00:00:00
Here's the problem with magnesium supplementation when it comes to sleep. The first thing to note is that most forms of magnesium don't cross the brain
00:00:07
barrier and sleep is produced by your brain. So, how can something that doesn't get into your brain affect brain
00:00:13
process? All you're doing is creating probably expensive urine.
00:00:18
However, there is one form of magnesium that seems to have some evidence in favor of it which we can speak about.
00:00:24
But it doesn't stop there. There's so much new evidence that we have including this myth of 8 hours. my fear about
00:00:30
giving melatonin to kids. Why you keep waking up in the middle of the night and the invention of the first new class of
00:00:37
sleeping medication that I actually favor and most people are not aware of it. Okay, let me write this down.
00:00:42
Matthew Walker is back and the worldrenowned sleep expert and neuroscience professor is sharing brand new research to combat
00:00:49
the sleep loss epidemic and help you get the perfect night's sleep. So society, we have struggles with sleep at night
00:00:55
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
00:01:02
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
00:01:08
that you are statistically 49% more likely to prematurely die versus those
00:01:13
people who were most regular in terms of going to bed and waking up at the same time. And worse, they had a 57%
00:01:20
cardioabolic disease risk increase. What the science really teaches us that there are
00:01:25
four pillars of good sleep. And then there's this incredible new study looking at sleep banking. And this is
00:01:30
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
00:01:35
parent. And we can go through all of that. But if you were to push me to say the three most impactful things that you
00:01:41
can start doing tonight to start sleeping better, it would be
00:01:49
I see messages all the time in the comments section that some of you didn't realize you didn't subscribe. So, if you
00:01:54
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
00:02:00
that anybody that watches this show frequently can do to help us here to keep everything going in this show in the trajectory it's on. So, please do
00:02:07
double check if you've subscribed and uh thank you so much because in a strange way, you are you're part of our history
00:02:12
and you're on this journey with us and I appreciate you for that. So yeah, thank you
00:02:20
Dr. Matthew Walker. Here in front of me, I have these cards which I'm going to
00:02:25
reveal a bit later, but these kind of hold what you consider to be the four pillars of great sleep. But you also
00:02:32
spend much of your professional career just studying the brain generally to understand human performance and how we
00:02:38
can change our lifestyles and also introduce some of these new sort of treatments to improve how our brain
00:02:44
performs. And I want to talk about all of that as well, but to start for anyone that is unfamiliar with you and has been
00:02:49
hiding under a rock, how do you summarize who you are professionally,
00:02:55
the sort of academic references you're drawing on, and the experiences and research you've done so that the viewer
00:03:01
listening at home understands the full world that you operate in, study, and
00:03:06
have experienced. I am a neuroscientist by trade, but my specialty is sleep. the effects of sleep
00:03:13
on the brain and the body. And I've probably spent about the past two decades trying to understand exactly why
00:03:20
do we sleep? Because 50 years ago, the crass answer to the question, why do you
00:03:26
sleep was the following? You sleep to cure sleepiness,
00:03:32
which is the factous equivalent of saying, well, you eat to cure hunger. No, you don't eat to cure cure hunger.
00:03:38
you eat to support all sorts of physiological and biological benefits. But now, and this is not due to my
00:03:44
research, is this all of the incredible colleagues whose sort of shoulders that I stand on, we've now had to upend the
00:03:50
question. We now have to ask, is there any major physiological system in your body or is there any operation of your
00:03:57
mind that isn't wonderfully enhanced by sleep when you get it or demonstrabably impaired when you don't get enough? And
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the answer now seems to be no. There is no such system. Even down to the level
00:04:10
of your DNA, your sleep and how you are sleeping or not sleeping will change the very DNA
00:04:19
nucleic alphabet that spells out your daily health narrative. And we can see
00:04:24
it all the way up to society. Sleep can change the fabric of society, can change
00:04:29
how we interact with other people. It can change our belief systems. can change how lonely or sort of hypersocial
00:04:37
we are. So to your question, I'm a sleep scientist by trade and I suppose my
00:04:42
mission has been trying to reunite humanity with the sleep that it seems to be so bereft of.
00:04:48
We had a fantastic conversation last time and my audience valued it tremendously. I know that cuz we we
00:04:54
often survey our audience and we we get to see some of the the backend stats and this conversation about sleep is
00:04:59
particularly personal to everybody listening because when we surveyed our audience ahead of this conversation today about 75 or 80% of the direio
00:05:08
audience struggle with sleep for a variety of different reasons. So we actually asked them a thousand of them
00:05:13
their questions to ask you today. But also the other reason I really wanted to chat to you is the science of sleep I
00:05:19
mean as is the way of science is always evolving. We're learning new things and even since we spoke last time, there is
00:05:25
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
00:05:32
this jar because I always want to know what the updated sleep science is so that I can be a better sleeper because I
00:05:37
agree with everything you've said about how foundational sleep is in my life.
00:05:44
And um I didn't know this at the start of my career. I didn't know this even a couple of years ago, five years ago. I
00:05:49
didn't know. I thought sleep was one of those things you could just take it all or leave. Yeah. I mean, and it's not your fault in
00:05:56
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
00:06:04
mind for the most part is blank. So, is it so catastrophic to lose, you know, an
00:06:10
hour or two of sleep? And you know, you have to then think about from an
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evolutionary perspective, it is such an idiotic idea to sleep because when
00:06:21
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,
00:06:27
you're vulnerable to predation. So on any one of those grounds, and especially all of them as a collective,
00:06:33
sleep should have been strongly selected against in the course of evolution. And my point is that, and it's often
00:06:40
been said that if sleep doesn't serve an absolutely vital set of functions plural, then it's the biggest mistake
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the evolutionary process has ever made. And we now realize it didn't make a spectacular blunder. But really, I guess
00:06:51
to the point of it is sleep is not a passive state. It's an incredibly active
00:06:58
state both in the terms of the brain and the body. And so you should not feel
00:07:03
sort of you know remiss or ashamed that you didn't value the importance of sleep because firstly as a subjective sense
00:07:10
you just think well my mind was offline for a while. Second we also know that we
00:07:15
don't teach the importance of sleep in education and doctors themselves you know there's a great study and they what
00:07:21
they found was that medical doctors across I think it was about 11 different curricula around the world they will
00:07:27
only receive about 1.2 two hours of education on sleep, but it's a third of
00:07:33
their patients lives. So there's a collection of sort of almost perfect
00:07:39
storms that have happened to keep society ignorant of the importance and
00:07:45
the value of sleep. I think that's why we often so short change it together
00:07:51
with also something terrible which is stigma. that people are so proud to say, well,
00:07:58
I've been eating really healthy the past couple of months, or, you know, I've been going to the gym, you know, three
00:08:03
times a week consistently for the past year. No one is ever going out into
00:08:09
society and saying, you know, I I've been getting 8 and 1/2 hours of sleep consistently every night. Because if you
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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
00:08:23
sleep then you must not be busy and if you're not busy you must not be
00:08:28
important. So can you do me a favor and for the listener at home can you tell me what
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the different groups of people that are listening to this conversation right now
00:08:40
are seeking from the extreme end being sleep apnnea. I get no sleep. I'm an insomniac to the other end where maybe
00:08:47
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
00:08:53
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
00:09:00
who have other sleep disorders like sleep apnoa which we can speak about. There's another disorder called restless
00:09:06
leg syndrome. It's a terrible disorder where your legs start to feel as though they've got this sort of creepy crawly
00:09:11
feeling and you've constantly got to massage them and move them. It's a terrible disruptor of your sleep. All of
00:09:16
these disorders are marketkedly undiagnosed, by the way. And then you've got another collection of individuals
00:09:24
who they don't have any sleep disorders, but they are either doing things that
00:09:30
will dismantle their sleep. So, either they're taking on things into themselves
00:09:36
like alcohol, caffeine, THC that aren't the sleep helpers, even though sometimes
00:09:42
they think they are. And then you've got perhaps the internal things that will prevent you from sleeping well. Things
00:09:48
like stress and anxiety. And then you've also just got life itself that can get
00:09:54
in the way. And then moving from the sleep disorders realm to the I don't
00:10:00
have a sleep disorder, but I'm probably not doing it right quote unquote when it comes to sleep. Then you've got the
00:10:06
people who are obsessed about getting it right and they are the bio optimizers.
00:10:12
this sort of the you know the biohackers and then you've also got I work with a lot of high performance individuals who
00:10:20
are really trying to just scratch out those last couple of percentages either if it's in business or often we're
00:10:27
working with professional athletes. These are the people for whom two or three percentage point changes can be
00:10:34
tens of millions of dollars or they can be the difference between standing on a podium at the Olympics or not. And so
00:10:42
there's there's a broad collection of wonderful characters. And since we last spoke, is there now a
00:10:47
lot of new sleep science and understanding as it relates to sleep performance and these three categories
00:10:53
of sleep deficient sleep disorders, lifestyle factors and then the optimizers. Yeah, I think there's there's a broad
00:11:00
collection of new evidence that we have. But maybe let me come on to the middle
00:11:06
group. You know, I used to say that for people who were deficient in their sleep, that sleep wasn't like the bank,
00:11:14
that you can't accumulate a debt. Oh, here we go. Okay. So, what we can see
00:11:20
here is that the jar used to be full, full of sleep credit when you're sleeping well. And then during the week,
00:11:27
I'm short sleeping. So, maybe I'm only getting five hours a night. So, I'm constantly going into debt. So, I'm
00:11:33
losing all of this wonderful sleep credit and my system is building up this collateral debt. And then we used to
00:11:41
think that sleep was not like the bank. That once you've gone into debt, unfortunately,
00:11:49
the lid is closed and even at the weekend, if you try to pay it back, you
00:11:54
can't put back credit into the system. However, there was a study published
00:12:00
from what's called the UK Bioank, which is this incredible data set. It's revolutionary. And they studied in this
00:12:07
particular research uh paper over 90,000 individuals. And what they did was they
00:12:13
essentially split them down into those individuals who were short sleeping during the week and then short sleeping
00:12:19
at the weekend. And they compared them to those individuals who were short sleeping during the week, but then long
00:12:26
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
00:12:33
remarkable how many people do this this catch-up sleep behavior. But what was amazing is that in the people who were
00:12:39
short sleeping during the week but long sleeping at the weekend, they had a 20%
00:12:44
reduced cardiovascular disease risk relative to the people who were short sleeping during the week but also short
00:12:51
sleeping at the weekend. Now, to be clear, both of those groups had a higher
00:12:57
cardiovascular disease risk than people who were sleeping sufficiently during the week and sleeping sufficiently
00:13:03
during the weekend. So, I'm not saying that it's a completely free lunch. But for the first time, we realized that at
00:13:10
least one system, major organ system in your body is like the bank, which is
00:13:15
that if your heart at the weekend
00:13:23
you can just keep putting credit back and your
00:13:29
system doesn't suffer as much for your heart. For your heart. Okay. But again, many of the other major
00:13:35
physiological systems don't show that. So work by people like Kenneth Wright at the University of Boulder, Colorado,
00:13:40
he's shown that your immune system doesn't rebound after long sleep at the weekend, your regulation of blood sugar,
00:13:47
your cognitive ability. So that's one way in which I've changed my mind regarding sleep in the bank. But there's
00:13:54
a very different new set of data that has changed my mind completely about this idea of sleep and the bank. Now
00:14:01
what we've just discussed here is to say I went into debt and then I was hoping
00:14:08
to try and pay it off with credit at the weekend. So the jar represents the debt that you have the sleep.
00:14:13
Correct. Yeah. And what I'm trying to do is force more coinage
00:14:21
in at the weekend to see if I can offset the debt that I created and get back to
00:14:27
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
00:14:34
you want. But here's this new remarkable data. It came from um Walter Reed
00:14:39
Medical Army Institute, a researcher called Thomas Balkan. And what he was interested in was flipping the direction
00:14:45
of the question. Not if I go into debt, can I pay back with credit, but what if
00:14:52
I know in future I'm going to face a debt, an upcoming debt, can I do sleep
00:14:58
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,
00:15:04
can I sleep a lot before it to create a What would the financial analogy be? The
00:15:11
financial analogy would be, let's say that we're coming up to Christmas. Yeah. And you're going to spend lots on, you
00:15:18
know, presents and all sorts of stuff. So, I know that in October and November,
00:15:23
I'm going to tighten my financial belt. I see. So that when I go into the sort of
00:15:28
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
00:15:36
of a debt situation because I've built up credit. So you can create sleep savings.
00:15:41
Correct. It's a sleepsaving system. So essentially, you know, what he was able to do, not just put the jar to full, but
00:15:52
he was actually packing in even more
00:15:57
so that you almost got this wonderful
00:16:04
overflow of sleep. How did he know? He didn't. It was the experimental hypothesis.
00:16:10
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
00:16:16
two or three nights of either no sleep or marketked sleep reduction. And in the
00:16:22
week beforehand with these army cadetses, instead of being limited to 8
00:16:27
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
00:16:34
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.
00:16:43
So they were extending their sleep duration and so that they had built up this
00:16:49
buffer. It's almost like a sort of a a sleep safety net that's in place so that
00:16:55
when you go into the tumble of sleep deprivation, you're sort of almost bolstered and
00:17:02
you're lifted higher and therefore your degree of impermanment that you suffer under conditions of sleep deprivation is
00:17:09
significantly less if you banked sleep beforehand versus those people who were just sleeping normally and then faced
00:17:16
the deprivation. they went down much further in terms of their cognitive and mental performance.
00:17:21
So he gave them challenges and tasks to do correct in two different groups. One group had sleep savings saved up from
00:17:27
sleeping well the previous week. One group didn't. That's right. And they performed remarkably different. So both of them were impaired relative
00:17:34
to a sleep rested person. However, the people it's sort of you know how how
00:17:39
much of a drop in your cognitive performance do you suffer? And what he found was that people who had built up this credit,
00:17:47
this savings account of sleep in the days, in the week beforehand, they suffered about 40% less of an impairment
00:17:56
relative to the people who had not created any savings plan. Now, they
00:18:02
weren't in debt. They were just net neutral. But boy, did they drop quickly. Whereas
00:18:08
those people who'd had some cash in the sleep credit system, they didn't fall
00:18:14
anywhere near as far. But this is remarkable for people like you were saying who are facing, let's say, if
00:18:19
I've got a sprint at work or I'm a medical doctor, I know I'm about to go on call for the next 40 hours. You're a
00:18:26
military, aviation, all of the new parents. All of these circumstances are places where now we know athletes is a
00:18:33
great example. When we work with a athletes, people like Michael Grner have demonstrated that athletes sleep
00:18:39
terribly typically the night before a huge performance. No matter, you know, of course, they're nerves.
00:18:45
But what you can do is you can have them bank sleep in the days before when they're not as nervous and therefore
00:18:51
their performance doesn't suffer as much even though they know they're going to be deprived.
00:18:56
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
00:19:02
pushing the 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
00:19:08
me your book was just staggering. It was like that was the catalyst moment, I think, in society for the mainstream to
00:19:14
really start talking and caring about sleep. However, there's still so many people struggling um because of all the
00:19:21
factors that you talked about when we're talking about group two who have those lifestyle factors, the stress, the psychological factors, the trauma, etc.,
00:19:28
etc. What can we give them, those people, the people that really really struggle,
00:19:34
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
00:19:40
information or advice that we can give them that will help them once and for
00:19:46
all sleep 8 hours a night and get their life back?
00:19:51
If you were to push me to say what are the three most impactful things that you can start
00:19:57
doing tonight to start sleeping better, it would be the following.
00:20:03
Digital detox. Okay, let me write this down. Digital detox. Okay, what does that mean?
00:20:08
1 hour before bed, try to limit activating social media engagement,
00:20:17
email, and text messages that are going to trigger you. It's fine to listen to a podcast, you
00:20:24
know. Thank God for that. You heard it here, folks. Right from that book. But it's also good to like and
00:20:30
subscribe, would you say? I would say that you know like and subscribe and then just click here so that you get the
00:20:36
latest notification you get that bell just click on the bell icon so that you
00:20:42
so it's not a problem of blue light a quick aside we've been taught this myth
00:20:48
of the blue light effect from devices and it really is a myth because an incredible Australian
00:20:54
researcher a guy called Michael Gradazar has almost singlehandedly changed the the what I think of as being
00:21:02
the zeitgeist for a while after a very influential paper which is a great paper and what they showed was that 1 hour of
00:21:08
iPad reading before bed ended up impairing your melatonin it disrupted sleep it reduced the amount of dream
00:21:15
sleep and even after they stopped reading the iPad the blast radius impact on your dream sleep lasted a week it's
00:21:22
almost like the drug needed to get washed out the system that even when you you'd stop using technology for an hour
00:21:28
before bed the impact of that technology ology even though you'd stopped using it could still be seen in the echo of sleep
00:21:35
disruption for a week later. It was a very influential study in a very prestigious channel. When was that a while ago?
00:21:41
That was probably about 10 years ago. But then Michael Gretazar, this incredible Australian researcher started to say, well, I can't replicate these
00:21:48
findings. And what he was discovering is that it's not the blue light that's the problem.
00:21:53
Now, the blue light will change aspects of your melatonin. And melatonin is a hormone. It simply tells your brain and
00:21:59
your body when it's nighttime, when it's time to fall asleep. It doesn't participate in the generation of sleep.
00:22:04
Melatonin is like the starting official at the 100 meter race. It brings all of the races to the line and it begins the
00:22:11
timing of the race, but it doesn't participate in the creation of the race itself. That's a different set of chemicals.
00:22:16
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
00:22:21
together all of the individual studies on a topic and we put them in a big statistical bucket. What they found is
00:22:27
that melatonin will only improve the speed with which you fall asleep by about um 3.4 minutes and it will only
00:22:34
increase the efficiency of your sleep by about 2.2%. So not much more than
00:22:40
placebo. Um, so melatonin is it it's now
00:22:45
the placebo effect is the most reliable effect in all of pharmarmacology. So you know maybe no harm no foul I would say
00:22:52
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
00:23:00
run the risk of confusing your morning brain into a dense nighttime fog. And
00:23:08
what I mean by that is 10 milligrams or 20 milligrams of melatonin is what we call a supra
00:23:15
physiological dose, which again is just a fancy medical term to say it's a size of magnitude of melatonin that your body
00:23:22
would never naturally release. It's far greater. So melatonin is the signal of
00:23:27
darkness. And normally by the morning hours, our natural release of melatonin has stopped and you're down to zero
00:23:34
levels again in the morning. In the morning. So, you wake up and your body no longer has the signal of
00:23:39
melatonin saying it's night, it's night, it's night. But if you've dosed yourself with 10 milligs or 20 milligs of
00:23:45
melatonin, you run the risk of saying, well, yes, I know it quote unquote knocks me out. But the problem is in the
00:23:53
first, you know, 3 or 4 hours of the waking morning, you're struggling because you're in this fog of a hormonal
00:24:00
melatonin, a hormonal signal saying it's still pitch black. No, it's not. It's
00:24:05
bright light outside, but your body is fooled into thinking it's pitch black because you've dosed yourself too high.
00:24:11
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
00:24:17
taking? Somewhere between probably about 0.1 to 3 millig.
00:24:23
And do you advise melatonin for people? Yes, in two conditions. The first or
00:24:28
circumstances I should say. The first is when you're going through jet lag. Wonderfully helpful. But timing is
00:24:35
critical. You need to create that sort of that artificial signal of night because let's say that you and I here in
00:24:42
Los Angeles, we're both going to fly back to London tomorrow and London is 8
00:24:47
hours ahead. So, we fly overnight. We arrive in London and then that first
00:24:52
night, let's say we decide to go to bed uh or I decide to go to bed in the hotel at midnight. The problem is here in Los
00:25:00
Angeles and my body clock, it's still 400 p.m. because London's 8 hours ahead.
00:25:05
So, my melatonin is not going to rise for probably another 6 or 7 hours. So, I
00:25:10
need to artificially hijack my melatonin system and tell my brain, "Oh, no, it's
00:25:16
not 400 p.m. It's instead it's midnight." And so, there under
00:25:21
conditions of jet lag, very helpful. The second is if you have a circadian rhythm disorder. Let's say that you're someone
00:25:28
who has a an advanced circadian phase. What that means is you're someone who
00:25:33
really can't get sleepy until 3 or 4 in the morning and you would prefer to be sleeping throughout most of the day. So
00:25:40
you you're almost nocturnal. Is that a genetic disorder? And yes, it's a genetic disorder in part.
00:25:45
How many people have that? probably one to two% of the population have a very severe adv what we call an advanced
00:25:52
circadian phase disorder but their melatonin can also be helpful because once again their melatonin part of their
00:25:59
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
00:26:06
morning you and I we start to get our signal of melatonin depending on our chronotype by somewhere between about 9
00:26:13
10 or 11 p.m. they may be delayed by 5 hours. So if we can give them melatonin,
00:26:18
we can artificially try to fool their brain into thinking it's actually earlier in their biological rhythm. So
00:26:25
they sleep earlier and they're more in sync with the rest of society. How does someone know if they're that
00:26:30
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
00:26:36
bring you into a laboratory and we will measure your innate level. So we will shut out sort of all windows. All clock
00:26:42
faces are gone and we just let you run your natural rhythm. And they have the same rise and fall in
00:26:49
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
00:26:57
radically different. Okay? For you and I, it's, you know, 910 p.m. 11:00 p.m. at night when we're starting
00:27:03
that melatonin crescendo. For them, it's 4:00 in the morning. So, we can measure it. It's not in their
00:27:08
minds. It's not their choice. It's a biological edict. Are you concerned that melatonin is
00:27:15
becoming more and more popular as a way to solve lifestyle issues that have
00:27:21
caused sleep impairment? Because I'm seeing loads of, you know, I'm an investor, so I see lots of companies now
00:27:26
pitching me different products that have melatonin in them as a sort of
00:27:31
day-to-day sleeping supplement. I think I'm really torn. I've been on both sides of this argument and I'm
00:27:39
cautious about it for two reasons. The first is in pediatric populations here in the United States.
00:27:45
Pediatric Yeah. So the people's use of melatonin in kids is increasing. So in pediatric
00:27:52
populations it's increasing exponentially. And in fact, if you go down the sort of the supermarket aisles
00:27:59
here in America, often if you go into sort of the the health sort of food section, there's this big purple
00:28:05
section. That's the melatonin section. And a large proportion of that is there dedicated to gummies for your children
00:28:13
with melatonin. And there was a study that was published about three years ago that showed here
00:28:20
in America over the past 10 years there has been a 53%
00:28:25
increase in poisonous overdose admissions to hospitals of melatonin in
00:28:31
the past 10 years. 503% increase. So firstly, we've got to be a
00:28:36
bit careful. The second reason is that melatonin is a bioactive hormone and
00:28:42
it's also involved in reproductive development. And there studies done back in the 1970s I think where they were
00:28:48
looking at juvenile male rats which is to say male rats who are going through adolescence
00:28:53
and they were dosing them with high amounts of melatonin and what they found is that that stunted the development of
00:29:00
the testes of the testicles and it caused testicular atrophy. Now, these were very high doses, but we've got to
00:29:07
be a little bit careful. We think we say, "Well, melatonin is a natural hormone, so anything natural is safe."
00:29:14
Melatonin overall in terms of its safety profile is very safe. It's actually a very good antioxidant.
00:29:20
But you've got to be careful because things like for example testosterone supplementation in males what we know is
00:29:26
that if you're injecting testosterone after a while after maybe 18 months or
00:29:31
so the testicles themselves will stop producing their own testosterone and
00:29:37
even if you stop the administration of the exogenous testosterone the injection
00:29:43
the testes never return their function of producing testosterone. Now, we don't have any evidence yet that
00:29:50
that's the case that if you keep taking melatonin at high dose, your body, the fear would be shuts down its own natural
00:29:56
production of melatonin. I've seen no evidence of that. In fact, I've seen evidence the contrary that even after
00:30:02
about 6 months or even 12 months in certain small cities, when you stop melatonin, the production starts again
00:30:08
naturally. It seems fine. Problem is, people haven't been taking melatonin for just 12 months. They've been taking it
00:30:15
for years. We've got no idea what happens after years. That was my hesitation when the first
00:30:21
time someone offered me melatonin is from doing this podcast and speaking to smart people like yourself, I've come to
00:30:27
learn this sort of principle that if you start making something for your body in terms of a hormone, if you start sort of
00:30:33
um consuming something externally like testosterone, your body will say fine, I don't need to do this. It will try and
00:30:39
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
00:30:45
about the case of testosterone because men know that if we start injecting testosterone then we're going to have to pretty much do it forever.
00:30:51
Yeah. Um if we want those levels to be the same. Yeah. That's the worry is that there are no free lunches in biology and usually
00:30:57
if you fight biology you typically lose. There's always a tradeoff and some of my
00:31:02
friends often like talk to me about like these miracle things or this thing or take medafanol and everything will be fine and da but what's the trade-off?
00:31:09
And I get most concerned when they say there isn't one cuz then I go we don't know it.
00:31:14
Yeah, you've got to be careful because absence of evidence is not evidence of
00:31:19
absence. Be very careful when you're doing that deal with with your physiology. So to
00:31:28
come back to sort of the three things, the first thing we were mentioning is digital detox and don't worry about the
00:31:34
blue light. Worry about light in general. I'll come on to that because that's the second. But Michael Gratazar
00:31:39
as I was saying what he found is that the blue light doesn't really disrupt your sleep. It's a combination of first
00:31:45
these devices that we use are attention capture devices and they are designed to
00:31:52
fleece you of your attention economy and they do it ruthlessly well. They've spent tens of millions of dollars
00:31:58
designing these products to do that. So what happens is that these devices
00:32:03
become hugely activating and as a result they essentially will be a mute button
00:32:10
on your sleepiness. So you could be there, you get into bed, it's 11 p.m. You think, I am so tired. I was falling
00:32:15
asleep on the the the couch watching television and then you get into bed, you start going onto social media and then you start doom scrolling and then
00:32:21
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
00:32:27
11 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
00:32:35
attentiongrabbing devices that will mute your sleepiness, but you have to be of a certain personality type. He found not
00:32:43
all of us are vulnerable to this sleep disruption of devices. You have to be someone who is perhaps neurotic, someone
00:32:50
who has high impulsivity or someone who is perhaps high anxious. If you are of
00:32:55
any of those kinds, you should be really careful about your use of technology in the bedroom. Now, for me to, you know,
00:33:03
sit here and say, look, put your phone in the car, in the garage, and that way,
00:33:08
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
00:33:15
wake up, what is it that you do? No, no comment.
00:33:21
Lots of you. You, it's just you and I, Stephen. Um,
00:33:26
I grab my phone before my eyes are even open. And what happens is this sort of small tsunami of anxiety washes over you
00:33:33
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
00:33:39
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
00:33:47
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
00:33:53
anxiety. You are anticipating an anxious event in the morning. And studies have
00:34:00
shown that when we create this anticipatory anxiety, the amount of deep sleep that you have drops significantly.
00:34:07
You don't sleep as well. And therefore, if we just do this little sort of version, this lit version of the morning
00:34:15
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,
00:34:21
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,
00:34:29
I'm not going to sit here and say, "Well, don't take your phone into the bedroom because the genie is out the
00:34:34
bottle and no matter what I say, it's not going back in anytime soon." And a friend of mine, Michael Brander, has got
00:34:40
this beautiful uh framework where he says you can take your phone into your bedroom. It's fine.
00:34:46
But you can only use your phone standing up.
00:34:53
What's his name? Michael Grande. He's brilliant. Mind his own business. And and what happens is that you you're
00:35:00
there and you think after about seven or eight minutes, 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
00:35:07
say that digital detox is the first friend that will really help your sleep.
00:35:13
The the second is regularity. And we'll come on to regularity when we speak about you know what really makes for
00:35:19
good sleep. If you were to only do one thing, not three things, but just one
00:35:24
thing. Go to bed and wake up at the same time. No matter whether it's the weekday or the weekend, regularity is king.
00:35:32
Okay. So that's the third pillar. That's correct. Regularity. Okay. And then I have
00:35:40
the T for timing. Correct. Which we'll go through these. Um quantity, which we've talked a little
00:35:45
bit about already, and quality. Correct. So when I looked at the science, for me, I created this
00:35:52
framework of the four macros of good sleep. You've heard of the three macros of food, macronutrients, fat, protein,
00:35:58
carbohydrate. To me, there are four macros of good sleep. And it's QQQRT.
00:36:03
QQRT and it stands for quantity,
00:36:13
quality, regularity,
00:36:18
and timing. And think of it less like pillars, but the four legs of a chair.
00:36:24
And if any one of these becomes unstable, the chair will topple over. So, I'll probably start with the one
00:36:30
that people have heard me bang on about, which is quantity. 7 to 9 hours. This
00:36:35
myth of 8 hours is nonsense. It's a wonderful range. 7 to 9 hours. And what
00:36:41
we know is that using that sweet spot of 7 to 9 hours, when you get less than that, the shorter your sleep, the
00:36:48
shorter your life. Short sleep predicts all cause mortality. Now, we say that there's the
00:36:54
minimum of 7 hours of sleep. And some people have argued perhaps correctly that look, if you look at these
00:37:00
mortality curves, there's not much of a percentage difference between sleeping six hours versus the seven that you're
00:37:06
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
00:37:14
think they've made a conflation because 7 hours is the minimum amount of sleep
00:37:22
that you need to survive. Because the way that we quantify what minimum is is
00:37:28
based on whether you die or you don't prematurely, the amount of sleep that you need to
00:37:35
survive is different than the amount of sleep that you need to thrive. And
00:37:41
people will conflate the former with the latter. So you've got to be careful when people are sort of touting on social
00:37:46
media saying, "Well, no, but look, you there's not much difference between my sort of survival rate on 6 hours versus
00:37:52
7 hours." You may have a just as much of a long life, but the quality of your
00:37:57
life will be very different. So that's quantity 7 to n hours. And is that does
00:38:03
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
00:38:08
four or five hours sleep. Did evolution not give parents any leeway or anything when they have kids that suddenly their
00:38:14
brain changes and now they can survive with less sleep? The evidence doesn't suggest that once you go through
00:38:20
parenthood, you get some magic sort of, you know, immunity shot that makes you,
00:38:26
you know, resilient and not vulnerable to a lack of sleep. And in some ways you could argue because we used to, you
00:38:33
know, live as a collective tribe and we would share duties at that point, you
00:38:39
know, mother nature doesn't really worry too much about you now because you've already procreated and you've passed on
00:38:46
your genetic code. So you are now the the sort of the you know the not
00:38:52
particularly well you know cured for individual through evolution. It's your
00:38:57
offspring gets so it sacrifices you in a way. I mean that's what we see in the animal
00:39:02
kingdom. Did you see that documentary about the octopus? Yeah, it it was just I mean I thought it
00:39:07
was beautiful documentary but um the TLDDR for anyone that hasn't seen it is once the octop and I'm going to completely butcher this so please ignore
00:39:14
um once the octopus has given birth it dies. Basically it doesn't move out of
00:39:20
that hole and it dies. Is that a rough? Well, I don't know if if it dies, but its level of of active life.
00:39:27
I searched, does the octopus die after reproduction, and it says yes. Female octopuses die after their eggs hatch.
00:39:33
After laying eggs, a female stops eating and devotes all of her energy to protecting and oxygenating them until
00:39:41
they hatch. Once they do, she dies shortly after, a process called semiol
00:39:46
parity, meaning they reproduce only once. This death is triggered by hormone
00:39:51
changes from the optic gland similar to mamalian proterty glands. And males die
00:39:59
shortly after mating as well, usually within a few months.
00:40:04
That is wild in some ways. It's, you know, it's it's tragic and it reminds me I'm so glad that I'm not an octopus. But
00:40:12
but but coming back to it, so for there doesn't seem to be some you know magic
00:40:19
cloak of invincibility that you put on when you go through parenthood.
00:40:24
Certainly what we know is that the number of individuals who can survive on
00:40:29
6 hours of sleep or less and show no impairment in either their brain or their body rounded to a whole number and
00:40:36
expressed as a percent of the population is zero. So quantity matters but it turns out
00:40:43
that we got it wrong in thinking that was the only thing because then came
00:40:49
quality. So QQRT quality is defined in sleep science as two things. The first
00:40:55
is something that your sleep tracker will measure which is the continuity of your sleep. Meaning do you sleep in one
00:41:02
or two nice long bouts throughout the night? That's good quality of sleep, nice continuous bouts versus your sort
00:41:09
of sleep is very fragmented by all of these awakenings. That's very poor quality of sleep. And the way that you
00:41:15
can measure it in your sleep tracker is just by looking at the app. And there'll be something called sleep efficiency.
00:41:21
Sleep efficiency is defined as the following. Of the time that you're in bed, what percent of that time is spent
00:41:27
asleep? And what we like to see is you north of 85% or above. So, this is kind
00:41:32
of like the users's guide to sleep trackers. What I want to see is 85% or
00:41:38
more. If you're less than that, we need to have a conversation. That's number one, good quality of sleep. The second,
00:41:44
which is what sort of what these trackers can't really do, but I can do in the sleep laboratory when you look
00:41:49
like a spaghetti monster cuz I put electrodes all over your head. I can measure the quality of your big, deep,
00:41:55
slow brain waves of deep non-REM sleep. And that is a second measure. The power
00:42:00
of those big slow brain waves. That's a second measure. And quality seems to be
00:42:06
as predictive as quantity in making a difference not just to your all cause
00:42:12
mortality but quality even more than quantity when it comes to mental health
00:42:18
has been showing the bigger signal. So again it's not that quantity doesn't
00:42:23
matter. You do have to get sufficient amounts of sleep but quality as much as quantity should be paid attention to and
00:42:31
I haven't said that enough. Mhm. The next is where we came to in our sort of three things that I was saying. The
00:42:37
first is digital detox. Then next thing I said is regularity. This is somewhere where I've also
00:42:43
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
00:42:50
described. It's called the UK Bioank data. And now they didn't look at 90,000 individuals, but they looked at 60,000
00:42:56
individuals. And they decided that they were going to compare and split them
00:43:02
into quartiles. So the most regular to the second most regular to then sort of
00:43:08
the third most regular and then the final quartile was those who were the least regular. And what does regular mean in this
00:43:14
context? Good question. highly regular individuals plus or minus 15 minutes in
00:43:21
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
00:43:26
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
00:43:32
when you're going to bed and waking up. So, it you're right, it's timing in a way, but I'll come on to why there is a
00:43:39
separate t for timing in just a second. But regularity here was okay, plus or minus. So, let's say you go to bed at
00:43:46
8:45 p.m. one night and then 9 and then 9:10 p.m. and then you're back to 8.
00:43:51
That's beautiful tight timing. I like that. Whereas the those people who were least regular, they were 90 to 120
00:43:59
minutes desperate. They were going to bed, let's say, at 11 one night, then 1 a.m. the next night, then they were
00:44:05
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
00:44:12
that those people who were most regular versus least regular, so they compared
00:44:17
the extremes of these two, those people who were most regular had a 49%
00:44:24
relative decrease in all cause mortality. So they were 49% less likely to prematurely die than those people who
00:44:31
were least likely to die. They had a 39% cancer mortality risk reduction. Great.
00:44:39
they had a 57% cardioabolic disease risk reduction. So that was
00:44:46
stunning. That regularity was incredibly powerful as a predictive signal of your
00:44:52
different forms of mortality. That wasn't the best part of the paper though. They had also measured quantity
00:44:59
as well as regularity in these same individuals. So then they decided to say, well, I'm going to take our measure
00:45:06
of quantity and regularity and we're going to put them both in the same statistical bucket and do a Coke Pepsi
00:45:12
challenge to see which one wins out in terms of predicting all cause mortality. We all bet in the sleep field, at least
00:45:18
I did, it was going to be quantity. I was wrong. Regularity beat out quantity
00:45:23
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
00:45:30
going to start sleeping 4 hours." but incredibly consistent 4 hours. You need both quantity and quality. But goodness
00:45:38
does regularity seem to carry a massive signal. So coming back to those three things, I would say digital detox, just
00:45:45
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
00:45:52
society. We get what I call junk light at night. So you've heard of junk DNA. Well, we
00:45:59
get junk light at night. We don't need all of this light and it fools our brain into thinking it's still
00:46:05
daytime outside. So no wonder as a society we have some struggles with sleep at night. Now that's due to many
00:46:12
reasons. Stress, too much caffeine, alcohol, THC. But excessive light is one
00:46:18
of the easiest things that you can do. So for the next 7 days, just do me this
00:46:23
experiment. If you can set an alarm 1 hour before your normal bedtime. When
00:46:30
that alarm goes off, turn off, and I I do this myself, turn off almost all of
00:46:35
the lights in your house. When you say all of the lights, do you mean the little red light on my smoke
00:46:40
alarm or No, that's fine. But, you know, so my wife and I, 1 hour before bed, almost
00:46:45
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
00:46:52
the television's cool and illuminated. I will set that down to about 5% of
00:46:57
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
00:47:04
of, you know, looking desperately uncool uh in in front of her when I'm tripping over things cuz it's complete black, you
00:47:10
know. Then start cooling the house or the room as best you can to around about 67 68° Fahrenheit or about 18°C. We can
00:47:19
speak about temperature, but just do this experiment for the next 7 days. 1 hour before bed, the alarm goes off. You
00:47:25
switch off all of the lights and ask the following question. Do you feel sleepier? Is it soporific? Does it make
00:47:32
you feel more sleepy as a result? But don't stop there. What you've gone and
00:47:38
done is the first positive experiment which is you've gone from the no intervention lights are on to then the
00:47:46
Matt's intervention which is now the lights are off for 1 hour before bed. Don't just ask is my sleep better when
00:47:52
the lights were out for 1 hour before bed. Once that 7-day period has finished, go back to doing what you were
00:47:59
doing before, which is keep all of the lights on and ask yourself, did my sleep get better when I did the intervention
00:48:06
and did my sleep go back to being worse when I stopped? Because I'm trying to teach you birectionality in the
00:48:12
experiment. Does that make some sense? Yeah. So, you get to you get to basically do an AB test. Correct. You get to see both sides of
00:48:19
the equation. And with that, it's more proof positive than just one direction alone. because who knows it could just be a placebo effect. So regularity
00:48:27
coming back to it is critical. So we've spoken about QQR quantity quality
00:48:32
regularity on the um regular regularity point. Why what's going on in
00:48:39
our brain that's making it from a hormonal perspective or other that's making it important for us to sleep at
00:48:45
the same time? It's a bloody great question. People don't respond to rules. They respond to
00:48:50
reasons not rules. So let me try and explain the reason behind the sort of the rule. When it comes to regularity,
00:48:57
we have something called a circadian rhythm that we've spoken about. And there's a clock that sits inside of your
00:49:04
brain deep in the middle of the brain. So we have it just turns out a brain
00:49:10
here. Lovely. Okay. So we've got one of these hemispheres here. And then I'm just
00:49:16
going to take out what we call the subcortical sections. So these are the areas that are below the subcortex. So
00:49:22
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.
00:49:28
And it turns out that right in the middle of the brain, right here, there's an area called the hypothalamus.
00:49:34
Now here, this structure here, this is the phalamus. This is the sensory gate of your brain. So all of your five
00:49:40
senses, sound, touch, taste, smell, they all flood into this gate called the
00:49:45
phalamus. And then the phalamus will decide whether it sends those sensory signals up to your cortex. And when it
00:49:51
sends the signals up to your cortex, you start processing them and you become consciously aware of the external world.
00:49:59
Now, as we're falling asleep, just as an aside, what's interesting is that this gate, the sensory gate, the phalamus,
00:50:05
once we start to fall asleep, the gate will close shut. Now your eyes are
00:50:10
technically still seeing, your ears are still hearing, your tongue is still tasting, but because the gate of the
00:50:17
phalamus, the sensory gate closes shut, those signals that are coming into your brain are no longer sent up to your
00:50:24
cortex. So you stop perceiving the outside world, which is just simply a different way of saying you've fallen
00:50:30
asleep. Now the hypothalamus, you've heard of hypo sort of hypertension or
00:50:36
sort of you know hypothermia or that means lower. So here's the phalamus.
00:50:42
This area here is called the hypothalamus. And it's a tiny structure but within that structure contains a
00:50:48
nucleus. And that group of cells the nucleus has a fancy term and it's called the supraismatic nucleus. But the
00:50:56
superismatic nucleus is your master 24-hour clock. Every cell in your body
00:51:03
has a clock inside of it. But this is the master clock. It's like Lord of the
00:51:09
Rings. There's one ring to rule them all. Well, there's one clock to rule them all. And here in the super
00:51:15
chaismatic nucleus, you get the 24-hour rhythm of being awake and being asleep,
00:51:20
being awake and being asleep. How does your brain keep quartzlike precision
00:51:26
24-hour clock time? How does it do that? The way it does that is that it uses
00:51:32
signals such as light and dark from your eyes from your eye. And so when light comes
00:51:39
through the retina, it tells the hypothalamus it's daytime and therefore
00:51:45
you should be awake. And its rhythm starts its awesome sort of upswing. And temperature can do this and feeding can
00:51:51
do this all sorts of different things. But for the most part, light is the principal governor that essentially acts
00:51:58
like electrical, I should say, photon fingers that pops the wristwatch dial out and resets it precisely. So, 24
00:52:05
hours every single day. Because if you're left in the dark with no signals of light, your clock isn't precise. It
00:52:12
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.
00:52:18
And people have done this experiment. The thing that keeps it precise is light. So, you need light to keep a
00:52:25
beautiful 24-hour rhythm. One of those things that's under the control of your 24-hour rhythm is your sleep wake cycle.
00:52:32
What if I'm doing exercise? Exercise is a wonderful entrainer of your circadian rhythm as long as you're
00:52:39
doing it at the right time. So, if you're starting to exercise at 3:00 or 4 in the morning, that's not good because
00:52:46
that's an activity signal that's going to confuse the brain into thinking it's the active period, which is normally
00:52:52
because we're a dional species, the day. And it's the same thing coming back to my point of regularity.
00:52:59
Using light as the best way to help with that regularity because light if it's
00:53:05
artificial at night fools your brain into thinking that it's daytime still outside.
00:53:11
I mean is there any such thing as non-artificial light? I mean I mean I guess with the sun but I mean is there a type of light that I could use at night
00:53:17
like candles or something or Yes. below 30 lux, right,
00:53:22
is not going to necessarily do you a disservice. Probably below 50 lux. Now, lux lux is just a measure of light
00:53:29
intensity. And you can download on the app store a free looks meter. And if you're an idiot nerd like me, you're
00:53:35
going all over the house at night and you're sort of putting it in different location, you're seeing any kind of
00:53:41
white spots here where you know the looks is too high, but you need to drop that that looks. By the way, it's a
00:53:47
great way if people want to say, "Look, my REM sleep is deficient. How can I get more REM sleep?" There's a great study
00:53:53
where they did something similar to what I'm telling you now. 90 minutes before bed, they turned down the lights to
00:54:00
below 30 lux, and they pulled out all of the blue light. And just that trick of
00:54:06
dropping the lights down 90 minutes before bed, below 30 lux, making it warm
00:54:12
yellow light, increased their REM sleep by 18%. Wow, it's a huge margin. So, no need for
00:54:18
pharmarmacology. But to your question, why is regularity
00:54:24
important? Well, I told you that light is one of the signals that can create regularity. It turns out that your
00:54:30
behavior is another thing that will tell your brain. So, meaning when you go to
00:54:37
bed and wake up at the same time, it acts like an anchor. It anchors your
00:54:42
circadian rhythm and it tells you almost like a scene in a movie. This scene is
00:54:49
now complete. A new scene starts. This scene is complete. A new scene starts. So every time that you're going to bed
00:54:55
at the same time and waking up at the same time, you are feeding the super chaismatic nucleus, the master 24-hour
00:55:01
clock in your brain, you're feeding it signals of regularity. And when it feeds on signals of
00:55:08
regularity, it improves the quantity and the quality of your sleep. Your
00:55:15
circadian rhythm likes consistency. It likes regular signals. When you feed it
00:55:20
signals of light, of activity, of waking up, going to bed, you improve the quantity and the quality of your sleep.
00:55:28
That's the reason behind the underlying rule. So having a TV in your bedroom is a terrible idea then because if on that
00:55:35
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
00:55:41
quite confused about like the behavioral pattern of what what I'm doing in my life. It's not going to associate the
00:55:46
bed with sleep. It's going to associate the bed with movies. That's one of the problems that we call con it's called conditioned arousal
00:55:53
which sounds a lot more salacious than it actually is. It's a term that we use in sleep medicine which may explain
00:56:01
insomnia. So with insomnia, let's say that the first time you go to this thing called a dentist and you get in the
00:56:07
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
00:56:14
15 visits when you get into that chair you are no longer looking forward to
00:56:19
getting into that chair, are you? Why? because you've learned the association that being in that chair typically leads
00:56:25
to a bad outcome. Now, the same thing is true with the
00:56:31
bed. If you start associating the bed with anything other than sleep, and we give you a pass in terms of sex, but
00:56:38
sleep and sex, anything other than that, you start to learn that this thing called my bed is this place where I'm
00:56:45
awake, where I work, where I eat, where we have conversations, where I watch television. And so, you know, if I were
00:56:52
to, and again, I'm stealing Michael Grand's point, but if I were to say to you, bed sleep, bed sleep, bed sleep,
00:56:59
bed sleep, bed sleep. Okay. If I were to say bed, scroll, bed,
00:57:04
eat, bed, work, bed, sleep, bed, TV, bed,
00:57:10
you confused. Yeah. Because there's no predictive signal. You've never bound an association. Now
00:57:16
the way this works to your disadvantage in insomnia is the following. The
00:57:23
insomnia event that begins the insomnia is typically not the thing that maintains the insomnia. So let's say
00:57:28
that I um had I experienced a really difficult bereavement and that triggered
00:57:35
a form of insomnia where I couldn't sleep because of the bereavement. Gradually the bereavement is not the
00:57:42
thing that's going to maintain my insomnia. It's because every time I have been going to bed over the past month, I
00:57:50
have not been sleeping. I've been wide awake in my bed. So now, because your brain is such an incredibly associative
00:57:57
device, it learns the association that my bed is the place where I'm always awake. And what do we then do? We need
00:58:04
to break that association in insomnia. So what we do is we say the 20-minut rule. If you've been in bed for about 20
00:58:10
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
00:58:18
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
00:58:26
because very quickly my brain starts to learn the association that my bed is the place where I'm wide awake. And you need
00:58:32
to break that association. So go to a different room in dim light. Just read a book, listen to a podcast, whatever it
00:58:38
is. And the rule of thumb is the following. only return to bed when you are sleepy and so there's no time limit
00:58:45
and that way you gradually relearn the association that my bed is the place where I always get consistent sleep
00:58:52
because otherwise it's the dentist chair you walk into your bedroom and you look at your bed and it's your nemesis and
00:58:59
you convinced yourself even before you get into bed I'm not going to sleep because that's the place where I always
00:59:04
don't sleep and by the way if you suffer from the 3M awakenings my first question
00:59:09
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
00:59:17
you more anxious. Yeah. And second, because your brain is such an incredibly associative device, you
00:59:23
start to then decide that 3:00 a.m. is the time when I need to wake up. If you
00:59:29
keep looking at the clock, you keep reinforcing that it's 3:00 or 4. And sleep at 3:00 in the morning is like
00:59:35
trying to remember someone's name. The harder you try, the further you push sleep away. Sleep is something that
00:59:42
happens to you. It's not something that you make happen. And so at that moment,
00:59:48
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
00:59:55
meditation. You can download apps. Next, if that's not your thing, that's okay. Do box breathing. You know, you can sort
01:00:01
of inhale for five, hold for six, exhale for seven. There's all sorts of
01:00:07
different numbers, but you can do breathing exercises. The third, if you don't like that, is a body scan. So,
01:00:13
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
01:00:19
to move through your body and gradually go down? How are my shoulder blades feeling? I just relax down into the bed
01:00:25
and gradually down into the chest, into the move through just relax. If none of
01:00:32
those things feel fun, the next thing you can do is take yourself on a mental walk. There's a great study from my
01:00:37
university, uh, the University of Berkeley, California, and we didn't do the study. Allison
01:00:43
Harvey did it. By the way, counting sheep, bad idea. Makes your sleep worse,
01:00:48
it turns out. Why is that? Because, well, with every kind of little bleeting cotton wool ball with a strange look on
01:00:54
its face that leaps over the fence that you're counting, you're reinforcing every minute of sleep that you're not
01:01:01
getting, and it seems to make matters worse. But what she found was that there's an alternative. If you think
01:01:06
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
01:01:13
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
01:01:19
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
01:01:26
granularity. And what's common about every method I've just described, meditation, box
01:01:32
breathing, sort of uh body scan, going on a mental walk, all of these things
01:01:38
have in common that you get your mind off itself. In that particular example where she
01:01:45
asks you to vividly think about a journey that you know, what did she find in the study? What she found is that
01:01:51
that increases the speed with which you fall back asleep significantly
01:01:57
because as I said it it's so you know her work to me demonstrated that it it
01:02:03
is so like that name because the moment I stop trying to remember someone's name
01:02:09
what happens you remember it I remember it and so when you do these types of exercises where you're getting
01:02:15
the mind off itself the next thing that you typically remember is your alarm
01:02:21
clock going off in the morning. Is this why people listen to very vivid
01:02:26
sleep stories and why I listen to serial killer documentaries?
01:02:32
Serial killer documentaries, true crime documentaries, I should say. That's a bit more uh nice to pallet.
01:02:39
I don't know of them. My suspicion is that they may be doing your deep sleep a disservice. anything
01:02:45
stick up for me in the comments. If you if you listen to true crime to fall asleep, please write it below in the
01:02:52
comment section. If you find it subjectively wonderfully pacifying and calming and there is not
01:02:59
death, naming, blood, and limbs being distributed at high velocity all over
01:03:05
the scene, I would say it's great. But if it looks like a Quentyn Tarantino movie or sounds like one, maybe harm and
01:03:12
foul rather than I mean just in my ears but yes. So you know we forget that to
01:03:19
the best of my knowledge the meditation company called calm now I have no affiliation with them they were doing
01:03:26
somewhat well but what they realized is that they wanted people to sort of meditate in the morning and when they used looked at their usage statistics
01:03:32
people were meditating in the morning but then there was a huge swath of usage right before bed people were
01:03:38
self-medicating their state of insomnia and then through a stroke of genius they realized when we were young we used to
01:03:45
love falling asleep to our parents reading us a story. Why is that any different when we become
01:03:51
adults? So they created sleep stories and they went from struggling as a
01:03:57
company I think to becoming the first or one of the first billion dollar valuation health companies out there.
01:04:03
they became a unicorn and now they can they've got you know people like you know Matthew McConnA they've got Harry
01:04:09
Styles and then occasionally they've got a a you know an unfortunate British sleep scientist um with a bad voice but
01:04:16
you can listen to these sleep stories and they are wonderfully soporific. Why? Because they get your mind off itself.
01:04:22
We we talked um earlier on about melatonin and uh there are other supplements which people talk a lot
01:04:28
about. One of the ones that's become really popular is magnesium. I've heard ashwagandha and I've heard magnesium a
01:04:34
lot. Yeah. Is there any efficacy to these? Are these are these useful? The first thing I would say is that if
01:04:40
you're suffering from sleep problems and you're looking to supplements, you're stepping over dollars to pick up
01:04:46
pennies. Okay. What you need to do is think about the fundamentals.
01:04:51
Regularity. Watch your caffeine intake. Make sure you're not drinking too much alcohol.
01:04:56
Get regular. Dim down half of the lights. Digital detox. Any one of those, but especially all of them combined are
01:05:03
going to get you log orders of better sleep than reaching for the latest
01:05:09
supplement bottle of whatever it is. The second thing to say is think about it from a logical standpoint. If there were
01:05:16
really some supplement that promises to be the Shangrilar of all respplendant
01:05:21
sleep at night, the drug companies would have been all over it decades ago. To
01:05:27
put it in context, it took George Lucas, I think, about 30 years to amass something like 4 billion in revenue from
01:05:33
the Star Wars franchise. It took Ambient 22 months. That's how big a business sleep farmer
01:05:40
is. Ambience is what a sleep pill. Ambient is a sleep pill. Magnesium, if you dig into it, and I I did a deep dive
01:05:47
about three years ago because I I kept hearing it too. This magnesium, magnesium. The first thing to note is that most forms of magnesium, magnesium
01:05:55
oxide or magnesium citrate, most of these forms of magnesium
01:06:01
don't cross the brain barrier and sleep is produced by your brain. So, how can
01:06:07
something that doesn't get into your brain affect brain process? Number one, there is one
01:06:14
form of magnesium that seems to have some evidence in favor of it. It's called magnesium L308.
01:06:21
But if you look at the literature, where did this story come from? It turns out that about 30 years ago, they started
01:06:27
looking at people who had disrupted sleep and they would assess their blood work. And what they found is that some
01:06:32
of those people were magnesium deficient. And when they supplemented them with magnesium and they became
01:06:38
magnesium normative, their sleep got better. But that's very different than saying,
01:06:44
"Look, you and I, we're currently magnesium normative and then dosing
01:06:50
myself with high volumes of magnesium. Am I imagining that that's going to make my sleep better?" The the analogy would
01:06:56
be, let's say I develop this incredible new oxygen saturation machine, and you
01:07:02
say to me, "Well, but Matt, my blood oxygen saturation right now, looking at my device, tells me it's 98.6%."
01:07:10
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
01:07:16
level. And that's the problem with magnesium supplementation. If you're magnesium normative, all you're doing is creating
01:07:23
probably expensive urine at at at that moment in time. Now, there may be an
01:07:28
indirect benefit of magnesium in that it does seem to relax muscles. And when the
01:07:34
body is in a state of relaxation, it sends a signal of relaxation back up a
01:07:40
branch of nerves called the vagus nerve that goes up to the brain and signals to
01:07:45
your brain you're starting to relax down and you get this state of quiescence and that's very helpful for sleep. So
01:07:52
magnesium may still have an indirect benefit on sleep through its relaxation kind of policy that it instantiates in
01:07:59
the body. But overall, magnesium is not really moving the needle if you look at
01:08:04
the studies. Ashwagandha is different. Ashwagandha and another
01:08:10
compound called phospatitile serarene. Phospatidile sererearine and ashwagandha
01:08:17
both of these supplements seem to help do one of two things. They either
01:08:22
ratchet down the fightor-flight branch of your nervous system and they can also
01:08:27
reduce the amount of cortisol that the body is releasing. That's important
01:08:33
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
01:08:39
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
01:08:47
and from a nervous perspective that I can't fall asleep." And let's say that you've done, let's say, you know, um, an
01:08:53
onstage event and it's incredible. You've got that onstage buzz. You come off stage at 11 p.m. And normally you'd
01:08:59
be fast asleep, but you know, you are so wired. It doesn't matter. You are tired,
01:09:05
as tired as can be, but you're so wired you can't fall asleep. That's the fight orflight branch being switched on and
01:09:11
you just can't fall asleep. You need to push it back off. Phosphatidal sererine and ashwagandha will both push you back
01:09:17
over into the more quuscent what we call parasympathetic nervous system branch.
01:09:22
That's good. However, they also will reduce cortisol and cortisol is a
01:09:28
wakeromoting hormone. Cortisol is fine. We It gets a bad rap. You need to have
01:09:34
your cortisol start to spike a few hours before bed and it helps with the waking up process. It's wonderful. Every day we
01:09:42
have a cortisol spike that starts happening before we wake up. It's one of the things that helps us wake up and
01:09:48
then it builds us to this beautiful crescendo midm morning where you should be awake and not needing caffeine
01:09:55
and it drops before bed and then it starts to peak in the sort of middle early afternoon and in fact
01:10:02
usually peaks at the late morning hours I should say and then it will start its awesome sort of downswing and what you
01:10:08
see is that right before you go to bed cortisol should hit its lowest point
01:10:13
what we call its nadia its lowest trough. Mhm. What's interesting, by the way, just as
01:10:19
an aside, is that insomnia we can classify usually as at least one of two
01:10:24
different types. There's actually multiple, but let's just say there are of those multiple, there are two types.
01:10:29
One is called sleep onset insomnia. I can't fall asleep. The other is sleep maintenance insomnia. I can't stay
01:10:36
asleep. when they've looked at people's cortisol on a 30 minute by 30 minute
01:10:42
basis on the 24-hour clock face, we go through just what we described. Just before we wake up, we get this rise in
01:10:48
cortisol. It peaks late morning and then it drops down and right before bed, our
01:10:53
cortisol is almost at its lowest point. With insomnia patients, they show exactly the same thing. A beautiful rise
01:11:01
in the late morning hours. It starts to come down, but then you see two anomalies. Right before bed, it goes
01:11:09
back up. And then in the middle of the night, even when it's starting to rise, it will
01:11:14
have this abnormal spike right in the middle of the night, too. And what we believe is that that may in part explain
01:11:21
sleep onset insomnia. Cortisol should be coming down and it should stay low right before we go to bed. But then it jumps
01:11:27
back up in insomnia patients. I can't fall asleep. And then it continues to
01:11:32
stay low throughout the first half of the night, but then it also spikes in insomnia patients. I can't stay asleep.
01:11:39
I've had so many founders speak to me and say, "Why didn't this particular ad that I ran on this platform work for me?
01:11:45
Maybe the copy wasn't good. The creative wasn't strong." But usually the problem is they're not having the right conversation because that ad never
01:11:51
reached the right person. And if you're in B2B marketing, that is much of the game. And this is where LinkedIn ads
01:11:57
solves that problem for you. Their targeting is ridiculously specific. You can target by job title, seniority,
01:12:04
company size, industry, and even someone's skill set. And their network includes over a billion professionals.
01:12:10
About 130 million of them are decision makers. So when you use LinkedIn ads, you're putting your brand in front of
01:12:16
the right people. And LinkedIn ads also drive the highest B2B return on ad spend across all ad networks in my experience.
01:12:23
If you want to give them a try, head over to linkedin.com/diary.
01:12:28
And when you spend $250 on your first LinkedIn ads campaign, you'll get an extra $250 credit from me for the next
01:12:36
one. That's linkedin.com/diary. Terms and conditions apply. We were
01:12:41
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
01:12:48
hour is potentially the most important hour of me being in bed. And I I say
01:12:54
this in part because my my girlfriend, she would wake, she'd have about six six hours, six and a half hours sleep. She
01:12:59
sleeps very very well. Perfect sleeper, but she'd always get up really really really early. And in part that was
01:13:06
because of 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
01:13:11
bed. Like just have that extra eighth hour." And in part that's because I learned that the further we go in sleep,
01:13:18
the more REM we're getting. Yeah. Okay. Can you explain that to me with these four blocks? Why that last hour is
01:13:25
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
01:13:31
that last hour of REM. Absolutely. So here we have the four blocks of sleep. So when we first fall
01:13:39
asleep, we go into light non rapid eye movement sleep. Stage one. This is the
01:13:44
stage of sleep that if I wake you up out of it, you say, "I wasn't sleeping." Now
01:13:50
you it's just that you're just in that transitional phase, this beautiful liinal state between the windows of
01:13:56
wakefulness and true sleep. So this is your bridge between the waking world and the sleep world. And it doesn't last for
01:14:03
very long. Maybe just 10 or 15 minutes at tops. Then you get into the workhorse
01:14:08
of sleep. This is stage two nonREM sleep. 50% of your night is spent in
01:14:14
stage two nonREM sleep. I don't like the word light nonREM sleep. I've often used
01:14:19
it, but it's not really it's we do a lot of cognitive processing in stage two nonREM sleep. It's good stuff. It's not
01:14:26
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
01:14:32
order for you to get to REM, but I'll come to that. So, we have fallen asleep 10 minutes.
01:14:38
Yeah. Now, we're in stage two nonREM sleep. We'll stay there for about 15 or 20 minutes. Then if it's in the first
01:14:45
couple of hours of the night, we go down into the very deepest stages of deep non-REM sleep. This is where the brain
01:14:52
wave patterns slow down. But the brain waves become incredibly big, huge, big,
01:14:58
powerful, slow brain waves. This is where you get an enormous amount of restoration, recovery of many of your
01:15:05
major physiological systems. So physical recovery, physical recovery, but mental too. Yeah,
01:15:12
it's during deep sleep that you take newly minted memories that you've learned and you hit the save button on
01:15:18
those memories so that you don't forget. Deep sleep essentially is going to futureproof the information that you
01:15:25
just learned today. It transfers information from a short-term storage
01:15:31
vulnerable reservoir to a more permanent long-term storage site. It's during deep
01:15:36
non-REM sleep when we have this communication. So think of those deep powerful slow brain waves like longwave
01:15:42
radio station when you used to tune into a radio station in a car. You get huge
01:15:47
ability for information transfer across long distances across huge paths in the
01:15:53
brain. It's amazing. So we've gone from light non-REM, then we go down into deep
01:15:58
nonrem. 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
01:16:04
two nonREM sleep. Wait, we've gone from 1 2 3 to two. Yes. So, we've gone, think about it more
01:16:13
almost like a roller coaster, right? So, we go from light nonrem and then we go down into stage two nonREM. Then, we go
01:16:20
down into deep sleep and then we're going to rise back up into light stage
01:16:25
two nonREM sleep. We're going to stay there and after about 70 80 minutes,
01:16:30
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
01:16:38
we call a hypnogog. I'll put this on the screen for anyone. Lovely. So what I'm describing here is
01:16:43
this roller coaster ride. So we've fallen asleep light stage one nonREM go down into stage two. Then you go down
01:16:50
and you have a heavy period of deep nonREM slowwave sleep. Stage three. And
01:16:55
then and that's what you see on your sleep tracker is deep sleep. This is light sleep. This is deep sleep. Stage
01:17:00
two nonREM sleep. Light sleep. Stage three nonREM sleep. Deep sleep. But then
01:17:06
you'll start to climb back up and then you may pop up and you'll have a short REM sleep period here after about 70 or
01:17:12
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
01:17:19
sleep and then up into REM. Down into nonREM sleep and you'll go up into REM. Down into nonREM sleep and up into REM.
01:17:26
So what's interesting however is that the ratio of nonREM to REM changes. Now,
01:17:33
there's a myth out there and it's a bit of a problem. We humans have a 90inute
01:17:40
average nonREM to REM cycle. So, we go down into nonREM sleep and then up into REM sleep every 90 minutes. Then, we go
01:17:47
back down into nonREM sleep and then up into REM sleep. So, we go down into nonREM sleep and then up into REM in
01:17:52
this 90minut cycle. The problem is that it's on average 90
01:17:58
minutes. It ranges from 70 minutes to to 120 minutes from one individual to the next. So you know these devices that you
01:18:05
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
01:18:13
90minute 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
01:18:19
on its 90minut cycle and it's going to figure out the perfect moment to wake you up. It's nonsense because my sleep
01:18:26
cycle may be 75 minutes. Yours may be 105 minutes. It's got no idea because it's using a hard-coded 90minute cycle.
01:18:33
It's it's in some ways nonsense. But we go down into nonREM sleep and up into
01:18:38
REM sleep every 90 minutes. What changes however is the ratio of non-REM to REM
01:18:44
within those 90inut cycles as you move across the night such that in the first
01:18:49
half of the night the majority of those 90-minute cycles are comprised of lots of deep non-REM sleep and very little
01:18:56
REM sleep. But as you push through to the second half of the night, now that seesaw balance shifts over and you spend
01:19:04
much more of your time in REM sleep in the second half of the night and particularly just as you said in the
01:19:09
last 2 hours of the night. Why is this consequential? Well, just as you said and you spoke about for your girlfriend,
01:19:15
let's say that you know I normally go to bed for argument sake and I'm not saying this is the ideal time, but I go to bed
01:19:20
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
01:19:27
going to wake up two hours early. So, I'm going to wake up at 6 rather than 8. I've lost two hours of sleep. So, how
01:19:33
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
01:19:41
lost 25% of my total sleep, but I may have lost 50 60 70% of all of my REM
01:19:49
sleep. Why? Because REM sleep comes in the second half of them, particularly those last couple of hours of sleep. So
01:19:54
that's why it's not just academic that you understand the sleep cycle relationship, but it's also pragmatic
01:20:00
because it can impact the amount. In fact, the easiest way if people said, "How can I get more REM sleep?" I would
01:20:06
say just sleep 15 minutes later into the day than you normally would do and you
01:20:11
will disproportionately bias yourself towards getting significantly more REM sleep.
01:20:17
And why does REM sleep matter? REM sleep is a brain state firstly that is incredibly active in some in fact
01:20:23
some parts of the brain particularly if I were to show you these deep emotional centers of the brain as I pull this
01:20:30
brain apart. So we've got these sort of deep emotional centers in the brain that sit
01:20:37
and in fact the sort of they're more just underneath in here tucked in inside just next to your brain stem at the top
01:20:43
of it. And these emotional centers are called the amygdala. And you have one on the left and one on the right side of
01:20:49
your brain. That part of the brain together with a memory structure that runs alongside it called the hippocampus. Those two parts of the
01:20:56
brain form what we call the limbic system. And you may have heard of the limbic system, the emotional centers of the brain. Those can be up to 40% more
01:21:04
active when you're in dream sleep than when you're awake. Dream sleep. Dream sleep is rapid eye movement sleep.
01:21:10
REM sleep. So REM sleep is the stage. Now it depends on how you define dreaming. If
01:21:15
you define dreaming as any mental activity reported upon awakening, then you dream in all stages of sleep. Light
01:21:21
non-REM sleep, deep REM sleep. So what would what would that sound like? Well, if I woke you up and said, Stephen, just
01:21:26
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
01:21:32
thought. What the most people think of dreams as the dreams that we have from
01:21:38
REM sleep, from rapid eye movement sleep. That's why we call it dream sleep. Dreams from rapid eye movement
01:21:43
sleep are flid the narrative. In fact, last night when you fell asleep and you
01:21:49
went into dream sleep, you became incredibly psychotic.
01:21:54
Excuse me. Now, before you reject my diagnosis of your nighttime psychosis, let me give
01:21:59
you five good reasons. When you went into dream sleep last night, you started to see things which were not there. So,
01:22:05
you were hallucinating. Second, you believe things that couldn't possibly be true. So you were delusional. Third, you
01:22:12
became confused about time, place, and person. So in psychiatry, we call that being disorientated.
01:22:20
Fourth, you had wildly fluctuating emotions. Something that we call being emotionally labile. You're all over the
01:22:27
place. And then how wonderful, you and I, cuz I'll include myself now as being psychotic. You and I, we both woke up
01:22:34
this morning and we forgot most if not all of that dream experience. So, we're suffering from amnesia. If you were to
01:22:40
experience any one of those five symptoms whilst you're awake, you'd be seeking some degree of psychological
01:22:45
help. But for reasons that we're only now understanding, it seems to be a normal biological and psychological
01:22:50
process. So, what are the reasons? Why do we dream? We dream for at least two different reasons. The first reason is
01:22:58
emotional first aid. REM sleep is what I've defined as
01:23:03
overnight therapy and it's during dream sleep where your brain takes difficult painful emotional experiences and it
01:23:11
acts like a nocturnal soothing balm and it just takes the sharp edges off those difficult painful experiences so that
01:23:18
you come back the next day and you have a memory of an emotional event but it's
01:23:23
no longer emotional. you don't have that same visceral regurgitation of of that
01:23:29
same emotional charge. Why is REM sleep able to do this
01:23:34
overnight therapy, this deepotentiation? Why is REM sleep able to sort of strip the bitter emotional rind from
01:23:41
theformational orange as it were? The reason is the following. Dream sleep,
01:23:47
REM sleep is the only time during the 24-hour period where the brain shuts off
01:23:52
a stress related neurochemical called noradrenaline. Now, you've heard of the sister chemical
01:23:58
downstairs in your body called adrenaline. Well, upstairs in the brain, we don't have adrenaline. We have noradrenaline. REM sleep is the only
01:24:05
time where it's completely shut off. And what we put forward is a theory called
01:24:11
overnight therapy where your brain has, as I told you, these emotional centers
01:24:16
and these memory centers. The emotional centers, the amydala, the memory centers, the hippocampus. You reactivate
01:24:22
those structures when you go into dream sleep. So your brain gets the chance to reactivate and replay and reprocess
01:24:29
emotional experiences. However, it's doing it in a quote unquote safe
01:24:34
neurochemical environment because that stress chemical of neuradrenaline is completely shut off. So, it's the ideal
01:24:41
neurochemical therapy for stripping the emotion from the memory. And we put
01:24:47
forward a theory that perhaps the quintessential disorder where this fails is PTSD.
01:24:53
Because when you speak to those patients, not only do we see that their REM sleep is disrupted,
01:24:59
when you speak to those patients, they will say, "Look, I just can't quote unquote get over the event." What they
01:25:05
mean by that is the war veteran who is now going to the supermarket and they
01:25:10
come outside and they're in the car park and the car backfires and they instantly have the flashback to the the sort of
01:25:18
detonation on the military field. And what's happening there is that the brain
01:25:23
has not stripped the emotion from the memory. So every time they relive the memory, they regurgitate that same
01:25:30
emotional reaction. So no wonder we proposed that the brain then comes back the following night and
01:25:36
says, "Look, I'm sorry, sleep. I've still got this trauma memory. Can you do your trick of stripping the emotion from
01:25:43
the memory?" And it fails again. So the next night it comes back and says, "I'm sorry to bother you, but I've still got
01:25:49
this emotionally charged memory. Please do your trick of stripping the emotion from memory." It fails again. This
01:25:55
sounds like the broken record of repetitive nightmares that we see in PTSD.
01:26:01
Why could this be happening? Levels of noradrenaline in the brain in patients with PTSD are too high. And I was at a
01:26:09
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
01:26:16
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,
01:26:23
which is just outside of Seattle on the west coast of America. And he had been treating his war veterans in the
01:26:30
Veterans Administration with a blood pressure medication called Preszicin.
01:26:35
Now, it turns out that prescineric drug because it's the Veterans Administration, so it's cheap and it
01:26:41
crosses the bloodb brain barrier. When prescin brain, one of the things that it
01:26:46
does is shut down levels of noradrenaline. Why was this interesting?
01:26:52
What he was perplexed by is that he was saying, "I'm giving this blood pressure medication to my war veterans with PTSD.
01:26:58
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
01:27:05
and I'm sleeping better and I'm feeling better." What he had done was
01:27:10
inadvertently treated their high levels of noradrenaline which were preventing
01:27:16
the brain from kind of stop dropping those levels of noradrenaline down and processing the emotion from the memory.
01:27:23
It was too high in those PTSD PTSD patients. But by treating them with this drug, he'd inadvertently brought the
01:27:29
levels of noradrenaline down during REM sleep. And then it ultimately became one
01:27:34
of the only prescribed medications in the Veterans Administration for repetitive nightmares because why? The
01:27:41
brain had finally got down into a quote unquote safe chemical state because neuradrenaline was too high. But he
01:27:48
treated them with this drug. So he had data that was in search of a theory. I
01:27:54
had a theory that was in search of clinical data. And so I raced to him after he gave us a presentation. I said,
01:28:01
"I think I know why you're finding what you're finding." I flew him down to Berkeley. We spent all day together. We
01:28:07
went out for a dinner together. And as I said, ultimately he went on to do clinical trials. And it it's not a cure all for everyone, by the way. It doesn't
01:28:14
work for everyone. But and I would say that there is now a better treatment for nightmares if
01:28:20
you're suffering from nightmares and it's called image rehearsal therapy or
01:28:25
IRT and it works through an incredible mechanism of memory that we actually had
01:28:31
discovered about gosh 20 years ago now called memory reconsolidation.
01:28:36
So when you learn information, it would be or let's take a word document.
01:28:42
Wouldn't it be staffed if you opened up a word document, you started typing in, you know, all this information, you hit
01:28:48
save, and then you come back tomorrow and you double click on the document and word has shut you out, you can't edit
01:28:53
the document. That's a really bad information storage system. It's a bad idea. Your human memories are just like
01:29:00
this. You form new memories, then you sleep, and you save them. But when you
01:29:06
come back and you reactivate that memory when you recall a memory, you bring it
01:29:12
back into this opened up state, it's like double clicking on the memory and the memory becomes fragile and malleable
01:29:18
once again. So you can update and edit that memory. And then the next night you resave it. It's called reconsolidation.
01:29:25
So the first night I save it. That's consolidation. Then I reactivate it. I modify it and then the next night I
01:29:31
reconsolidate it. So coming back to nightmares, it turns out that you can do
01:29:37
this with trauma patients who have nightmares caused by trauma. For example, let's say that you got into a
01:29:43
horrific road accident and you went through your brakes failed, you went through the red light, you got t-boned,
01:29:49
it was just traumatic, was all traumatic. And what you do with the therapist
01:29:54
because you're having these repetitive nightmares of reliving that same car crash every night, you work with them
01:30:02
and you tell them the dream. You recall the dream actively out loud. But then
01:30:07
working with a therapist, what you do is you modify the outcome. So instead of me saying the brakes failed, now in the new
01:30:14
scenario with your therapist, you say, "Well, you look down and there's a manual handbrake in the car." So you
01:30:20
realize that you can actually just gradually start applying the handbrake and you bring the car to a safe halt and
01:30:25
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
01:30:31
trauma memory and you're rewriting the narrative and then you sleep and you
01:30:37
update that memory. And by recalling and rewriting the memory each and every
01:30:43
waking day, you end up dissipating the severity of your trauma nightmare every
01:30:49
single night. And it's called image rehearsal therapy for nightmares. It's incredibly powerful. It's probably more
01:30:56
powerful than the presin drug that I spoke about. And I'm guessing people don't sleep and
01:31:01
also have nightmares for a variety of reasons relating to trauma generally. Ah, it's a good question perhaps which
01:31:07
is in some ways what's the difference between a bad dream and a nightmare
01:31:12
because all of us will have bad dreams. Bad dreams are usually things that
01:31:18
happen infrequently. Maybe you have them once every month, every couple of months. Yeah. The definition of nightmare disorder is
01:31:24
that you have to have these dreams frequently, maybe at least twice a week. They have to wake you up
01:31:31
out of your sleep and you have vivid recall. Plus, it has to cause you some kind of
01:31:38
daytime distress where you're not feeling good about the day. It's causing you mental anguish. And furthermore, if
01:31:46
it starts to lead to hopelessness or a sense that your life is not worth
01:31:52
living, you absolutely need to go and see someone. And here's what we've discovered about nightmares.
01:32:00
Short sleep duration, not getting enough sleep, sleeping less than six hours predicts by about 100 to 150% higher
01:32:08
percentage chance of you having suicidal thoughts, attempting suicide or
01:32:14
tragically suicide completion. That's bad sleep. It turns out that nightmares, so if
01:32:22
short sleep has a 150% higher likelihood of suicidality,
01:32:29
having nightmares has an 800% higher likelihood of suicidal tendencies
01:32:36
associated with it. Now, we don't think that nightmares are causing suicidal
01:32:41
tendencies. That's not what we believe. We believe, however, nightmares much more than disrupted sleep. Nightmares
01:32:49
seem to be the canary in the coal mine. Nightmares are this distress beacon that
01:32:54
leaks from our electrical static of sleep at night and it is incredibly
01:33:00
sensitive to your suicidal tendencies, your suicidal attempts and as I said
01:33:05
suicide completion as well. Nightmares are a biomarker. If you are having
01:33:11
distressing nightmares that are waking you up, you need to go and speak to someone about it. It's absolutely
01:33:17
paramount because there are good effective ways that you can dissipate those nightmares.
01:33:23
I was trying to understand whether it's a a malfunction or it's a signal. I guess it might be both.
01:33:28
It's a very good question which is is it adaptive or is it maladaptive? Is it a
01:33:35
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
01:33:42
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
01:33:47
emotional first aid and it turns out that your thinking is incredibly astute.
01:33:52
We believe that at least normative dreams not nightmares nightmares may be the system failing just as I spoke about
01:33:59
in PTSD with repetitive nightmares and in fact repetitive nightmares are so consistent in PTSD that you can't
01:34:06
receive a diagnosis of PTSD without having repetitive nightmares. That's how sort of diagnostic they are. But
01:34:12
dreaming, normative dreaming, even if they're bad dreams, is beneficial. How
01:34:18
could I make that claim? There was a study done by a late sleep scientist, a woman called Rosaline Cartwright, and
01:34:25
she was studying people who had gone through a difficult period, let's say bereiement or very bitter divorce. And
01:34:31
they had become depressed because of that experience. And around the time of the experience, she was seeing them as a
01:34:38
therapist and she was having them do dream recall. So she was having them create dream diaries every single night.
01:34:45
And then she tracked these patients for a year. And it turned out about roughly half of them by 12 months later had
01:34:52
remitted from their depression. They'd got better. They'd got past their depression. The other half were still
01:34:57
depressed. So then she took that data and she went back with those two groups
01:35:03
and she said, "Is there anything different about their dreams and it turned out that there was both of those
01:35:10
groups of people whether they cut free of their depression or they stayed in their depression. Both of them were
01:35:15
dreaming at the time. Both of them were having REM sleep, both of them were dreaming. What was the difference then?
01:35:21
Those individuals that went on to gain remission to their depression and get get better, those people were dreaming
01:35:28
of the events itself at the time that they were happening. Whereas those other
01:35:34
people who didn't go on to gain clinical remission, they were dreaming. They just weren't dreaming of the experiences
01:35:40
itself. In other words, it's not just sufficient to have REM sleep. It's not
01:35:45
just sufficient to have REM sleep and be dreaming. You need to be dreaming of the
01:35:51
difficult, painful experience that you're going through to gain that clinical resolution. Damn. So, if I have something going on
01:35:57
in my life, I need to think about it before I go to bed. Yes and no. What you have to realize is that it's
01:36:05
taken us, depending on who you believe, 3.4 million years of evolution to
01:36:10
develop this thing called homminid sleep and dreaming and REM sleep.
01:36:15
I think that that evolutionary millions of years probably understands what the
01:36:22
correct blueprint playlist of dream experience is and should be for me at
01:36:29
night. And therefore, I don't need to worry about it. I shouldn't try to force anything. That's the first function of
01:36:35
dream sleep is that it's emotional first aid. And we've got good data for that.
01:36:40
But there's a second completely independent benefit of dreaming. Dreaming is a form offormational
01:36:48
alchemy. Dreaming is creativity. Now I told you that during deep non-REM
01:36:55
sleep, we take new memories that we've learned and we fixate them like Amber sort of setting a fossil in and we do
01:37:01
that during deep sleep. That saves the individual pieces of the new stuff. Then
01:37:06
comes along REM sleep which happens after deep sleep. And the second phase of memory processing happens. That's
01:37:13
where REM sleep starts to fuse all of the things that you've recently been learning with this entire back catalog
01:37:19
of information. And so you wake up with a revised mindwide web of associations
01:37:25
that is capable of diving solutions to previously impenetrable problems. So,
01:37:31
you know, it's almost you, it's like group therapy for memories that REM sleep gathers in all of the information
01:37:37
that you've learned during the day and everyone gets a name badge. But unlike the waking logical connections that you
01:37:43
make already, REM sleep is like a Google search gone wrong that you insert, let's
01:37:49
say, diary of a CEO, and it takes you to page 20. This is dream sleep.
01:37:54
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
01:38:01
was someone who had, you know, they had found a diary that had been lost, you know, a long time ago. And the guy who'
01:38:08
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,
01:38:13
non-obvious connection. But it turns out that that's what dreaming is all about.
01:38:18
It's almost as though we go to sleep with the pieces of the jigsaw, but by way of dreaming, we wake up with the
01:38:25
puzzle complete. And when you start to fuse things that shouldn't should not normally go together, but when they do
01:38:32
every now and again cause a marked advance in evolutionary fitness, that is the biological basis of creativity. It's
01:38:40
the reason that no one has ever told you, "Look, Stephen, you should stay awake on a problem." They don't. They
01:38:46
tell you to sleep on a problem. And in every language that I've inquired about to date from, you know, from French to
01:38:55
Swahili, that term sleeping on a problem or something like it exists. My point
01:39:01
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01:39:08
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01:41:04
What is the uh most important thing we haven't talked about as it relates to the personas of those people that are
01:41:10
probably listening right now and for the reasons why they might have clicked? You know that they're probably looking again. We have the optimizers, we have
01:41:16
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
01:41:21
should have talked about for them? It may be the dystopian future. Let's talk about the dystopian future
01:41:27
then. What is a podcast if it does not contain, at least in this day and age, a
01:41:32
dystopian future? What is the dystopian future? Probably the most spectacular discovery
01:41:38
that has happened since you and I last spoke is the discovery of what we call the genetic short sleepers.
01:41:46
These are individuals who by way of a genetic mutation can survive on as
01:41:51
little as 6.25 hours of sleep. In other words, 6 hours and 15 minutes of sleep.
01:41:57
and they show zero impairment in their brain or their body, they can do just
01:42:03
fine on six hours of sleep. I know where this is going. And we have four genes that we've
01:42:09
identified now. The first two genes. The first one identified was called the DEC 2 gene, DEC2 gene. The second was called
01:42:16
the ADRB1 gene, which I granted I know it sounds like the next Radio Head album, but it's it's not the next Radio
01:42:23
Head album. Um, and these genes allow these individuals
01:42:29
to get away with an amount of sleep that normally would cause predictive disease and sickness just as we've spoken about.
01:42:36
So, at this point, probably some people listening are thinking,
01:42:41
I think I'm one of those people. Just to put it in context, your the probability
01:42:48
that you will be struck by lightning in your lifetime is 0.00. 00064
01:42:55
highly unlikely the chances of you having the ADRB1 gene is 0.004
01:43:03
and the DBR1 gene is the short sleeper gene is one of the short sleeping genes. So in other words you are statistically
01:43:09
more likely to be struck by lightning in your lifetime than you are to have that short sleeping gene. So the probability
01:43:16
is is is low by the way. Why is this the case? Why do they get
01:43:22
away with this? And we've discovered now by using sort of um genetic manipulations, we understand why. First
01:43:28
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
01:43:34
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
01:43:41
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
01:43:47
and I, we may sort of go up to like 80% brightness when we're awake and then sometimes it will flicker and then we'll
01:43:54
go down and we'll have pretty solid sleep, maybe sort of, you know, down to 20% but the lights are not quite off,
01:44:00
you know, where sleep is is good but not amazing. These people have an all or
01:44:06
nothing phenomenon. They are all 100% bright light throughout the day and then
01:44:12
and they can maintain 17 18 hours of wakefulness, no problem. And then when they sleep, they sleep
01:44:19
hard. They have much more efficient sleep. Remember we spoke about sleep efficiency and I want it 85% or above.
01:44:26
Almost all of their time at night spent in solid, stable, sound sleep. And the
01:44:31
depth of their sleep they have is greater. So they're awake more throughout the day. They build up a
01:44:36
stronger wakefulness drive which is called adenosine which means that when they sleep they sleep harder throughout
01:44:42
the night which means that they can then be awake for more powerful stints during the day. Second they don't suffer from
01:44:48
jet lag. What the what do you mean they don't suffer from jet lag? Because of their strength of wakefulness
01:44:55
drive when they are circadium misaligned it's as though they haven't traveled between time zones. They can just stay
01:45:01
awake. They have a strong drive for wakefulness. Who are these people? They are these genetic short sleepers.
01:45:08
And do they pass these genes onto their children? Yes, they do. And so their children have the same they're heritable.
01:45:14
Can I have Well, firstly, let's take a step back before I get to the dystopian. This
01:45:19
tells us something above and beyond biological fascination. It says there is a profound statement in evolution.
01:45:28
Mother nature has figured out a way genetically to zip file sleep. Zip file. You can compress eight down
01:45:36
into six. You know on your computer how you can get a collection of files, you group them all together and then you say
01:45:41
compress these files and you compress them and you zip them into a single file
01:45:46
and it's dense, it's packed and it takes up less amount of volume.
01:45:52
Do they have the same life expectancy? They seem to from everything we can tell.
01:45:57
So somewhere along the way through genetics, evolution has figured out how
01:46:02
to go from eight and compress it down to six. Where's the dystopia? Well, we've
01:46:07
all heard of crisper, which is this genetic editing manipulation tool that a lab next door to mine at UC Berkeley
01:46:14
discovered, Jennifer Downer. She won a Nobel Prize for it. Is there some future,
01:46:20
and I hope not. Is there some future where we start to genetically engineer people from a need of 7 to n hours down
01:46:27
to a need of six? Imagine the reduction in health care burden cost because right
01:46:33
now the burden of insufficient sleep is vast. Insufficient sleep will cost most
01:46:39
nations about 2% of their GDP. Here in America it's $411 billion of cost caused
01:46:46
by insufficient sleep. In the United Kingdom it's about $40 billion. In Japan, it's $50 billion.
01:46:52
Solve the sleep loss epidemic, which I've been trying to do by saying, you know, sleep enough. And you could, you
01:46:59
know, cause massive financial disruption in the good way. But here, if you start
01:47:04
to genetically engineer people, could you reduce the burden that is caused by people currently who need 7 to9 and take
01:47:13
that burden away because they no longer need 7 to9? Why did you say I hope not? Well, I hope
01:47:18
not because I think here's the following that happens. It's not that I'm against that idea. I would love for the burden
01:47:25
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
01:47:32
think about people arguing, well, imagine the productivity benefits. I mean, huge upsides of that. You know,
01:47:39
people are being more productive and they're probably spending more. So from a capitalistic society, it's the perfect it's the adman's dream because when when
01:47:46
you're asleep, it's antithetical to a capitalistic society. Why? Because you're neither producing nor consuming.
01:47:51
That's very cynical and I don't buy into that. But nevertheless, so all of these things would be marketkedly better,
01:47:56
would they not be, if we genetically engineered this way. Why do I fear it? I
01:48:01
know for a fact that as soon as six becomes the new eight, everyone starts
01:48:07
sleeping four. And now I'm just back into the same battle again because six is the minimum
01:48:13
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 four
01:48:19
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
01:48:24
sleep currency, you know, inflation that I'm always fighting a battle and at some
01:48:30
point I'll always be on the wrong side of that battle. Crazy. These people with this gene can
01:48:38
thrive on four to six hours sleep without any negative effects that most
01:48:43
of us would experience. Correct. It's so you know what is going on there and
01:48:49
what we're seeing is this this incredible density of sleep and this
01:48:54
epic drive for wakefulness. They are more efficient sleepers. They can get done what you and I take eight hours to
01:49:01
do. They can do it in six. And I guess you is there a way to easily test this? I guess go into a lab and get
01:49:06
Yeah. So if you've ever done, you know, I think um you know all of those genetic testing kits out there where and a lot
01:49:12
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
01:49:18
company I think it's called Prometheus. Again, I have no affiliation with them. I don't know how valid they are, but
01:49:23
then you upload your raw genetic data into their model and then it will list
01:49:29
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
01:49:35
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
01:49:42
scientist nerdy. They will just give you this kind of raw just kind of janky you
01:49:48
know 50page report. The interface is terrible, but you can go in there and you can search to see, you know, what
01:49:55
form of the deck 2 gene do I have or what form of the ADRB1 gene do I have?
01:50:01
And it will tell you, are you a genetic short sleeper or are you not and you can find out.
01:50:06
I've been thinking a lot lately about um about certain diet states as well and whether they have an impact on sleep.
01:50:11
We're talking about circadian rhythms there. I was thinking about fasting a lot and also I think me myself and Jack
01:50:17
over there are in ketosis right now. I was wondering if you when you think about brain performance
01:50:22
and sleep and different sort of states do you think much about fasting or about ketosis or
01:50:29
Yeah, it's a mixed bag if you look at it. Certainly what you eat will change
01:50:35
how you sleep. But perhaps more powerfully is how you sleep dramatically
01:50:41
changes how you eat and how you dispose of those calories and what happens inside of your body when you are
01:50:48
underslept. But so I have lots of cravings when I've short slept. Yes, you have. And there's a reason why
01:50:55
is firstly two appetite hormones called leptin and ghrein will go in opposite
01:51:00
directions. So they sound like hobbits, I And I've got some Lord of the Rings thing here, but leptin is the signal
01:51:07
that says to your brain, you're full. Yeah, you're you're satiated. Don't eat anymore. Ghrein is the opposite. It kind
01:51:14
of makes your tum stom tummy growl and it says you're hungry. You're not full. You need to eat more. When you are
01:51:21
underslept, leptin, which says you're full, stop eating. That hormone is impaired. It drops away. So you lose the
01:51:29
I'm full signal. and worse still the ghrelin signal which says I'm hungry that increases
01:51:36
and so now you have about a 30 to 40% increased hunger drive and the final
01:51:42
part of this is that when you are underslept and taking on board calories the way that you dispose of that energy
01:51:49
is different your body has a higher prediliction when you are sleepdeprived
01:51:55
to disposing of calories as fat rather than storing it for example as glycogen
01:52:01
in the muscles. Oh, so when I'm under slept, um that's why you know you're more likely to get
01:52:06
belly fat. Correct. And what's worse is that there was a great study where they looked at
01:52:12
people who were dieting and either getting sufficient sleep or not getting sufficient sleep. What was fascinating
01:52:18
is that both of those groups, whether you were well-slept or not wellslept, you both lost weight. In fact, you lost
01:52:24
about the same amount of weight. So you'd think, okay, so that's fine. The problem was if you looked at what you
01:52:30
were losing, there was an issue. Those people who were dieting but not getting sufficient sleep, 70% of all the weight
01:52:38
that they lost came from lean muscle mass and not fat. In other words, when
01:52:44
you're not getting sufficient sleep, you keep what you want to lose, which is
01:52:50
fat, and you lose what you want to keep, which is muscle.
01:52:55
Oh gosh. Damn. It's important, isn't it? The sleep stuff. But coming back to ketosis, by the way,
01:53:00
I would say when people go into a fasted state, usually what we see is that their
01:53:06
sleep gets shorter. And they'll say, "I sleep almost more efficiently. I'll sleep for maybe just
01:53:12
four or five hours, but I feel more alert and more awake."
01:53:17
Now, some of that has to do with the ketosis. When you are calorically deprived,
01:53:23
the brain starts to realize that something is wrong because you are lacking calories. You're going into
01:53:29
starvation. So, it drives on a chemical called ereexin. Ereexin is a
01:53:34
wakeomotmoting chemical and it forces your brain to release much more of this wakefulness chemical called ereexin. So
01:53:42
now when you're fasting, it's easier to stay awake for longer and your brain will deliberately stop you from sleeping
01:53:49
as much. It's not because it wants you to sleep less. It's because the only time during
01:53:56
our evolutionary past that we unexperienced short sleep was when we
01:54:02
were in a caloric deficit. And the reason came comes back again to this idea that you have to stay awake longer
01:54:07
because you're not finding food. Now, your brain doesn't know you've deliberately decided to fast, which is a
01:54:13
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
01:54:20
peck in a hand basket." You know, mine goes 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
01:54:27
about five five six hours, my Whoop scores plummet. Yeah. Until I kind of come out the other end,
01:54:33
which might take a couple of weeks and then my sleep scores seem to stabilize again. But that initial transition
01:54:39
period, it looks like it's having a physiological shock. It is. And the shock is this chemical ereexin, which is this wakering chemical
01:54:46
which will force you to stay awake in a very solid fashion. By the way, case in point, people with narcolepsy,
01:54:53
this sleep disorder where they inadvertently and uncontrollably fall asleep during the day. They have the
01:54:58
opposite. I just telling I was just telling you that when you are fasting, your brain dumps out this chemical
01:55:04
erection to force you awake and you're wide awake. People with narcolepsy when we've studied their brains, they have a
01:55:11
deficiency of this brain chemical arexin. So they can't stay awake in a
01:55:16
stable fashion. They have the opposite of your fasting problem. You're wide awake because you've got too much
01:55:21
erection. They've got too little Rexin and they therefore they can't sustain
01:55:27
stable wakefulness during the day. So they're constantly falling asleep. M this story of ereexin has led to the
01:55:34
invention of the first new class of sleeping medication that I actually favor and most people are not aware of
01:55:40
it. It's a new class of we're on to essentially web 3.0 of sleep medication.
01:55:45
Web 1.0 were the benzoazipines things like Xanax and Valium not great for
01:55:51
sleep. The second wave the web 2.0 those were things like ambient lanesta sonata.
01:55:58
Both of those drugs worked in a very similar way where they go up to your cortex and they tickle a receptor called
01:56:06
the GABA receptor, GABA, GABA. And it's the major neuroinhibitory transmitter of
01:56:12
the brain. So when these drugs flood your brain, they just hit the red light and they stop neural firing of the
01:56:18
cortex. Essentially, they sedate you. And sedation is not sleep. But when you
01:56:24
take an ambient, you mistake sedation for sleep. It's not quite the same. It's not
01:56:30
naturalistic sleep. But after we realized by way of the story of narcolepsy that narcopsy
01:56:37
patients, they don't have this chemical erection and they're falling asleep inappropriately during the day. Well,
01:56:43
think about what insomnia is at night. Insomnia is almost the opposite of
01:56:49
narcopsy, which is that narcolepsy patients, they're falling asleep during the day when they want to be awake.
01:56:57
Insomnia patients are awake at night when they want to be asleep. So what they realized is that what we can do if
01:57:04
this chemical ereexin, this wakefulness volume button in the brain is a problem
01:57:10
in insomnia patients. What if we were to just develop a drug that doesn't sedate the cortex like ambient? Instead, it
01:57:18
goes down into the brain stem where the center for erection is. And these new drugs and they're called the Doras
01:57:24
drugs, D A small s. And it's a class of drugs. There are three FDA approved and
01:57:31
I'll try and spell them out for you. They're called suvaxent, lumberexent, and daredexent.
01:57:38
Exactly. Why my sinapses are filled with things like those names, but there you go. They're three FDA approved drugs.
01:57:45
And what they do is they act like a clever set of chemical fingers. They go down into the brain stem where this sort
01:57:51
of erection is being released and they just dial down the volume on wakefulness and then they take a step back and they
01:57:58
allow the antithesis of wakefulness to come in its place which is this thing called naturalistic sleep. Now if you
01:58:06
look at that those clinical data they absolutely make you sleep for uh not
01:58:12
necessarily a longer period of time but you're awake a lot less. So you've got nice sleep efficiency, more continuity.
01:58:19
But I as a scientist could be very skeptical and I could come along and say, "Okay, so this new drug, it
01:58:26
increases your total sleep time, improves your sleep efficiency, but I have four words. Yes. And so what? Just
01:58:34
because I've added sleep to your night, how do I know that that's functional
01:58:39
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,
01:58:45
they did a study where they looked at what we call the glimpmphatic system in your brain. There's a cleansing system
01:58:51
in your brain that kicks into high gear during deep non-REM sleep. And it flushes the brain of all of the
01:58:58
metabolic toxins, two of which are things called beta amalloid and ta protein, which are the culprits of
01:59:04
Alzheimer's. And that's why we know that sleep is so important because at night, it's a good night sleep clean. It's a
01:59:09
power cleanse that washes away the Alzheimer's toxins. So they did a study. Heavens knows how they got these people
01:59:16
to participate. But they brought them in. They were 50 years or older and in
01:59:21
the morning and the night before they had a lumbar spinal puncture and they siphoned off cerebral spinal fluid. So
01:59:29
they could measure how much of the metabolic detritis was in the brain before sleep and in the brain after
01:59:35
sleep including the metabolic waste product sort of including beta amalloid and and tow
01:59:41
protein and they either had one of these drugs the Doras drugs or they had a placebo
01:59:49
and fair enough when they took the this new class of medication the web 3.0 to the Dora drug, their sleep got better.
01:59:56
But what they also found is that not only did their sleep get better, but they had cleansed the brain the next
02:00:03
morning of more beta amaloid and ta protein than the placebo group. In other
02:00:08
words, it wasn't just epifenomenal junk sleep. It was beneficial sleep. It was
02:00:14
adaptive useful sleep because that drug induced sleep had washed away more of
02:00:19
the Alzheimer's proteins. And it was the first demonstration and they've now replicated it in animal models that this
02:00:26
is a sleeping pill that isn't disadvantageous which we know to be the case for things
02:00:33
like ambient. In fact, ambient there was a recent study that showed that it decreases the cleansing pulsing fluid by
02:00:40
about 30 to 40% at night. But this is a new class of medications that does the
02:00:45
opposite. And this is new. And this is new. The Doras drugs D O R A small s. problem is that a lot of
02:00:51
insurance companies here in the United States currently do not reimburse. Some do and I believe that it's some of these
02:00:59
of the three doors drugs, not all of them are available in Europe or in the UK. Probably about right and because they're just so expensive
02:01:05
and if you pay out of pocket, it can be up to $400 a month for these
02:01:11
medications. Now, some insomnia patients when I go to them and say, "At the end of a shockingly bad month of sleep, if I
02:01:17
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
02:01:24
sleep over the previous month, would you like to give me $400?" Most of them would say, "Absolutely, take my money."
02:01:29
But still, people are being priced out at this stage, but the Doris drugs, please look into them if you're
02:01:34
struggling with insomnia as well as CBTI. I didn't realize there was so much new science and research that had been
02:01:41
discovered on how to sleep well, what's going on in the brain, and also some of the lifestyle factors that have made
02:01:48
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
02:01:54
a SEO. Is I'm going to put a link below because I think this is a particular episode where if you share this
02:02:01
conversation with some of your friends who particularly struggle with sleep or sleep optimizers or who have sleep
02:02:06
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
02:02:11
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
02:02:16
your own personalized link to share this episode. And those of you that share this episode, whether it's on your
02:02:22
story, on social media or in a WhatsApp group or wherever, on email with your friends, you will collect points for
02:02:28
every person that listens and I will reward those. Um, you'll see as you click on the link who have shared it the
02:02:34
most. In part, I say this because so many of you come up to me in the street and they came up to me after our last conversation and they said, um, that
02:02:40
conversation you did with Matt Walker was so amazing. I sent it to my aunt and she now d she did this and she's changed this and blah blah blah blah and she's
02:02:46
now sleeping well. And then all the downstream impacts of that have been profound. So I'm going to create this little system
02:02:53
to encourage all of you to share it with someone that um is struggling at the moment with sleep because I do believe I do believe that sleep is upstream from
02:03:00
so many of the downstream symptoms that ruin our lives whether it's relationship issues whether it's libido issues or
02:03:07
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
02:03:14
that a sleep-d deprived person has their genes fundamentally working differently. You talked about 700 genes working
02:03:20
differently. Yeah. 711 genes are distorted in their activity caused by a lack of sleep. Some
02:03:25
genes that are overexpressed that are related to cardiovascular disease or stress or inflammation and other genes
02:03:32
that are impaired which are associated with your immune system. So you become immune deficient
02:03:37
and it can be a downward compounding spiral if you're such a person that's really continually strugg struggling
02:03:42
with sleep and building up some of that sleep debt. So that link is below. Check it out. And we have a closing tradition
02:03:47
on this podcast where the last leaves a question for the next. The question left for you is what did success bring you
02:03:53
that you never could have dreamed of?
02:03:58
It brought me two things. one beneficial one less. So
02:04:06
beneficial is that I have now the chance and have gifted the chance to
02:04:14
fly around the world and tried to speak the word of sleep because the physiology
02:04:20
of it is so silent. And I used to lament why me because there are so many other
02:04:26
much better sleep scientists in the world than me. And a friend after I was saying like I don't understand why me
02:04:32
imposter syndrome and he just told me to shut up and accept that it's you and
02:04:40
instead asked the question what are you going to do with it and I changed how I embraced that. So I've been so fortunate
02:04:46
that my life after publishing the book that you're holding changed forever and almost all for the
02:04:53
better. And I'm so fortunate. I have lived a life of such fortune by way of
02:04:59
the sleep mission. I would say though that there is
02:05:05
also, and I suspect you may experience some of this too, when you raise your
02:05:11
head above the public parapit, don't be surprised if shots are fired.
02:05:17
And if you're someone who has even the vaguest
02:05:24
hint of insecurity, comments will do you a lovely
02:05:30
disservice. And so I think there's a degree of kind of vulnerability and
02:05:35
insecurity that you can develop by way of becoming um someone who is in the eye
02:05:40
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
02:05:46
about whether it's you know your intellect or your voice or your you know
02:05:52
disastrous you know boyband haircut whatever it is um I would say that's the only slight downside overall I am the
02:06:00
most fortunate human that I know. I am so gifted by way of this thing called sleep. It's a love affair that's lasted
02:06:06
me almost 25 years and I believe it's the most beguiling topic in all of
02:06:12
science and it has treated me so well. You happy?
02:06:18
More than you could imagine at this moment in my life. I am the happiest
02:06:24
I've been. Why? I have a a piece that I found in
02:06:30
life for reasons that I can share or not share. And go ahead and share them. I'd love in my
02:06:36
life. You know, I found my person and and she is she
02:06:43
appeared like lightning from a clear blue sky. Never saw her coming.
02:06:49
And it's interesting that
02:06:57
I've never been able to be more myself, even with myself,
02:07:03
than I have with her. Every day she makes me want to be a better person.
02:07:10
And I have found peace that I have never had
02:07:16
before. That you've never had before? No.
02:07:21
Did you have peace last time we spoke? I wouldn't say I was without peace. I
02:07:28
didn't know this type of peace and I never believed in this notion of
02:07:33
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
02:07:41
such uh I didn't think there was such a one. I would have told you if you'd told me
02:07:47
that two years ago, you'd given me your love story of certainty. I would have
02:07:52
thought you're misguided and that, you know, you just need to put down whatever
02:07:59
substances you're using because you're delusional because there isn't such a thing. Um,
02:08:07
she's a gift and I hope I never take her for granted.
02:08:12
I doubt it. There's a an incredibly sad story of a gentleman called Clive Wearing. And
02:08:20
Clive is a famous individual in the neuroscience world. And Clive was the
02:08:27
man who the movie Momento was based on, which is a movie where a
02:08:33
man has brain damage and he has profound amnesia. And from that moment forward, he can never make any new memories
02:08:39
whatsoever. He's densely amnesic. And he was a real life individual. He
02:08:45
contracted a virus that destroyed his memory centers. And from that point forward, he could no longer make any new
02:08:51
memories. And he lived in just 2 or 3 seconds of time. And that spotlight of
02:08:57
consciousness just moved forward in time. He had no recollection of the past. He had no anticipation of the
02:09:02
future. And the only thing, the only person that he remembered and he would recognize is his wife. So he could have
02:09:09
spent this whole three hours speaking to you. And then you would walk out the room for five minutes and you would walk
02:09:15
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
02:09:21
only person that he remembered was his wife. But the problem was he never remembered how long it's been since he
02:09:27
last saw his wife. And so every time that she would walk into the room after
02:09:33
being out of it for 5 minutes, he would jump out of his chair and he had this
02:09:38
incredible elation and he would run and he would hug her and kiss her. And I
02:09:44
think sometimes we take our partners for granted and the only time we realize how
02:09:50
precious they are is when they're gone. And I often think about that that
02:09:55
complacency can be one of the greatest negative forces in a relationship. And I always think about Clive Weiring even on
02:10:03
the days where I'm having a bad day or I'm in a bad mood and I'm not myself or I just don't want to be around someone.
02:10:09
I always try to remember his reaction. And when my wife walks back in from work
02:10:14
or I see her, you know, first thing, I try to remember how his reaction was and
02:10:21
how I truly feel at the time despite the blanket of negative stress trying to
02:10:27
drown that feeling out. It's a beautiful thing. I think about
02:10:33
that a lot as well. In what way? just the part of I'm way more cognizant now on a frequent basis
02:10:40
almost on a weekly basis of how I'm going to feel when my time is up as it relates to rel
02:10:48
my romantic relationship like I think even like mid argument I will now think and this actually happened like a couple
02:10:54
of days ago it wasn't really an argument we're disagreeing about something I literally said mid mid uh dispute that
02:10:59
we were having I said we're going to regret this so much and what I meant was when I when that When that phone call
02:11:05
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
02:11:11
wasted doing this. Yeah. I'm really going to regret it. How much would you give to have that 30 minutes? Exactly. And it's like, you know, we're
02:11:17
arguing about, I don't know, some whatever it might be, some trivial thing. It's actually really helped me because in the midst of those storms,
02:11:25
um, 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.
02:11:31
um it liberates you from the pettiness that a sense of immortality can create
02:11:37
and that pettiness results in the complacency that you're describing that like I I took you for granted.
02:11:44
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
02:11:51
provide nuance there which is this doesn't mean don't address things correctly. I was just about to say conflict is critical. You've got to
02:11:58
fight well, but let it be me versus you and the problem. Like me and you versus the problem versus me just going at you.
02:12:04
Yes. You have to be fighting for each other, not fighting against each other.
02:12:09
Yeah. Exactly. And that you have to try to then in that context of Clive wearing
02:12:15
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
02:12:23
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,
02:12:29
you always come out feeling better than you did before. And with conflict, if you do it well, you typically, it may
02:12:36
not be the hour after or even the day after, but if you do it well, you typically are better as a couple after
02:12:42
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
02:12:48
saying is Clive Wearing's story to me of how he loved his wife with an intent
02:12:55
that I'd never experienced before until I met my much better half
02:13:01
prevented me from resentment. Resentment is the barrier that will keep
02:13:06
you from reparation and a future of I think equinimity.
02:13:12
Because when you resent someone, it means that you haven't processed, you haven't moved forward. And resentment
02:13:18
usually comes by way of I think a poor choice of things such as did I win the
02:13:23
argument? Did you win the argument? It's not about point scoring at least. And I've done that before. I've been guilty
02:13:30
of all of that behavior. But now with this person that I cherish most, you
02:13:36
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
02:13:43
the conflict afterwards. And I'll always want to reach out with an olive branch
02:13:49
because it's not worth it. Just as you said, when that call comes, you know, I I think of that sometimes
02:13:55
when I have a bad day. Let's say someone, you know, I come back to my car and my car is being rearended when it's
02:14:01
been parked or, you know, I was coming here to fly out and we were 4 hours on
02:14:08
the tarmac waiting and there's a guy in front of me who's getting all agitated
02:14:13
and giving the the ground staff all sorts of vitriol. And I was thinking, look, when you're on
02:14:20
your deathbed, my good fellow, are you going to look back at this day and think, gosh, you know, I remember that
02:14:27
one day when I was on that flight coming out to LA and it was 4 hours delayed.
02:14:32
No, of course you're not. So, if you're not stressing about it when you're dying, why are you stressing about it
02:14:38
now? It's just not worth it. Live. Thank you. Thank you so much. I
02:14:45
mean, I can't thank you enough for the profound impact you've had on so many millions of people. Um, being the the
02:14:52
chief torchbearer of the subject of sleep and creating a movement around sleep, but also a heightened awareness
02:14:59
of ourselves and our struggles. And that is something that you'll never understand. Like, you'll never understand the full magnitude of the
02:15:04
many millions of people you've positively impacted. Um, but I mean even though you'll never get to meet them all
02:15:10
and you'll never get to hear all of their thank yous, they are very very real people and they are that the them
02:15:16
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
02:15:23
live a happier healthier life because of the work that you do. So it's um incredibly important work, Matthew,
02:15:28
and I hope you long continue it and I long continue being the conduit of this very important information to people like me and my audience. Couldn't
02:15:35
appreciate you more. Thank you so much for saying that. I can't lay claim to any such um uh affirmations, but I would
02:15:43
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
02:15:49
colleagues in the field and all of those who came before me. Um I'm just the mouthpiece and not a particularly good
02:15:54
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
02:16:00
opportunity to say that.
02:16:06
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 dire of a
02:16:12
CEO. Welcome to my inner circle. This is a brand new private community that I'm
02:16:17
launching to the world. We have so many incredible things that happen that you are never shown. We have the briefs that
02:16:23
are on my iPad when I'm recording the conversation. We have clips we've never released. We have behindthe-scenes
02:16:28
conversations with the guests and also the episodes that we've never ever released. and so much more. In the
02:16:35
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
02:16:40
the types of conversations you would love us to have. But remember, for now, we're only inviting the first 10,000
02:16:46
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
02:16:52
daccircle.com. I will speak to you then.
02:17:10
Oh, hey.