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- [00:00]
A
Hi, guys, and welcome back to another episode of biohackit. If you follow me on Instagram. A couple of weeks ago, I posted that I had increased my sleep score. And I posted that if you guys want to learn about my sleep protocol, that I mean tampering with and tweaking with a little bit here and there. My guest today, Dr. Chris Winters.
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B
How'd your day go?
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A
Was absolutely incredible. He's a sleep expert and a neurologist, and he came on the show to teach us about all things that actually are worse than what things actually improve your sleep.
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B
The functioning of your day is much more in line with how you feel about your score than the way you act actually slept. Look at your sleep tracker at the end of the day, not the beginning of the day.
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A
That can sign and signal that there are other things going on in your body. You could have a parasite issue. You could have.
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B
Did you say parasite? It's crazy to me that you said when you wake up, the first thing popped in your head was a parasite.
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A
I'll tell you why. And what about people like Elon Musk who probably only get. Well, he's said to only get three to four hours a night and he's so high functioning.
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B
Yeah, I think there's.
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A
I just think he's an alien.
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B
Firstly, top two questions I get from people. How can I fall asleep faster if I wake up? How can I get back to sleep quicker? To me, the best thing you can do for your sleep.
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A
So to learn more about how to improve your sleep, what supplements actually really work for sleep? And what quick habits can you stack that will dramatically change your sleep quality and quantity? Tune into the episode. So on average, if most people are sleeping like six, six and a half to seven hours, that's the bell curve, right?
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B
Yeah.
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A
How much deep sleep and REM sleep should somebody be getting within that six and a half, seven hours? Because I'm wondering for myself, because I woke up this morning and I saw my aura ring in my eight sleep. I'm like, damn it, Iman, you're only getting six and a half hours a night. That's not good. You should be averaging at least seven to eight and a half. Like, I was like, I have to start going to bed even sooner because that's bullshit.
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B
Well, it depends what happens if you go to bed early. If. If you go to bed early and you're like, I'm asleep in five minutes, then yeah, it sounds like you probably need more sleep.
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A
Okay.
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B
If you're going to bed early as a lot of people do, a lot of clients, a lot of patients. And they just sit there. Then they don't need it or they go to bed, they wake up three hours later and they're up for a couple hours. That's your brain saying, great that you've decided to be in this bed. Great that you've decided to buy an extra large pizza. It's not a problem that you can't finish the pizza by yourself.
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A
Right.
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B
Nobody looks at, you know, finishes half a pizza, calls her doctors. I need an appetite stimulant. I am starving to death. Why? Because I can't finish my dinner. What's your dinner? It's an extra large pizza with a lot of meat. Okay, well, why did you think you could finish it? Well, my friend who's a football player eats a whole football. You know, so we have to look at it ourselves and kind of take our body's cues as being helpful. If you're saying to me, look, every time I sit down, I fall asleep. I can't drive a car without falling asleep. I can't get through a meeting without falling asleep. Then you do need more sleep. But for a lot of people, it's, they look at their aura ring, they got a certain number, they had a different number in their head and they immediately treat that as some sort of pop quiz. Like, oh, I failed the OR exam today. And what's really interesting about trackers is your day will be dictated by the functioning of your day is much more in line with how you feel about your score than the way you actually slept. So if you wake up and your little oura ring has frowny face, you'll have a frowny face day. So we have to be to me, I tell my patients, look at your sleep tracker at the end of the day.
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A
Okay, not at all. So don't check it first thing in the morning.
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B
How'd your day go? That was a great day. I interviewed this guy who sleep and I was running around, went to the gym, had a great workout. I was on the treadmill with my best two mile times ever. Okay, so it sounds like you had a great day. What did your r ring say? It was a smiley face. Fantastic. It was a frowny face. Well, what does that mean? And to me it's sort of like I remember a baseball player telling me one time he went to his, his, his manager and said, I can't play today. I got a bad ring score. And the manager was kind of like, look great, you're going to play anyway. And he had two Home runs that day. And he called me up because I couldn't remember your name. But we figured, finally figured it out. I just wanted to let you know because for years you've been telling us it's not about tonight. Tonight's sleep is irrelevant. It's all about the sleep you've been getting over the last 30 days. So to me, you could have a terrible night of sleep and win an Olympic gold medal. People do it all the time. So keeping things in context and letting that ring sort of guide you in terms of if you're averaging six and a half hours and set aside six and a half hours and move on with your life.
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A
So I have two questions for you over there. One is that if people are waking up in the middle of the night, you're waking up at 2, 3 in the morning. That can sign and signal that there are other things going on in your body that are disrupting. You know, you could have a parasite issue. You could have other things that are playing it off.
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B
So you say parasites?
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A
Yeah, Even things like parasites can come up. Right? So. So there's crazy to me that you
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B
said when you wake up, the first thing popped in your head was a parasite.
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A
You know why? I'll tell you why.
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B
Wow.
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A
I'll tell you why.
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B
So not sleep apnea?
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A
No, no, no, no.
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B
Parasite.
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A
I'll tell you why. So when it comes to Chinese medicine, different organs are linked to different parts of your body at different clock times. So normally, if you're waking up at a set window every single time, so if you're waking up between 2am and 3am or something like that, there is a circadian rhythm issue over there, and a lot of Chinese doctors will talk about it. And there's also sometimes a parasite issue because that's when they get active. So. Because in Chinese medicine, the way they clock it, they time different organs with, like, different, you know, working. But this time it's this. If it's this time, it's that. So that's why I thought to myself, it's that. Two, if you're getting into bed and you get an outburst of energy at night versus you're really tired in the morning, you could have a dysregulated cortisol issue. Right. So cortisol is not obviously in the right direction. So don't we think we should also be paying attention to those things when looking at sleep hygiene?
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B
Of course. So, number one, everybody wakes up at night. That is not a pathological state. Generally, average human's waking up five to eight Times per hour. Most people never knew that until they got a sleep tracker that showed all the awakenings. So. And I would sort of separate out an awakening where you remembered waking up. If you said, chris, did you wake up last night? I would say, no, it's not true. I probably woke up five or six times an hour. I just don't remember it. Versus an arousal is what you're seeing on your watch. So if somebody says, look, I was never waking up, but over the last six months, I've gained some weight, I'm waking up more and more. This is absolutely something we should pay attention to. Would I go in terms of my differential diagnosis of why this is going on to pinworm right off the bat or take. No. Could happen. Ask me how many times in my career I've seen people waking up because of a parasite. Very few.
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A
How many of them have been tested for parasites?
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B
Well, I guess what I'm saying, though, is I'm going to test you for sleep apnea first, of course. And when you stop breathing for 48 seconds, 100 times an hour, let's treat that first and then see what happens. And then you start working your way down the pathway of, okay, Chris, I'm treating my sleep apnea, but I'm still waking up during the night. My point is, we shouldn't be too upset about waking up at night. Okay, top two questions I get from people. How can I fall asleep faster? What happens if I wake up? How can I get back to sleep quicker? And to me, to me, the best thing you can do for your sleep is adopt a present attitude of you're going to wake up and go to the bathroom. Sometimes it's not that big of a deal. In fact, if you sit there, do some breath, work, pray, meditate, think about your celebrity crush, whatever you want to do, and you're happy being in bed awake, it's doing probably 85 to 90% of what sleep's doing. So what I see day in and day out are people who are upset about it. And that's the definition of insomnia. There's no such thing as a person who can't sleep. There are people who have an idea about what their sleep is going to be, and when it differs from that reality, they get upset about it because they think there's a consequence to it. That's what insomnia is. So if you don't find being in bed awake to be particularly upsetting, I don't. I love it. Then it never really sinks its teeth into you. So we just have to be very careful about what are we doing about people who wake up. Because that's when negative pills and all kinds of bad treatments start to get into the mix. It's natural that we wake up. We're supposed to do that.
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A
I think waking up that much is not, I was not thinking about it from that perspective of people who are not getting the amount, adequate amount of REM sleep or deep sleep. So how much on average, if the average bell curve is six and a half to seven hours within that bell curve, how much of that should be your REM and how much should to be properly rested?
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B
Yeah, so generally speaking for an adult you could take half of your night and that's light sleep. It's about 50% transitional and light sleep. And then the remaining is going to be divided between deep sleep and REM sleep. So ideally 20% REM sleep, 20% deep sleep and the rest light sleep. But number one, sleep trackers do not do a great job of tracking that. I think sleep trackers are fantastic for calculating the amount of sleep that you're getting, which is important because for a lot of people, they underestimate it.
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A
Right.
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They think they're not sleeping. I see patients every, every day who feel like they're only sleeping an hour at night, when in fact they're sleeping closer to five or six. They don't perceive it. So understanding how much you're actually sleeping is really important. I do think there's benefit in looking at sleep trackers in terms of if you're never getting REM sleep night in and night out, could it be a medication, could it be a disorder? Absolutely. But yeah, so it's generally about half of half or 20 to 25% in both those stages.
- [09:58]
A
Spring cleaning looks a little different in my house these days. It's not just about organizing my closets, it's about what I'm actually bringing into my space. Especially as someone who cares deeply about my metabolic health and lowering overall toxin burden load. I've been using Branch Basics for almost five years and it's just one of those swaps that totally makes sense to me. I used to have a whole cabinet of different cleaners, all with ingredients I couldn't even pronounce. And the more I learned about hormonal health and environmental toxins, the more that started to bother me. So I switched. What I love is that everything is built around one powerful concentrate. I dilute it to clean my kitchen, bathrooms, laundry floors, even produce and makeup brushes. It's plant based and mineral based. Fragrance free and made safe certified, which means it's screened against known and suspected harmful chemicals that we do not want in our homes or in our bodies. It feels aligned with how I live. I'm not extreme about everything, but I am intentional. And this is one of those small shifts that adds up day in and day out. If you're doing a reset in your home, I really encourage you to look at what's under your sink too. Branch Basics is available@target.com, target in store, Amazon and of course branchbasics.com you can get 20% off@branchbasics.com with code biohackit20, which is B I O H E C K I T20. After you purchase, make sure you tell them you heard about them from our show because a clean home should actually feel clean also for your body. And then what about you also touched upon that, hey, somebody could say they have a bad sleep score, but they perform so well at work, whatever they're doing. That could also be somebody who has a highly dysfunctional nervous system. Right. That they just wake up and they grind themselves and they push and they push and they push. But they're completely ignoring that this aspect of their life. Right. Because there are other parts of their life that they're hyper vigilant, they're over performers, they're over pushing themselves. And a lot of people are like people can be highly dysregulated so. Well, how would you be able to track that this person is a dysregulated person who might not have a good nervous system versus this is just how much sleep they need and they're functioning just fine.
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B
Yeah. So we, we talk about this a lot, that there are genes that allow individuals to get inadequate sleep and perform quite well. They've never come up with a great name for. I always call it horsepower. Meaning you look around a medical school class, they're not the most brilliant people in the world. They're very high horsepower. People stay up all night on call, you never see a bed or a call room, yet you function the next 48 hours without any sleep. Not everybody's able to do that. It's a double edged sword. Sure, it gets you through your residency, your law clerk, whatever your thing you're doing. You're a police officer on shift work. But it's something that will probably eventually shorten your life. So to me, how do you recognize those people? I think you recognize those people by you put them in a position where they're sitting quietly like a meeting, a lecture A church service behind the wheel of a car, and they're falling asleep. Brains have to sleep. There's no getting around it. They have to drink some water from time to time. You've got to breathe some air, eat some food and sleep. These are non negotiables. So when your body is not getting adequate amounts of sleep or there's dysfunction in the sleep, it will be reflected as a desire, a drive that is high for sleep. Meaning that somebody's sitting down talking to you during an interview, and they fall asleep in the middle of the interview. That's a massive red flag. But it's interesting that culturally we would look at that as, wow, great sleeper. He can sleep anywhere. He fell asleep during a podcast. Yes, he's exhausted. So we only pay attention in the media to people who, quote, unquote, can't sleep, whatever that means. To we completely ignore hypersomnia. And hypersomnia is the number one sort of sign that you are short changing your sleep, either through sleep quality, sleep quantity, or consistency.
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A
You guys were also coined by the San Francisco Giants as being their secret weapon.
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B
Yeah, I think their pitching and batters were their secret weapon. But, yes, I've worked for them in the past.
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And you coined the term circadian advantage. So I want to talk a little bit about what that term actually means.
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B
Yeah, so you mentioned circadian rhythms, which are really important and often overlooked in the sense that the San Francisco Giants obviously play on the west coast and they have to fly to play the Yankees every now and then, and that travel and that jet lag becomes a problem. So they'll go play the Yankees for a while. And generally speaking, for every time zone we travel, it takes us about a day to adjust.
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Right.
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So if they go out to the east coast, play the Yankees, play the Mets, after about three days, they're adjusted to the East Coast. So when they fly back to San Francisco to play a game, they're the home team and have the home field advantage, but they don't necessarily have the circadian advantage. They might be playing the Atlanta Braves. And if you're a gambler, you may want to pay attention to this. I'm kidding. The Atlanta Braves have been playing in Seattle, then they went down to play the Dodgers, and now they've come up to play the Giants, who've just gotten back from the East Coast. So the Giants have the home field advantage, but the Braves actually have the circadian advantage because they've been hanging out on the west coast for a while. They're all adapted to the west coast, the Giants are now dealing with that east to west jet lag. And so you get these unusual situations where, yeah, you're the home team and your fans are cheering for you when you do something good, but your body is not adjusted to that time period. And so that was the, the premise of our research, that, you know, part of what a home field advantage is is usually you're more likely to have the circadian advantage, but there are weird times when you don't. And so we can all learn. I'm not a huge sports fan, but I think sports are a great little laboratory to look at that. We all kind of deal with these circadian things all the time. Even the transition we just did from standard time to daylight saving time, we don't ever fully adjust. And so usually, you know, I use products like Natrol melatonin. I don't use melatonin every night, but when I travel or during, you know, times we're changing time zones or daylight saving to standard or back. It's a great way to sort of quickly adjust your body and get over that performance slump that comes with it.
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A
What are your three top tips for people if they're doing long? Like, I travel to the Middle East a lot, right. And I'm coming back and I'm working different time zones and stuff. What are your three top tips for people to work on their circadian health? Yeah, to like get you acclimated to the time zone you're traveling to faster rather than taking three days.
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B
So I would say, number one, some sort of melatonin product. I'm not big on sleep aids and sleeping pills, but I think that the thoughtful use of melatonin can really help people. So that would be number one. Why does melatonin work? It's working through light. There's some really interesting light products. AO re timer, there's some light boxes, but I like the ones that you wear like the AO glasses where they are shining a light in your eyes at designated times. And so if you pair those devices and maybe some sunglasses with some sort of jet lag calculator, hey, I am sitting here in Miami. In seven days I'm going to fly to the Middle East. I will be there for, you know, a week or two and then I'm coming back. You put all this into the calculator. It will tell you, okay, starting tonight, this is when I want you to exercise. I want you to move your dinner a little bit earlier. I want you to move your wake up time a little bit earlier. So it Starts to do things, manipulating your light, manipulating your meal timing, your exercising to get you prepared for the trip. And then once you get there, it will give you some ideas of what to do to quickly acclimate to that time. There's also some really interesting research that came out of Chuck Cliff Saper's lab in Harvard many years ago that fasting when you travel can be helpful. That you're actually turning off the circadian axis of your brain. You don't really turn it off, but you're suspending it. If you think about a squirrel is living its life looking for nuts and a mate and suddenly the nuts run out. It's not in that squirrel's interest to go to sleep until it finds food. Food is more important than sleep. As much as I hate to say it, lack of food will kill you probably a little bit quick. Well water will maybe not food. So what happens is when you are your body senses that you're not eating or you're starving. It suspends one rhythm and turns on a different one. So if you don't eat when you travel, you ignore the bees off cookies and all the great food on the airplane and wait till you get your location and wait further. Once you get to that location for the next meal time and have that meal, your body will often reset its circadian rhythm along with that timing. So fasting when you sleep, a melatonin product and exercise schedule doesn't change when you travel. It's as essential as brushing your teeth.
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A
So essentially if you're somebody works in the morning, stick to that.
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B
Yeah.
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A
And what do you think about getting like natural light in the eyes and things like that? They're like when you land to some grounding, get some natural light.
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B
Absolutely.
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A
And also recently because I hosted a supper club in for south by Southwest, Rhonda Patrick basically said creatine is another great addition for people with like high dose creatine. So when you're getting to a place taking up to 20 milligrams.
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B
Yeah. Which is basing that on. It was some research about it had less to do with jet lag and more to do with if something's interrupting your sleep, are there things that you can do to offset some of the negative con cognitive consequences. And there were two really interesting studies about higher doses of creatine that allowed you to sort of be your best at that meeting at south by Southwest even if your sleep was disturbed. So I always tell patients and athletes that the creatine is plan B. It's not. Well, I'm Gonna stay up and do some stuff and as long as I hammer the creatine tomorrow, I'm gonna be okay.
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A
I, I think that's what people try to get wrong. I think when you're talking about health, your foundational aspects is your hydration, quality water that you're drinking, how much sleep are you actually getting? Is a good quality sleep, like you said, and making sure eating properly, no supplement can out like kind of win that right. Supplements, not even clothes and supplement come second tier. As a solution in good quality supplements such as yours that offer that advantage that you can have to make sure you hit those goals. But those goals are still your core pillars of your foundational.
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B
Absolutely. You know, I remember British cycling many years ago, said, look, we're not doing well in the Olympics. We have great cyclists, but we're always coming in fifth and fifth and sixth. And they hired an individual who said, well, let's make everything we do 1% better. We'll make our helmet 1% more aerodynamic, we'll make our kit that we wear 1% lighter. The shoes one, you know, whatever. And they just crush the next Olympics. And I think about that a lot with things like supplements that they're not going to take somebody who's never ridden a bike and win you a gold medal. But if you're close to the gold medal and can't quite get there, that's where things like Natrol Ultra sleep, like the creatine, like the, you know, the glasses and headbands and rings can really take somebody who's kind of at the, outside the podium and put you on the podium. I think that's the best way to think about these things.
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A
You've also consulted for the FBI and the US Military, which I thought was fascinating. When someone is in a life or death environment, what is. And sleep is not an option. They're like, in that place, what is the number one tool you give them to maintain executive function?
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B
That's a great question. That's a fantastic question. And I think about this a lot because there is an individual out there, maybe she works for the FBI or the military, and she's basically saying, I fly a plane, I land on carriers, this is my schedule. And let me tell you something, the military, special forces, Naval special are some of the worst schedules I've ever seen. I'm always kind of like, it feels like the question, okay, I'm living in a place with no food, how can I eat food? Yeah, I'm like, I can't magically make it so not to Be flip about that. I would say probably in those situations, FBI and military, it's probably pharmaceuticals. The medications we use for hypersomnia, narcolepsy, using these things off label, where you've got to land that plane, you've got to capture somebody in the middle of the night with night vision goggles, and you haven't slept because you had to stay under the radar to get. It's probably some sort of drug to keep you up. But I think the better spin to put on that would probably be, what are you doing in the 30 days prior, prior to that elite operation? I think is probably the best answer to your question. And that's where I often say sleep's the most important thing in the world. Tonight, sleep is irrelevant. What I'm trying to say is if you're constantly doing the right thing and something weird happens tonight, flights canceled, friends in crisis, and you're up all night talking to them on the phone, you're gonna be okay. It's like skipping a meal. I skipped breakfast today, and I'm doing okay because I generally don't skip breakfast. I'm getting my meals and trying to eat well. So I think it's doing all the things right to prepare you for that upcoming thing in your life where sleep's not going to be an option.
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A
In all your career, kind of doing this and working with different, like, clients and patients and all that stuff. What has been the most insane turnaround story you've had on someone's like, you
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B
mean they were doing poorly and then they weren't? Yeah, yeah, I think.
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A
And you were even shocked by that?
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B
It's funny. I'm shocked on a daily basis. I think the ones that shock me the most are patients who deal with hypersomnia disorders. Narcolepsy, idiopathic hypersomnia is a condition called Kleine Levin. I was working out with a guy one morning, some guys in a neighborhood where I used to live would get up and work out. And one of the fathers was talking about his high school daughter in terms of she's been diagnosed with treatment resistant depression. She is probably not going to graduate high school. She's really smart. And, you know, and parents always say that she's so smart, but she's not going to grab. And so as he was talking, he doesn't want to get out of bed, sleeps all the time. I just said to him, as we're doing our burpees or whatever. Have you ever considered narcolepsy? Has her doctor ever considered that? He's like, no, no, nobody's ever mentioned that before. So she came to see me in the clinic. She had flagrant narcolepsy. We treated her for narcolepsy. This young woman is a second year in college. She is straight A's, got into a very, you know, prestigious, you know, third year program as an undergraduate at the University of Virginia and is just crushing it. It kind of brings tears to my eyes because had I. I am famous for missing workouts for people like, if you are going to work out, I'm going to stand you up. And it means it's not personal. It's just because I'm lazy and I'm like, always have something I need to do instead of the workout. Right. I really need to like, make sure the garage is cleaned up or whatever. So I, you know, I just happened to be there that day. And some of these hypersomnia disorders are some of the most missed disorders in medicine. So if you're listening and you're. You sleep all the time and you always fall asleep and you can never feel awake or refreshed. You talk to your doctor and just say, do I have narcolepsy? Because those are the biggest turnarounds I've ever seen in my life. I mean, they're just incredible. From complete dysfunction on all kinds of medications for ADHD and depression and anxiety and bipolar mood disorder too. I don't take any of that. I'm just taking my narcosy medication and killing it.
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A
What do you think the root cause of a lot of these, like, really serious sleep disorders is? Like, what does it come down to? Because it has to be a reason people are having them, right?
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B
Yeah.
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A
And what are the patterns?
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B
I'm going to set aside insomnia for a minute. Sleep apnea, I think, has a lot to do with the fact that as a population, our weight is going nothing but up. Although I do think last year, probably because of the GLP drugs, for the first time as a population, weight went down. I've been told this by a weight loss doctor that that could be wrong. But I think they seem to know what they were talking about. For the first time as a population in the United States, our collective weight went down probably because of these drugs. So I think that the relentless increase in weight and our struggle with what to do with obesity in this country has led to more sleep apnea. Now, you mentioned menopause at the top of the show. Women who are going through menopause suddenly have much bigger risk for sleep apnea. There's something protective about Estrogen, we've never been able to figure out. So if you're a small woman and suddenly you're not sleeping well, you might be snoring, you might not be consider sleep apnea, because doctors will completely miss that in you. So insist on, hey, could I have a home sleep study? Because I think I might have sleep apnea. And if you don't, great, check it off the list. Move on with your life. When it comes to why do we have narcolepsy? There is a genetic narcolepsy. There is also an autoimmune. There was a great case study back in the day that One of the H1N1 vaccines probably kicked off a big bunch of narcolepsy in a lot of people. That, yeah, we help with a little flu, but we also cause this autoimmune disorder in a lot of people. So they're still kind of working out those two different mechanisms. Restless leg syndrome probably has to do with dysfunctional iron. A lot of people can be deficient, but there's also primary restless leg. But that's a genetic disorder as well, too. Insomnia. Insomnia is interesting. Insomnia, no matter how much we talk about the right things for insomnia, it doesn't ever seem to get better. I think with more information, more things being thrown out at you, more even good information, hey, we discovered this great thing that sleep does. It protects you from Alzheimer's, it protects your heart, whatnot. It puts people under this pressure that I've got to go to bed and sleep perfectly tonight or I'm going to have dementia by the weekend. And I've got a big weekend plan, so I cannot afford to have dementia. You know, it's that kind of mentality. So I think that the more we talk about sleep and the more information we put out is great, but it also leaves a lot of people scared that they're not doing it right.
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A
When you brought up dementia, it was actually brings me to my next question for you, because most urologists study Alzheimer's, but you chose to look at sleep as a big component of that. So was there a 30? Was there a specific shift that you did in residency where you saw that there was a line between sane and psychotic blur for people? Did you see something come up that you're like, you know what? I think these people are not being diagnosed correctly with Alzheimer's. Yeah. So because there's a massive sleep component to that as well, right?
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B
There is.
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A
When you said dementia, I was like, wait, there's that correlation as well.
- [28:35]
B
Yeah. So we've always known that people who sleep inadequately. And when I say inadequate sleep, I'm generally referring to shift workers, people who work two jobs, people who would ordinarily sleep more, but their life circumstances. I'd love to sleep more. I gotta drive this Uber and make a living so I can pay my mortgage. So they're shortchanging their sleep. They're in careers that do that. Trauma surgery is a famous one, because no matter, nobody is trauma surgeon nine to five, and those individuals tend to have dementia more. And so we've always known it probably has something to do with inadequate sleep, but we don't know why. And there was a woman, Nettergaard, it was the University of Maryland, I believe, who discovered that it's probably because when we sleep, we engage a glymphatic system that pumps out impurities from our brain, mainly tau proteins. It's the stuff that kind of makes up the glial tangles and neurofibrillary tangles in Alzheimer's plaque. So it's like. I think of it like a bilge pump. Like, the boat has that little pump in the bottom that's constantly pumping out the little bit of water that gets in there, that when you don't have it, you could turn your bilge pump up for a day. Your boat's not going to sink. But if you're never pumping that water out day in and day out, you're radically increasing your risk of dementia. So I'm a neurologist, and neurologists can do movement disorders like Parkinson's dementia, stroke, epilepsy, and sleep. So even though I specialize in sleep, we see a lot of dementia, we see a lot of headache, we see a lot of movement disorders. So it's one of those things that I find very encouraging that even if you possess the genes for dementia, that if you're somebody who sleeps and really optimizes your sleep and does all the things that you're talking about, you know, sets aside time for sleep, exercises, eating well, creates a consistent sleep schedule. You can. You can change your odds of getting these disorders just by the things that you do. So we're not beholden to our genes, even though that it might tilt things further from our favor. But there's a lot of doctors, a doctor out at UCLA, Dr. Bresden, who basically says Bredesen, that says we diagnosed diabetes too late. By the time you're showing blood sugar abnormalities like that, you've missed the boat. So you're wearing a glucose monitor he also believes that we diagnose sleep apnea too late. By the time you're, you have sleep apnea on a sleep study, you should have been treated for that a long time ago. And those two things, he said, could account for a significant portion of dementia. So this is sort of beyond where medicine is sort of caught up. But I probably tend to believe in some extent.
- [31:08]
A
So is there things that patterns people can notice in themselves if they're still young enough 20s, 30s, even early 40s, that they can correlate when checking their sleep score or looking at how many times they're waking up at night or anything like that that can correlate to them maybe developing something like Parkinson's, Alzheimer's and dementia later?
- [31:25]
B
Yeah, and I love the idea of the 20 year old doing that. It's, to me, it's, I always call it the sunscreen effect, meaning at some point, like when I was young, we'd go to the beach. The first three days you were there, you just recovered from the blistering sunburn. And then you kind of moved on with your beach vacation. And you know, my children, we were so crazy about sunscreen. I live in Florida now. I look like I live at the North Pole because I'm so pale. But you know, I'm very careful about sun. And I love the idea of somebody in their twenties now being really careful about their sleep. I think this is the time to where you can make the changes. Look, there's never a wrong time to take a supplement like, you know, Natrol, like, like the magnesium. But if you start that early and you're always getting the magnesium and you're multiplying that by an additional 20 years of taking the right supplement with magnesium and gab and botanicals in it, or you're taking, you know, you're exercising early, you're creating a consistent sleep schedule and making your bedroom nice and cool and doing all those things. It's like the investment advice people always give. You start investing in your 20s. If you wait till your 30s, you're shortchanging yourself like $2 million by the time you retire. I think sort of the same thing. So I think that that's one of the wonderful things about social media and platforms like yours, that you're engaging people to do this in a much earlier age versus my health is failing now. I'm ready to sleep. Well. Well, yeah, it's a little too late.
- [32:50]
A
It's a little bit too late for that. That's why. So what is the ideal age? 20s would obviously be ideal. But most people are, you know, college partying. They don't really give a shit. This younger generation is a lot more aware, which is I'm super proud to kind of see.
- [33:02]
B
Yeah.
- [33:03]
A
But let's say if you miss the boat in your 20s, what is the next best time that the impact that you make will actually like register in that sleep bank and benefit to you?
- [33:13]
B
I would say it's tonight. And what I mean by that is if you're 30, go for it. Start now. I don't think there's a window there. You know, the lovely thing about a 20 year old is they can abuse. And I know this from working with athletes.
- [33:28]
A
Yeah.
- [33:29]
B
Is they can abuse themselves, stay out all night, go to the clubs in Miami, and they can still show up and be the best person on the court or the field. And that's a difficult conversation to have with a 20 year old. With this little sleep doctor comes in, I'm like, man, you should probably get a little bit more sleep. Why? I lead the league. I'm making so much. This sounds really unfun what you're talking about. I'm like, look, you can do it now or you can be replaced in five years. I've seen people with amazing talent that five years you're like, remember that guy? He was so good. Whatever happened to that guy? You're more likely to get hurt. You're more likely to see a drop off in your productivity. You're more likely to have mood issues that affect your motivational issue. Just name something. And dysfunctional sleep or inadequate sleep is going to make that more likely to end your career. In fact, we did that research many years ago. So if you want a long career and lots of money and prestige and all the cool things that go along with, I guess, being a famous baseball or basketball player, figure it out now. And people do. Like I'm seeing that I'm old enough now to remember a time when people had no idea why I was talking to them. And now it's like, oh, I'm so glad you're here. Here, I got some whoop data I want to show you. And this is a 19 year old right out of high school.
- [34:46]
A
Yeah.
- [34:46]
B
So the culture has really radically changed.
- [34:49]
A
Yeah.
- [34:49]
B
And it's, it's awesome. Like, my job is so much easier. I'm just polishing things now rather than being giving a lump of clay and told to mold it into something beautiful.
- [34:59]
A
How much sleep do you think Tom Brady is getting? A night ton.
- [35:02]
B
In fact, here's my funny Tom Brady Story I have. I was on his podcast and I didn't really tell anybody about it, my kids or whatever. And I got a call at 3 o' clock in the morning and, you know, I wants to get a call.
- [35:18]
A
You're like, I'm sleeping, man. Why are you calling me at three in the morning?
- [35:21]
B
Three o' clock in the morning. Call from a son of mine who was at the Naval Academy. So my first thought is, oh, he's expelled. He's done something. He stole something and threw it in a pool as a joke and, and thought it'd be funny. And now they're expelling it. So you get the call, it says your son's name on the phone. I'm like, yeah, what's going on? What's going on? He's like, dude, Tom Brady just tweeted about you. I'm like, okay. He's like, oh, I just wanted you to know. At three in the morning, three in the morning. So I think Tom Brady gets a ton of sleep.
- [35:49]
A
How much on average do you think he's getting?
- [35:51]
B
I'm guessing, you know, it's interesting. My guess, it's a little bit less now that he's a little bit older and he's no longer playing professional sports. Although every time he pops up on my Instagram, he's like playing in a professional, like flag football, making perfect pass. Why are you not playing? I think you should. You're better than probably 50 of the people in the league. So my guess, he's probably an eight and a half hour guy, on average maybe nine, you know, if he can get it. And you know, to me, I'm obsessed with not necessarily the best athletes. And so we're not talking about Tom. I'm obsessed with the people who have long careers. You know, why did you have a 15 year career but this other person who was a better player than you had five? And I think it has everything to do with getting your shit together when it comes to your sleep and your schedule and then being probably lucky with genetics. But, you know, he had a long career. He didn't really get that injured. We know people who sleep longer are less likely to get injured and recover quicker from the injury. So any professional athlete who doesn't have sleep in their, like top five list, I don't think is really. In fact, I was talking to a young player with the Blue Jays about this and I said something to him. He's like, yeah, he's, I do that already. He goes, I think this is all part of me Being a pro, I thought that was so interesting. Like, that he's like, great that he's already thinking about this. But listen, I, I think this is part of my job description at this point. Like, I'm not a pro baseball player if I'm not paying attention to my sleep.
- [37:21]
A
Right. Anyway, and what about people like, Elon Musk could probably only get. Well, he said to only get three to four hours a night. And he's so high functioning.
- [37:28]
B
Yeah, I think there's.
- [37:29]
A
I just think he's an alien.
- [37:30]
B
Firstly, I'm gonna. I'm gonna plead the fifth on that one. I, I. You could really. I could be convinced very easily. I'm a man of science. If you're like, yeah, he's not of this Earth. Okay. Yeah, kind of. I kind of like, dude, I kind of felt that all along, actually. You have that sense, like, you have a sense somebody's lying to you. Like, I have a sense, like, I have a sense that. Yeah. You don't behave. You know, it's funny you say this, I don't know if this will get me in trouble or not. He behaves like somebody who's created a humanoid robot. That's pretty good. Yeah, but you know what I'm saying, Like, I know you're a real person because of your mannerisms and your expressions, and you look like a real human. There's something about him that's like a really good robot. Like, they almost got it, but. But you, like, missed the mark, passing the Turing test. Like, I think you're a robot. And like, oh, yeah, there you are. You peel off the face and it's electronics.
- [38:29]
A
So, anyway, I always find that fascinating. I was like, if this man sleeps three and a half to four hours a night, and he is not only one of the wealthiest people on the planet, but he is powering innovation at a speed that we can barely even keep up with. I'm like, how is this even working? So you're not from this planet.
- [38:46]
B
I don't think he's sleeping four hours a night. So it's interesting. There's a couple things going on there. Number one, perception. One of the things I love, the game, one of the games I love to play with patients is if you have a sleep tracker. Our ring. Whoop. Band Withings. Watch, Whatever. When you wake up, get a little journal. When you wake up, you write down how much you think you slept.
- [39:03]
A
Okay. Before you look at your data.
- [39:05]
B
Before you look at your data. And then at the end of the day, you say you have a Great day, bad day. And then you write. Then you get to look at your data and how close is your perception to that device. And what I often see is a lot of individuals overestimate their sleep. I see people who underestimate their sleep. So I think Elon, somebody who underestimates it, like, if I talk to his partner or partners, I think he has several. And I would, you know, get a little scroll of all these women.
- [39:33]
A
Yeah.
- [39:33]
B
How much do you think Elon sleeping? My guess is they say, oh, probably, I don't know, six. And he thinks four. So I think he's definitely what we call a short sleeper. He's on that left side of the bell curve. Tom Roth was this researcher in Detroit his whole life, looked for people and tried to figure out what's the smallest amount of sleep that people are getting. On average, he came up with like four and a half. He found two people, I think, in his career who was sleeping about 4 hours and 45 minutes and felt great, like they didn't need more. It was not that they were sleep depriving themselves. It was that if you put them in a resort in Jamaica, they would sleep 4 hours and 45 minutes, wake up, and be like, let's go. And if they tried to sleep more, they wouldn't be able to. This is highly unusual. So I think most people who talk about getting, you know, two hours sleep only sleep four hours, are probably getting more now. I would also ask him, are you falling asleep during the day? Do you nod off in your airplane flying?
- [40:24]
A
That man don't seem like he's falling asleep.
- [40:26]
B
No, I. I don't disagree with you. I don't. So those are funny. There's a radio DJ in London. I used to be on his show. He's, oh, Dr. Winner, it's great to see you. How's sleep? What's the world of sleep treating you? You know, whatever. And he's like, you know, I only sleep four hours a night. And I was like, listen, I want you to. You got all these fans, tape a camera to your head.
- [40:43]
A
Yeah.
- [40:43]
B
And just livestream 24 hours a day. I said, I want to see what it looks like to only sleep, whatever it was, two or three hours, four hours a day. He's, oh, don't do it. You're hilarious. Got to go now. Take care. And he would never do it, but I was like, just turn it off when you go to the bathroom and you want to do something intimate with your partner, but keep it on. Show me. Because science has been Looking for you since the beginning of sleep research. Like, if you're truly only sleeping three hours, I want to be the person who finds you and reports you. Like Dr. Winter found a guy who's only sleeping three hours and runs a radio show.
- [41:15]
A
He's that high and is doing great.
- [41:17]
B
Yeah. And seems like exceptionally high energy. Like maybe drug induced high energy thing, but yeah. I mean, you look at Elon like, he doesn't look tired.
- [41:25]
A
No.
- [41:26]
B
You got all kinds of ideas.
- [41:27]
A
He doesn't look all present. I'm not sure. I'm not sure.
- [41:29]
B
Yeah, they're sort of sleep deprived ideas, but yeah, he's got ideas.
- [41:33]
A
Yeah. So, yeah. Do you think that comes down to certain people's genetics? Essentially certain people's.
- [41:37]
B
I actually have my d. I'm sorry to interrupt you. I love asking patients, what do your parents do for a living?
- [41:43]
A
Right.
- [41:43]
B
My mother's a trauma surgeon. My father is a high profile attorney who I've never seen in a bed. And you probably going to be like that too, right?
- [41:52]
A
Dysregulated nervous system, dysregulated sleep hygiene. Not knowing the difference, you know, I also feel like when, you know, I'm. I'm South Asian originally, so our parents would just lug us wherever we went. They're like, go to sleep wherever. Your aunt's house, doesn't matter. Sleep on the stool. They didn't base their lives around us. We had to do what they said. Now my friends who have children are like, my child, I must go home right now because my kid needs to nap. Because the nap gets disrupted, the kid's not gonna sleep at night. I'm like, guys, you are so type A. Your children need to have flexibility because if they're just structured into these, like, quiet little environments, then they can't adapt to life.
- [42:25]
B
You're 100% correct.
- [42:26]
A
Right? So in order to make more adaptable, versatile, dynamic adults, you gotta train them as children to be like, hey, we're out. You're gonna sleep here. This is part of the protocol.
- [42:36]
B
Absolutely. I remember one time going camping with our kids and, you know, s' mores were done, it's getting late, and the adults want to sit around and talk. And I was like, okay, guys, you all need to go to bed. All three of them went to the same tent, unzip, got in their sleeping bags, zipped up and went right to sleep. And I remember, I remember one of the other parents saying, God damn, like,
- [42:58]
A
how'd you do that?
- [42:59]
B
What they said was, you're so lucky you have Good sleepers. I said, there's no luck here. This was something that we coach train them like you train them. So, and, and what you're getting at is I need you to believe that sleep is important, but also understand that life is going to happen and things may not. So you've got to create that adaptability. In fact, when our kids were about six years old, I told them, you know, when they arrived at that age, look, you're practically an adult now. You can go to bed whenever you want to. What I meant was be in your room at 7 o'. Clock, you know, whatever time we decided you need to be in your room. But in terms of when you wanted to go to bed and turn the lights out, you can. If you're really into your magic Treehouse book, keep reading. I don't care. Now I'm going to wake you up same time every day. I'm going to do it kindly and nicely, but I wanted them to have some sort of control over it and not turn your light out. If you don't get to sleep, you're going to get sick and do badly on your spelling test. So I understand where that type A is coming from. We want our kids to sleep well and be healthy and good little citizens. But you have to kind of relinquish some of that control and let them know you may get in bed tonight and not fall asleep right away. It's fine, right? You're gonna be okay.
- [44:07]
A
What is the best like or healthiest sleep latency somebody can have? And for anybody listening, sleep latency is when you get into bed and actually fall asleep. So what on average you consider good versus somebody who's exhausted.
- [44:19]
B
So I would say 10, 15, 20 minutes somewhere in there. So it's called 15. 15's good. I think if it's five minutes is not great. So. And that goes against everything that everybody wants. If you look at a media article, how can I fall asleep Faster? Faster. What are. Here's some simple tips and tricks to fall asleep faster. Fall asleep. So we have this sort of fascination with speed to unconsciousness. And sleep should be a thing where you get in bed and you're there for a minute, you know it's okay. So if you're falling asleep in two minutes, and this is what I hear all the time from the partner, it takes me forever to fall asleep. I wish I could be like Hank. Hank's asleep before his head hits the pillow. I'm way more concerned about Hank than I am you.
- [45:02]
A
Yeah.
- [45:02]
B
So if it's 2 minutes or 30 seconds or I'm asleep before my head's the pillow, then I think your point is very important, which is, why are you so driven? Like when I walk into a restaurant, I don't even wait to order. I just eat food off of other people's tables. Like, whoa, why? Because I'm so hungry.
- [45:19]
A
What's going on in your body? Yeah, right.
- [45:20]
B
What's going on? You're starving to that. So I think when you start getting into. It's taking me 45 minutes, an hour, two hours. My first question is, how do you feel about it? If the answer is, oh, I don't mind, then I don't really mind. But if it's like, oh, I'm really frustrated about that, then we start simple. Like, are you going to bed a little bit too early? You know, you're a retired accountant, you spend most of your day watching Hot Bench and not really doing anything. You don't exercise. And, you know, maybe you're 80 years old, you may not need nine hours in bed. So are you looking for a realistic amount of sleep? And then after that, you know, some supplements using something like melatonin. If you struggle with that onset around daylight saving time, you're a shift worker or whatnot, trying to increase exercise. I always tell people, if you don't exercise, you gotta exercise. If you're already exercising, exercise a little bit more. So any kind of working your way up from there. But I think 15 minutes is probably a good thing to shoot for.
- [46:13]
A
Talking about exercise, I just saw a report and whoop had basically released it, that people who work out later in the day at night before they sleep, it actually curves like 20 or 30 minutes off their sleep. So workouts should be done in the morning. Guys, if you're listening to this, so don't go and work out and kill yourself after work because you also raise your cortisol and your body goes, oh, I'm hyper alert now. I'm just starting my day. So actually after like mid afternoon, which is why they tell you to cut the caffeine and stuff as well, you actually have to teach your body to start winding down and release that cortisol and kind of go into more of a rest and digest sort of a state so you can prepare for bed because you're not just magically going to click your fingers and fall asleep unless you are that lucky. And I'm jealous.
- [46:53]
B
If somebody says to me, when should I work out? I always say the morning. Morning always ask me when I work out. It is not the morning. So if you're somebody who says you don't. I don't. I do not. I have gone through periods where I do. I just don't like it.
- [47:06]
A
Right.
- [47:07]
B
So what I do is as soon as my clinic's over, I work out around four and then I work very hard to, when that workout is over, to do exactly what you're saying. Get my body temperature down.
- [47:19]
A
Yeah.
- [47:20]
B
To start to rest and relax. Look at lighting, look at temperature. What are you eating? So if you ask me, do you feel like exercise in the morning makes your sleep. Absolutely. Yeah, absolutely. But you know, I was just talking to a guy today who's a business person. He has to get up at 5:30 in the morning anyway if he's going to get his workout and he's getting up at 4, that, that's, that's even worse. So. And a lot of athletes are like, look, I close baseball games. I don't even start my work day until 10 o' clock at night. I'm super jacked up on caffeine. I have to go in there and strike three people out. So you know, there are ways that if you're like, listen, I can't do this morning exercise, you know, saunas, cold plunges and things like that where we can manipulate body temperature. I love the devices you put on your bed to cool your bed. Looking at lighting in your environment. What are you eating at night? Not only in the timing of it, but what are you, you know, whether the constitution of the eating or are you moon milk or something. There's all kinds of little things that can really help you mitigate that cortisol jump that you get with your exercise and try to get yourself kind of grounded very quickly. Meditating after you exercise, there's lots of ways you can do it. But morning's best is anybody who tells you otherwise is, is not, is not being truthful.
- [48:32]
A
And I know also some people are more sensitive to light than others. So you know, I got, when I got my DNA tested, one of the things that came back was light sensitivity. And I was like, I never realized that. So I started getting a blackout mask and I wear that now and it's a little pressurized around my periorbital and what that does, it helps me stay asleep longer and it did improve my REM sleep and my deep sleep. And I was like, oh, that's interesting to know that my DNA was a type that was affected by natural light. And so I need to, if I'm going to sleep, need to have the Blackout and a little bit of pressure, and it did definitely improve my sleep. And I wake up feeling more rest.
- [49:06]
B
Oh, I've told people if everybody listening to this podcast has bought a mask, whatever you want, and if you need recommendations, just text me. There's so many good masks on the market.
- [49:15]
A
Right.
- [49:16]
B
And wore it for one week. My guess is 50% of people would continue to wear it because they would see such a change. It doesn't take much, especially for somebody like you. Travels a lot. You're going to be in a great hotel in a couple days. What's the lighting situation there like? And that's where you really start to see things like melatonin supplements shine, because you're pairing it with lots of light and exercise and temperature changes and social interaction in the morning, and then you're really shutting that off at night. And with an eye mask, I mean, there is no light getting in.
- [49:49]
A
Correct.
- [49:49]
B
And a lot of people cannot simply make their bedroom that dark. Got a skylight, got a curtain that doesn't close. Like I always tell people, if you're in your bed at night and you've got your hand in front of your face and you can see your fingers, it's probably not dark enough.
- [50:03]
A
Absolutely.
- [50:03]
B
So I. I travel with this mask everywhere I go. It's a game changer for a lot of people.
- [50:08]
A
You, earlier in the episode also talked about the glymphatic system. So I really want to educate people. What is a glymphatic system? Why is it so important? And how does sleep play into that?
- [50:18]
B
Yes. So when I was in medical school, I remember this because it struck me so strange that the professor said your body has a lymphatic system for getting rid of waste, but your brain doesn't. And I remember thinking the most important organ in your body doesn't have a
- [50:35]
A
way to get rid of it.
- [50:36]
B
Makes no sense. Well, fast forward many years and this. This researcher finds it and she names it the Glymphatic system. And she discovers not only is it getting rid of waste, it's just very delicate and hard to see on a dissection, but it does exist. And it's something like 10 to 15 times more active when we sleep. So it makes sense that if you're not getting enough sleep, if you shortchange your sleep and you're not engaging that system to its maximum ability over the course of a lifetime, you might accumulate some stuff in your brain that you don't want there. So I tell patients that this is a really encouraging thing that we're starting to understand why it is that sleep might play this cognitive health role. And dementia is coming for a lot of people. Cognitive slowing memory problems are coming for a lot of people. And it's really heartening to look at the research it says, but if you're somebody who really pays attention to your sleep. Do you remember 60 Minutes did that with, they interviewed all those hundred year olds. I mean some of these. And when they died, they donated the brain to science. And I remember watching like these people do the cha cha and they're 100 years old and they're like mentally sharper than you are, they're running circles around the interviewer, they die and when they dissect their brains in a lot of situations, there were pathological signs of dementia there, there were brain atrophy, increased size of ventricles, but they're not manifesting the signs that you would think of with dementia. And I always thought, I can't prove this, but I always thought, I bet those people are hell of a. They're great sleepers.
- [52:07]
A
Yeah.
- [52:08]
B
You know, and they're doing all these things to maximize the potential and they're not manifesting what one. So if somebody showed me their brain, I'd be like, oh, that guy's got dementia. Yeah, no, they didn't. Right up to the time they were born, they never really showed that. So I always wondered if nutrition and exercise and dancing the cha cha with your partner of 73 years or whatever in good sleep, you know, kind of makes that difference. And that's where I think, you know, let's try to make our 94% awesome sleep, 97% supplement and exercise and great nutrition and light and blocking light and consistency of schedules, all those things are great.
- [52:42]
A
When you guys were creating Natrol, what were the key ingredients that you thought this. Ha. With all the research that you saw, the brain scans you've seen, you know, health issues people were having, what were the key ingredients? It just came to me to be like, this is what we're going to start with. This is going to scientifically make a difference. And what did you see correlated on the research that impacted what you put in there?
- [53:01]
B
Yeah. So to be clear, I wasn't putting anything in there. Some scientists were doing that. But what's interesting is I've been approached by supplement companies for a long time and never really decided wanted to do much with them because I always felt like, number one, you're overselling what they these things do. Number two, I don't believe in the ingredients that you're using.
- [53:19]
A
Right.
- [53:20]
B
When they troll approached me, I thought their, their, their messaging and their science was just indisputable and they really gravitated towards things we have great research for like melatonin. There's amazing research in melatonin. I was just talking to a researcher, Phyllis Z, who does a lot of this circadian research up at Northwestern and understands that melatonin is extremely important for people with circadian rhythm disorder. So they use melatonin. They really advise people to use it intelligently. Here's when it's a good time to use it. Here's where it's at. This is a very studied. They use a distinct amount that's, that's well within the, the research parameters. So that was important.
- [53:59]
A
By the way, just on that melatonin thing, what is a good time to take and what is the dosage that. Because melatonin is also very controversial.
- [54:06]
B
It is, and I think it's controversial for a lot of reasons. We can get into. To answer your question, generally speaking, we make melatonin and it tends to be made. And the way I described, if you're outside throwing a ball back and forth with somebody like a baseball on a field, at some point you're not going to be able to see the ball until it's right up on you and you go like, let's stop throwing this ball because I'm just going to get hit in the face with it because I can't see it very well as the sun starts to go down about that point where you would stop throwing a baseball. That's the time when we have our maximal melatonin secretion. So a lot of people don't understand that and they're taking it right when they go to bed. So what you're doing is you're essentially creating a melatonin spike at 11 o' clock at night when our natural melatonin spike happened when the sun went down. So I always try to advise people, if you're just trying to support good sleep, trying to do it around the time of sunset is really when we're
- [55:01]
A
making body's natural rhythm.
- [55:02]
B
And that's why I think a lot of people who use it chronically will tell you it worked for a while
- [55:07]
A
and then stopped working.
- [55:08]
B
And then it stopped. Because what's happening, happening is, have you ever flown from the west coast to the east coast, it's time to go to bed. You go to bed, it's 11 o', clock, but your brain's like, no, it's not. It's eight because it's still, you're still on west coast time. What's happening is, yeah, the sun's going down, but you've been used to that melatonin spike happening much later. So for a lot of people, when you're taking melatonin late at night, you're creating a melatonin spike that's telling you it's 11 o', clock, you're getting this big melatonin spike from your supplement that's telling you. Right. Okay, the sun's going down, so we should be ready to sleep in three or four hours. But we're ready to sleep now. So the proper timing of that's important. Especially if you're trying to fly out to the west coast or you're flying to the Middle east and you're fixing
- [55:48]
A
your sleep hygiene or fixing your sleep hygiene.
- [55:50]
B
Yeah, the timing really makes sense. And that's why looking up good research about timing, using a sleep calculator that allows you to understand when the optimized time for what you, you're using makes a lot of sense. So that, that, that, that makes a big difference in terms of how these drugs work or these chemicals, how these supplements work. This is a non drug containing supplement.
- [56:11]
A
And then what other ingredients did you love in the supplements that you can tie back to data and research with all the information you've been fed, all the research you looked at, brain scans, habits, patients walking in, what do you think was so impactful?
- [56:22]
B
So I'll start with gaba. GABA has been around for a long time. GABA is a precursor to a lot of other neurotransmitters. There is some debate as to how much of it gets into the central nervous system. But that GABA is, you know, GABA is the main downregulating neurotransmitter in our brain. In fact, when we were talking about narcolepsy, one of the treatments for it are medications that affect GABA that allow you to feel more awake because it gets rid of that suppression. So GABA is very important. I think the botanicals are really cool. There's lemongrass, chamomile, tart cherry. Tart cherry has got a ton of research about it. I don't think I've ever gone to a professional sports organization that doesn't have tart cherry all over the place. It's anti inflammatory. It also tends to promote sleep in a very natural way. So again, it's just kind of a nice way to wind down. I like to do things like have, you know, herbal Teas. When I, I grow my own chamomile and lemon balm. So lemon balm. I might have said lemongrass. It's actually lemon balm and chamomile are in there. So, you know, using something that's kind of natural as a tool, trigger for. Hey, when your body's feeling this, this, this chemical hit its system, there's some relaxing properties to it. And I always tend to think that if cultures, you know, for millennia have used things like chamomile Dale, it's probably something to it. And I love the, the taste and, and the, the aroma of chamomile. I think it's a wonderful thing to travel with. So, you know, with the ultra sleep, it's the melatonin gaba and these three botanicals that have quite a bit of information behind them. Actually. If you look up tart cherry, it's really fascinating, actually.
- [57:50]
A
Yeah, that's on Tik tok. It was a point in time that all these young influencers were doing the tart cherry cocktail or drink mocktail.
- [57:57]
B
The, the, the, the sleepy girl mocktail.
- [58:00]
A
Exactly. Sleepy girl mocktail. And they were like taking it. I was like, wow, this whole thing. I also have noticed that people who have sluggish livers, if they get the proper liver support, that also helps them stay in a good pattern of sleep longer and healthier.
- [58:13]
B
Absolutely. No, I mean, one of the worst things, I mean, in terms of a sleep dysregulator is early sign, early stages of liver failure. I mean, when you can't detoxify your body effectively, it's not great for wakefulness. And if you're not feeling your best during the day, you're not going to sleep your best at night.
- [58:32]
A
So coming kind of towards the end of the episode, I also want to go over one more thing. As a neurologist. You know, the prefrontal cortex goes offline when retired. We all know that, right? How much of modern anxiety epidemic is actually just a collective neurological response to being chronically under arrested?
- [58:51]
B
How much of the insomnia epidemic is.
- [58:54]
A
Is being anxiety epidemic?
- [58:55]
B
Oh, I think it's because so many
- [58:58]
A
people suffer from it.
- [58:59]
B
Massive. It's massive.
- [59:00]
A
Okay.
- [59:00]
B
Massive. I love that. You know, and, and, and what you're basically saying is everybody's a filter. Like my filter is probably a little bit more dysfunctional than others. It tends to go away as you get older. It's why grandpa always says things that embarrass you in front of your girlfriend. You know, if they're around that prefrontal Cortex sort of is our online editor. It plans out movements. It's sort of mapping out our lives sort of behind the scenes. And it really takes a hit with. Sleep is disturbed and it's a big player in anxiety. So I think that you couldn't overstate that if you tried that in the life we live right now where we can be consuming media 24 hours, it could be good media reading War and Peace and. But the fact that we're so on all the time and don't make time to sort of unplug, we do create this sort of constant revved up. It's interesting because people always say, I have my cortisol checked and it's high. Therefore, you know what? Well, cortisol is a chemical that we all rely on. It's fight or flight. It's. You smell smoke when you're in bed and get ready to fall asleep, you're suddenly going to be very awake. It's great that we're not beholden to it. Like Rocky and Hail Mary. I love that little note that their alien species had no control over sleep and were completely vulnerable when they slept. So they wanted other people to watch them. The little Ryan Gosling character was being asked to watch where humans we sleep. It's undeniable. But we can interrupt sleep. If the house is on fire, there's a problem. So if you're always thinking, your house is on fire, what a negative when it comes to sleep and blood pressure and cardiovascular health and I mean, name something that's not affected by our chronic anxiety and I would be hard pressed to name something. So, yeah, I think you couldn't make a stronger statement for why we struggle right now with anxiety and sleep. It's. It's everywhere.
- [60:56]
A
And what is the difference between these light sleepers and really deep sleepers? You know, there's some people who you just what you do that for. And then there's people like me who the house will probably be burning down. And I'd probably.
- [61:09]
B
This is the problem in our marriage that, you know, my kids would come in, they'd vomit over the place, blood's coming out of their nose. And then they would be like, the next morning, I'm like, wow, so why the sheets covered blood? Like, your son came down bleeding out of his nose, sick to his stomach, and you slept through the whole thing. Like, my wife would not leave us, leave me alone. With kids when they were little, I would have to sleep on the floor next to the crib, you know, because. So I think the differences are A couple things. Number one, a lot of that was being sleep deprived in my training, not getting enough sleep. So when sleep becomes scarce, the drive to get it becomes intense. Meaning that I can make any light sleeper, deep sleeper by telling them, look, you're not allowed to go to bed until midnight and we get you up at 4. So join, go to West Point or the military academy and you'll be a deep sleeper very quickly, even though you're anxious just to beat the band. That's part of it, I think. I think there's changes that people see. You talked about being in menopause. I think there's something about women, particularly after birth, that there's their vigilance kind of goes up a little bit. I suspect that it's a, it's a physiological function. I look at lions. What does the male lion do? He sits away from everybody else. He kills an antelope, eats it and gives the rest to the pack. And maybe wants to kill a baby if he wants to protect his place in the spot, but he does nothing. It's the female that has to find the food, do all this stuff, watch out for predators, take care of the pride. Like they have all these responsibilities that the male does. And so I think evolutionarily their sleep has just become wired to the point where we're looking out for a baby's cry or something that's protecting because husband's not going to help, he's not going to do anything, he's going to sleep right through it. So I don't know, I find that really fascinating. But I think if somebody's feeling like, look, my sleep is really very solid up until a few weeks ago, a few months ago, and now it's not. And I've tried the supplements and all the things. I think that's when you might want to, you know, get some sort of sleep evaluation. Because in my experience, by the time most people come to a clinic, they should have been there three years ago.
- [63:11]
A
Right.
- [63:12]
B
You know, so pay attention. You know your body better than anybody.
- [63:15]
A
For women also listening, one of the great things, you know, hrt, starting younger versus it being full blown menopause, which a lot of people are treated for. So things like perimenopause can start showing signs and symptoms as young as 34, 35 now. So working with somebody who understands your hormones and adjusting things accordingly. Progesterone has been a game changer for me. I was waking up a lot more in the night and then I kind of got on low dose progesterone. Oral progesterone. And it was a game changer for me personally, helping me stay, sleep and restful. And now if the house is burning down, I don't feel like the house is burning down. I won't wake up.
- [63:49]
B
You know, you say something. I, I'll say two points.
- [63:51]
A
But even my dog sleep like that.
- [63:52]
B
There you go. I, I love it. What kind of dogs you.
- [63:54]
A
Three dogs. I have a pit, a Sheba and a Italian mastiff.
- [63:58]
B
Oh, wow. Big dog.
- [63:59]
A
And by the way, they will sleep. What my mastiff. Oh, somebody can break into the room.
- [64:03]
B
In the bed.
- [64:04]
A
In the bed. She's like my weighted blanket.
- [64:07]
B
I love weighted blankets. But no. Two things about menopause. Number one, when I wrote my first book, they said, this is too long. You got to cut something out. I thought, I'll cut the menopause stuff out. Nobody really cares about, you know, is really talk about the biggest mistake of my life. Not that I think it was important. I just thought that, oh, nobody's going to be looking to my book for that. Huge mistake. Number two, you have to be very careful. I'm 53 years old. When I was going through menopause or when I was going through menopause, when I was going through menopause.
- [64:36]
A
Men also go through menopause, by the way.
- [64:38]
B
Yeah. They do actually put the men in menopause.
- [64:40]
A
Right.
- [64:41]
B
So when I was going through medical school, I remember thinking that HRT was dangerous.
- [64:49]
A
Yeah.
- [64:49]
B
Put somebody on this, they're gonna have a stroke.
- [64:51]
A
They lied to you about it.
- [64:52]
B
They lied. You know, and it was interesting when you look back at that research. I mean, number one, I think even in a drug that is dangerous or has some sort of risk to it, it's still contingent upon us to say, look, Celebrex might increase your risk of having a heart attack by whatever, 2%. But without it, my knees hurt so badly I can't really do anything. So I think it's okay for a patient to say, I hear what you're saying. I'm going to take that 2% risk because this allows me to go to the gym, workout, be active. And I think we really made big mistakes with hrt. So I think anybody who's struggling with their sleep, who might fit that category that you think you're in, that you were talking about, really needs to find an advocate who's not only okay with HRT but really embraces, is educated about it. Because if you're looking at a 50 year old guy or girl went through medical school, I think I'm prejudiced and biased in a way I'll never be able to. I mean, I've fully embrace it. I know I recommend it all the time, but it's still like training that was ingrained in us. And when you go back and reflect on, I mean, that New York Times piece about HRT was just shockingly good that I think that as a sleep expert and on my podcast I've done so many episodes about menopause and how our sleep changes with our cycle and all this stuff to make up for the sin of taking that out of
- [66:19]
A
my book, it's crazy. For example, that's research study that was done, was done on synthetic hormones, not bioidentical. So bioidentical hormones actually do not have any side effects. If anything, they're incredible for women. And we robbed women out of decades of their life by scaring them. And then the new research that just came out said that, oh, by 65, you should stop HRT. You don't need to take it. It's actually the opposite. You can absolutely stay on. There's no research to state why you should get off HRT at 65 years old. And if anything, you actually needed more. But they tell you start supplementing it a little bit sooner when signs come up so that your body is doesn't run out of fuel. It has what it needs. It has a raw material to give you what it needs. So at 32, 34, 35, you're seeing shifts in your sleep, your skin texture, brain fog is creeping up on you. A lot of women have had a lot of kids, you know, two, three children. Okay, then look into your hormones, look at your hormone profile and see how you can support it with somebody who knows about HRT and can give you what you need to get the job done.
- [67:18]
B
The fact of the matter is, women are at a disadvantage when they go to a provider and talk about fatigue, sleepiness, brain fog. It's, it's unfortunate, but it's just we don't believe women. We will tell them this is part of gaslight. Then this is part about. This is what you decided to have kids. This is so I think that again, you know yourself, you know how you felt in your 30s. Now you're 35, there's no reason for you to be struggling to stay away, dealing with fatigue. There is something wrong. And if the first doctor that you go to can't figure it out, that's okay, go to the next doctor. And if they don't believe you, don't think it's a big deal. They say, look, that's what it is to be 30. 30 is candles on a cake. It means nothing. So, you know, I think about these things all the time in our clinic and, you know, not only in terms of sleepiness, but in terms of fatigue. And this is a great reason to be tracking your sleep. Like you were saying, I love asking it questions. You got a sleep mask. Did you notice a difference in your scores when you started wearing. You're now on progesterone. You're on some sort of hrt, you're on a patch, whatever. What does your tracker show? From the time you started using it till now, that's where these things shine. You don't believe. You don't believe me when I say alcohol isn't helpful. Your sleep, that's fine. Don't believe me. I'm. One opinion. Look at your tracker. Don't believe me. Like, when you. You go out and tie one on that night and you fall asleep immediately. Yeah, but did you sleep better? You know, what does that score look like? I love those things.
- [68:45]
A
I'm just so glad I got to do this episode with you because sleep is such a. I literally posted about this, like, two and a half weeks ago. I wrote to my community on Instagram. I was like, I'm trying to work on improving my sleep score and, like, little tricks and tips I can give people. So this was such an helpful and educational episode for me to learn from you about what's working, what's not, and kind of like what's bullshit and where trackers are handy versus don't not get married to the data.
- [69:09]
B
Yeah. Let it guide you. It's a. You know, it's. You know, I always find it to be a nice truth teller. Elon Musk is telling me he gets four hours of sleep. Okay, let me take a look at your tracker.
- [69:19]
A
Yeah, hand it over.
- [69:21]
B
Hand it over, y'. All. Your tracker says 6, 10. Okay. So, you know, I'm telling you, Chris, do you get enough? Yeah, I average about 7 hours of sleep a night. Hand it over. This says 6, 10. Okay. Well, I guess I've been traveling a lot. So to me, I just find these things to really help keep us in a lane of. I do get into ruts of traveling too much, taking too many red eyes because I want to get home quickly and not balancing out. Maybe I should stay a little longer and sleep in the next day in this nice hotel room and take a noon flight. And instead of the first light out of the brutal first one out because I want to see a few extra patients. Like, I think my patients would be like, hey, listen, I want the best of you.
- [70:03]
A
I don't. Yeah.
- [70:04]
B
I don't need the 5A. Yeah. Boarding zone to you. Like, I need something better than that. So. Yeah, I think it's great that you care. And. And it's also great that we having models of people who are doing well and are healthy but want to be a little bit more. I think that's. That's where this whole community can really shine. And yeah, Maybe it's only 2 or 3% better with your melatonin supplement or 2 or 3% better with your sleep mask, but multiply that 2 to 3% over the next 10 to 20 years. This is massive differences. So if you're looking you to, you can't fall asleep. Will the sleep mask help you tonight? Probably not. But don't underestimate what these things can do for you over a long period of time. Absolutely.
- [70:49]
A
Absolutely. Thank you so much for making your way down and joining me for the episode.
- [70:53]
B
I appreciate your time. Yeah, absolutely.