains, they have a
deficiency of this brain chemical
orexin. So they can't stay awake in a
stable fashion. They have the opposite
of your fasting problem. You're wide
awake because you've got too much
orexin. They've got too little orexin
and they therefore they can't sustain
stable wakefulness during the day. So
they're constantly falling asleep. Mhm.
This story of orexin has led to the
invention of the first new class of
sleeping medication that I actually
favor and most people are not aware of
it. It's a new class of We're on to
essentially web 3.0 of sleep medication.
Web 1.0 were the benzodiazepines, things
like Xanax and Valium. Not great for
sleep.
The second wave, the web 2.0, those were
things like Ambien, Lunesta, Sonata.
Both of those drugs worked in a very
similar way where they go up to your
cortex and they tickle a a receptor
called the GABA receptor, GABA, g a b a,
and it's the major neuroinhibitory
transmitter of the brain. So when these
drugs flood your brain, they just hit
the red light and they stop neural
firing of the cortex. Essentially, they
sedate you. And sedation is not sleep.
But when you take an Ambien,
you mistake sedation for sleep. It's not
quite the same. It's not naturalistic
sleep.
But after we
realized by way of the story of
narcolepsy that narcolepsy patients,
they don't have this chemical orexin and
they're falling asleep inappropriately
during the day.
Well, think about what insomnia is at
night. Insomnia is almost the opposite
of narcolepsy, which is that narcolepsy
patients, they're falling asleep during
the day when they want to be awake.
Insomnia patients are awake at night
when they want to be asleep.
So what they realized is that what we
can do if this chemical orexin, this
wakefulness volume button in the brain,
is a problem in insomnia patients, what
if we were to just develop a drug that
doesn't sedate the cortex like Ambien?
Instead, it goes down into the brainstem
where the center for orexin is. And
these new drugs, and they're called the
DORAs drugs, d o r a small s. And
they're a class of drugs. There are
three FDA-approved.
I'll try and spell them out for you.
They're called suvorexant, lemborexant,
and daridorexant.
Exact
Why am I synapses are filled with things
like those names, but there you go.
They're three FDA-approved drugs.
And what they do is they act like a
clever set of chemical fingers. They go
down into the brainstem where this sort
of orexin is being released and they
just dial down the volume on wakefulness
and then they take a step back and they
allow the antithesis of wakefulness to
come in its place, which is this thing
called naturalistic sleep.
Now,
if you look at that there's clinical
data, they absolutely make you sleep for
uh not necessarily a longer period of
time, but you're awake a lot less. So
you've got nice sleep efficiency, more
continuity.
But I as a scientist could be very
skeptical and I could come along and
say, okay, so this new drug, it
increases your total sleep time,
improves your sleep efficiency, but I
have four words, yes and so what? Just
because I've added sleep to your night,
how do I know that that's functional
sleep? How do I know that that's useful
sleep? Couldn't it just be like junk
DNA? It could be just junk sleep.
Well, they did a study where they looked
at what we call the glymphatic system in
your brain. There's a cleansing system
in your brain that kicks into high gear
during deep non-REM sleep and it flushes
the brain of all of the metabolic
toxins, two of which are things called
beta amyloid and tau protein, which are
the culprits of Alzheimer's and that's
why we know that sleep is so important
because at night it's a good night's
sleep clean. It's a power cleanse that
washes away the Alzheimer's toxins.
So, they did a study.
Heavens knows how they got these people
to participate. But, they brought them
in. They were 50 years or older.
And in the morning and the night before,
they had a lumbar spinal puncture and
they siphoned off cerebrospinal fluid so
they could measure how much of the
metabolic detritus was in the brain
before sleep and in the brain after
sleep, including
the metabolic waste products sort of
including beta amyloid and and tau
protein.
And they either had one of these drugs,
the doras drugs,
or they had a placebo. And fair enough,
when they took the the this new class of
medication, the web 3.0, the dora drug,
their sleep got better.
But, what they also found is that not
only did their sleep get better, but
they had cleansed the brain the next
morning of more beta amyloid and tau
protein than the placebo group. In other
words, it wasn't just epiphenomenal junk
sleep. It was beneficial sleep. It was
adaptive useful sleep because that
drug-induced sleep had washed away more
of the Alzheimer's proteins. And it was
the first demonstration and they've now
replicated it in animal models
that this is a sleeping pill that isn't
disadvantageous,
which we know to be the case for things
like Ambien. In fact, Ambien there's a
recent study that showed that it
decreases the cleansing pulsing fluid by
about 30 to 40% at night.
But, this is a new class of medications
that does the opposite. And this is new.
And this is new. The doras drugs, d o r
a small s. The problem is that a lot of
insurance companies here in the United
States currently do not reimburse. Some
do.
And I believe that it's some of these of
the three doras drugs, not all of them
are available in Europe or in the UK.
And because they're just so expensive.
And if you pay out of pocket, it can be
up to $400 a month
for these medications. Now, some
insomnia patients, when I go to them and
say at the end of a shockingly bad month
of sleep, if I went to them and said,
"Look, if you gave me $400 now, could I
I could wave a magic wand and eradicate
all of that bad sleep over the previous
month?" Would you like to give me $400?
Most of them would say, "Absolutely.
Take my money." But, still people are
being priced out at this stage. But, the
doras drugs, please look into them if
you're struggling with insomnia as well
as CBT-I. I didn't realize there was so
much new science and research that had
been discovered on how to sleep well,
what's going on in the brain, and also
some of the lifestyle factors that have
made sleeping so hard for so many
people.
And with that in mind, I want to do
something that I've never done before,
which is a world first for the Diary of
a CEO. Is I'm going to put a link below
because I think this is what a
particular episode where if you share
this conversation with some of your
friends who particularly struggle with
sleep or are sleep optimizers or who
have sleep disorders, they'll get a ton
of benefit from it. So, what I'm going
to do is in the description of wherever
you're listening to this podcast right
now, there is a link. And if you click
on that link, um you'll see that you've
got your own personalized link to share
this episode. And those of you that
share this episode, whether it's on your
story on social media or in a WhatsApp
group or wherever, on email, with your
friends,
you will collect points for every person
that listens. And I will reward
um you'll see as you click on the link
who have shared it the most. I in part I
say this because so many people come up
to me in the street and they came up to
me after our last conversation and they
said, um
"That conversation you did with Matt
Walker was so amazing. I sent it to my
aunt and she now she did this and she's
changed this and blah blah blah blah and
she's now sleeping well." And then all
the downstream impacts of that have been
profound. So,
I'm going to create this little system
to encourage all of you to share it with
someone that is struggling at the moment
with sleep because I do believe I do
believe that sleep is upstream from so
many of the downstream symptoms that
ruin our lives, whether it's
relationship issues, whether it's libido
issues, or whether it's creativity
issues. I mean, I was reading through
your work and I saw your conversation
with Rogan not so long ago where you
talked about the fact that a
sleep-deprived person has their genes
fundamentally working differently. You
talked about 700 genes working
differently.
>> Yeah, 711 genes are distorted in their
activity caused by a lack of sleep. Some
genes that are overexpressed that are
related to cardiovascular disease or
stress or inflammation and other genes
that are impaired, which are associated
with your immune system so you become
immune deficient. And it can be a
downward compounding spiral if you're
such a person that's really continually
struggling struggling with sleep and
building up some of that sleep debt. So,
that link is below. Check it out. And we
have a closing tradition on this podcast
where the last guest leaves a question
for the next. The question left for you
is, "What did success bring you that you
never could have dreamed of?"
It brought me two things.
One
beneficial, one lesser.
Beneficial is that
I have now the chance and have gifted
the chance to
fly around the world and
try to speak the word of sleep
because the physiology of it is so
silent.
And I used to lament, "Why me?" Because
there's so many other much better sleep
scientists in the world than me.
And a friend after I was saying like, "I
don't understand why me? I have imposter
syndrome." And he just told me to
shut
up
and accept that it's you and instead ask
the question, "What are you going to do
with it?"
And I changed how I embraced that. So,
I've been so fortunate that my life
after publishing the book that you're
holding
changed forever
and almost all for the better. And I'm
so fortunate. I've lived a life of such
fortune by way of the sleep mission.
I would say though that there is
also, and I suspect you may experience
some of this too,
when you raise your head above the
public parapet,
don't be surprised if shots are fired.
And
if you're someone who has even the
vaguest
hint of insecurity,
>> [laughter]
>> comments will do you lovely disservice.
And so, I think there's a degree of kind
of vulnerability and insecurity that you
can develop by way of becoming someone
who is in the eye of the public that had
I not been in the eye of the public, I
probably wouldn't have been, you know,
as self-conscious about whether it's,
you know, your intellect or your voice
or your
you know, disastrous, you know, boy band
haircut, whatever it is.
Um I would say that's the only slight
downside. Overall, I am the most
fortunate human that I know.
I'm so gifted by way of this thing
called sleep. It's a love affair that's
lasted me almost 25 years.
And I believe it's the most beguiling
topic in all of science. And it has
treated me so well.
You happy?
More than you could imagine.
At this moment in my life,
I am
the happiest I've been.
Why?
I have a
a peace that I found in life
for reasons that I can share or not
share. And Go ahead and share them. I'd
love to hear about this in my life. You
know, I found my person. Okay. And
and she is she
appeared like lightning from a clear
blue sky.
Never saw her coming.
And
it's interesting that
I've never been able to be more myself
even with myself
than I have with her.
Every day she makes me want to be a
better person.
And
I found peace
that I've never had before.
That you've never had before?
No.
Did you have peace last time we spoke?
I wouldn't say I was
without peace.
I didn't know this type of peace.
And I never believed in this notion of
the one. You know, I was a scientist,
I'm a hard-nosed empirical kind of guy.
And I just did not imagine it would be
such
uh I didn't think there was such a one.
I would have told you if you'd told me
that 2 years ago
you'd give me your love story of
certainty, I would have thought you were
misguided and that,
you know,
you just need to put down whatever
substances you're using cuz you're
delusional cuz there isn't such a thing.
Um
she's a gift.
And I hope I never take her for granted.
I doubt it. There's also an incredibly
sad story
of a gentleman called Clive Wearing.
And Clive is a famous individual in the
neuroscience world.
And Clive was the man who the movie
Memento
was based on, which is a movie where a
man has
brain damage and he has profound
amnesia. And from that moment forward,
he can never make any new memories
whatsoever. He's densely amnesic.
And he was a real-life individual. He
contracted a virus that destroyed his
memory centers. And from that point
forward, he could no longer make any new
memories.
And he lived in just two or three
seconds of time. And that spotlight of
consciousness just moved forward in
time. He had no recollection of the
past. He had no anticipation of the
future. And the only thing the only
person that he remembered and he would
recognize is his wife. So, he could have
spent this whole 3 hours speaking to
you.
And then you would walk out the room for
5 minutes and you would walk back in and
you'd say, "Hi Clive. Nice to meet you."
And he'd say, "Hi, what's your name?"
Had no recollection. The only person
that he remembered was his wife.
But the problem was he never remembered
how long it's been since he last saw his
wife.
And so every time that she would walk
into the room after being out of it for
5 minutes, he would jump out of his
chair and he had this incredible
elation.
And he would run and he would hug her
and kiss her.
And I think sometimes we take our
partners for granted.
And the only time we realize how
precious they are is when they're gone.
And I often think about that that
complacency
can be one of the greatest negative
forces in a relationship. And I always
think about Clive Wearing
even on the days where I'm having a bad
day or I'm in a bad mood and I knock
myself or I just don't want to be around
someone, I always try to remember his
reaction.
And when my wife walks back in from work
or I see her, you know, first thing
I try to remember how his reaction was
and
how I truly feel at the time despite the
blanket of negative
stress
trying to drown that feeling out.
It's a beautiful thing. I think about
that a lot as well.
In what way? Just the part of I'm way
more cognizant now
on a frequent basis, almost on a weekly
basis, of how I'm going to feel
when my time is up as it relates to my
romantic relationship. Like I think even
like mid-argument I will now think and I
mean this actually happened like a
couple of days ago. It wasn't really an
argument, we were just disagreeing about
something. I literally said mid mid uh
dispute that we were having, I said,
"We're going to regret this so much."
And what I meant was when I when that
day when that phone call rings and
someone gives me bad news that either
I'm going or you're going I'm going to
regret that this 30 minutes was wasted
doing this. Yeah. I'm really going to
regret it. How much would you give to
have that 30 minutes back?
>> Exactly. And it's like, you know, we're
[ __ ] arguing about I don't know, some
chocolate, whatever it might be, some
trivial thing. It's actually really
helped me because in the midst of those
storms I'm thinking through to that
moment when you get that phone call and
like you're ill or I'm ill and some
we're not going to be around much
longer.
Um it liberates you from
the pettiness that a sense of
immortality can create and that
pettiness results in the complacency
that you're describing that like
I did I took you for granted. Yeah. So,
it's a nice little mechanism now for me
to go, "Is this an important thing? Is
this really important?" And I have to
provide nuance there which is this
doesn't mean don't address things.
>> Correct. Yeah, I was just about to say
conflict is critical. You've got to
fight well. But let it be me and versus
you and the problem. Like me and you
versus the problem versus me just going
at you. Yes. You
>> You have to be fighting for each other,
not fighting against each other.
>> Yeah, exactly. And then you have to try
to then in that context of Clive Wearing
don't shy away from conflict if you need
to have the conversation.
Often it's like the gym. If you do it
well
you even on the days when you kind of go
into the gym, you think, "I I don't want
to do this or I just I don't feel good."
You always come out feeling better than
you did before.
And with conflict, if you do it well
you typically it may not be the hour
after or even the day after, but if you
do it well, you typically are better as
a couple
after than you were before the conflict
as long as you do it well. So, I'm not
saying don't have conflict. What I'm
saying is
Clive Wearing's story to me
of how he loved his wife with an intent
that I'd never experienced before until
I met my much better half
prevented me from resentment.
Resentment is the barrier that will keep
you from reparation
and a future of I think equanimity.
Because when you resent someone it means
that you haven't processed, you haven't
moved forward. And resentment usually
comes by way of I think a poor choice of
things such as, "Did I win the argument?
Did you win the argument?" It's not
about point scoring at least. And I've
done that before. I've been guilty of
all of that behavior.
But now with this person that I cherish
most
you know, I think of his lessons. It's
not that we don't have conflict, we do.
It's just that I value the person far
beyond the conflict afterwards. And I'll
always want to reach out with an olive
branch.
Because it's not worth it just as you
said when that call comes
you know, I I think of that sometimes
when I have a bad day. Let's say
someone, you know, I come back to my car
and my car has been rear-ended when it's
been parked.
Or, you know, I was coming here to fly
out and we were
4 hours on the
tarmac waiting
and there's a guy in front of me who's
getting all agitated and giving the the
ground staff all sorts of vitriol.
And I was thinking, "Look, when you're
on your deathbed, my good fellow
are you going to look back at this day
and think, 'Gosh, you know, I remember
that one day when I was on that flight
coming out to LA and it was 4 hours
delayed.'" No, of course you're not.
So, if you're not stressing about it
when you're dying, why are you stressing
about it now? Mhm.
It's just not worth it. Mhm.
Live.
Thank you.
Thank you so much. I mean, I can't thank
you enough for the profound impact
you've had on so many millions of people
um being the
the chief torchbearer of the subject of
sleep and creating a movement around
sleep, but also a heightened awareness
of ourselves and our struggles. And that
is something that you'll never
understand. Like you'll never understand
the full magnitude of the many millions
of people you've positively impacted. Um
but I mean, even though you'll never get
to meet them all and you'll never get to
hear all of their thank yous
they are very very real people and they
are they you they them themselves are
these little ripples through the ocean
where their children and then the
generations to come get to sleep better
and enjoy their lives and live a
happier, healthier life because of the
work that you do. So, it's um incredibly
important work, Matthew. And I hope you
long continue it and a long a long
continue being the conduit of this very
important information to people like me
and my audience. Can't appreciate you
more. Thank you so much for saying that.
I
can't lay claim to any such um
uh
affirmations, but I would say that I
stand on the shoulders of giants and
that um I am simply relaying all of the
incredible work of all of my colleagues
in the field and all of those who came
before me. Um I'm just the mouthpiece
and not a particularly good one at that.
And for all of their work, it's really
the appreciation that I give to them.
So, thank you for giving me the
opportunity to say that.
>> [music]
>> Make sure you keep what I'm about to say
to yourself. I'm inviting 10,000 of you
to come even deeper into the Diary of a
CEO. Welcome to my inner circle. This is
a brand new private community that I'm
launching to the world. We have so many
incredible things that happen that you
are never shown. We have the briefs that
are on my iPad when I'm recording the
conversation. We have clips we've never
released. We have behind the scenes
conversations with the guest and also
the episodes that we've never ever
released and so much more. In the
circle, you'll have direct access to me.
You can tell us what you want this show
to be, who you want us to interview, and
the types of conversations you would
love us to have. But remember for now,
we're only inviting the first 10,000
people that join before it closes. So,
if you want to join our private closed
community, head to the link in the
description below or go to the
DOACcircle.com.
I will speak to you there.
>> [music]
[music]
[singing]