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A
Hi guys, it's Tony Robbins. You're listening to Habits and Hustle. Crush it.
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You guys are in for a huge treat. We have one of our favorite guests ever.
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There you go.
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On this podcast. His podcast has still be. I think you're still like the number one most downloaded podcast. That's why I keep on bringing you back, because you bring it. We have the sleep doctor.
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Thank you.
B
Thank you, Dr. Michael Bruce, back on the podcast.
A
Thanks.
B
Thank you so much for coming back.
A
This is the three peat, right?
B
It is a three peat. And you think like, how much more information can you even know about sleep?
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Fair question.
B
Right? But you like, but you cease to amaze every time you give like better and better, more concise new information every time.
A
Well, it's interesting because sleep is such a new field in medicine that there's like new things that we learn about all the time. I think that's one of the reasons why I like the field so much is because I, because I'm like this avid sleep nerd. I like read all the literature, but it's, it's something new happens. Like something miraculously new happens really quite often. One of the things that I was reading about recently, like current events in sleep, somebody was asking the question is Ozempic or Majaro the next CPAP machine, right? So for folks out there who are don't know what all this means. So for people who have sleep apnea, which is a situation where your throat closes the middle of the night, a lot of people have to wear a mask on their face which pushes air down their throat to keep their throat open. It's also a weight dependent situation in many cases.
B
Right.
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So Zep Bound, which is another name for Manjaro, which is of course like a GLP1, is now recently been approved by the FDA for sleep apnea.
B
Really?
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Right. Very interesting. Right. So now all of a sudden it's very interesting. So yeah, Manjaro has the. As Zep Bound, that's the trade name, is now available for people who have sleep apnea. If you meet certain conditions, like you have to have a bmi, that's a certain amount and things like that. But that's the first time something like that has ever happened.
B
So you mean people are now being prescribed Manjaro or, or Ozempic for sleep.
A
Issues, you could in theory do it. There's one drug that has actually been approved by the FBA to do it. So to answer your question, yes, that is a possibility. So then people say to me, like, well, Dr. Bruce, I don't want to get put on a CPAP machine. I'd rather just do a weight loss drug and see what happens. And so the question becomes, is that a good idea, Is that a bad idea? What do we think about that on the sleep medicine side of things? So I'm going to be honest with you. I think it's got some pros, but I think it has more cons than it does pros in the general sense. So the pros are you lose some weight, which is probably pretty good pro. But in fact, weight loss may or may not have anything to do with your airway. So depending upon where your weight sits on your body. So for example, if you got a lot of weight around your neck and you lose that weight, that's probably going to help sleep apnea because it's not crushing your neck in the middle of the night. But if you carry most of your weight through your hip area, it may or may not have a tremendous effect. So I could see it as a combination, as an example. So, for example, you might get put on CPAP machine, then use a GLP1 and then the pressure for the CPAP machine gets lower and lower and then we can take you off the machine. So I think there's a lot of different ways. I think people need to be creative, but it's kind of interesting idea.
B
Oh my. Yeah. I mean, first of all, Ozempic and Monger, these drugs are like taking over the world.
A
Well, here's what's weird. They've been around for 20 years. Like this is what people have been using for, to treat diabetes for forever like this. There's not a whole lot of new, new science here other than changing the indication a little bit. What's also been interesting is it appears to hit the addiction centers in some way, shape or form because of cravings. So now they're Talking about using GLP1s for gambling addiction, sugar addiction, porn addiction, things like that.
B
Really? Well, it also just takes away your, like, your desire to live. That's what it does though, right? Because it's like I don't feel like eating. I don't feel like going out to the. I don't feel like gambling because it's like you become so tired on it. You get, become like on it.
A
Yeah, I don't even have any patients that have. I've gotten on them yet. But it is fascinating.
B
It's. Can I tell you something? When it, when it came out, like. Well, wouldn't I know 20 years ago? It's been out by the way we're going to get into sleep, you guys, so just give me two seconds. But when it was, like, really popular, like three, four years ago, I tried it for a week just to see. Yeah, I was so nauseous. I was so sick on it.
A
A lot of people have pretty decent side effects. A lot of people don't even lose weight on it or the weight loss takes really long time. And one of the things that they're trying. Yeah, one of the things that they're trying now is doing micro dosing of GLP1.
B
Yes. That's a big. That's a very big trend right now.
A
And that seems to be one that seems to lower side effects for people. So they're not just getting this full dose, they're getting a smaller dose, and that seems to have some fewer side effects. But I don't, I don't. I haven't seen any research yet to make me think one way or another.
B
Well, because they were saying that the reason why people were getting so nauseous and sick was because the doses were. The dose was so big.
A
Oh, there you go.
B
And that's why they started. It became a popular thing to do, this microdosing. But anyway, like, I just found, like, if you have no. If you have no desire to, like, actually, like, live.
A
Probably not.
B
I mean, I'd rather. I'd rather be 10 pounds heavier or 20 pounds heavier. Right. Like, it's ridiculous. Okay, so let's get into all the other sleep stuff. So your new book is called Sleep, Drink, Breathe.
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Wellness is Too Fucking Complicated.
B
Wow. Yeah. You make it really easy. Like, that's okay. So why do I need to read that book if I. If I sleep, drink, and breathe every day? Is there something that you're gonna teach me that I don't know about?
A
I'm so glad you asked that question. So the truth of the matter is, is I wanted to look at what I call the dominoes of wellness. So I was reading this book by my friend Joe Polish called Life Gives to the Giver. And in it there was a section where he talks about these skills that you get that it's like a domino. And so one skill that knocks over so many other things, right? And so it's kind of like a. A crawl, walk, run sort of idea. And I started thinking, like, what are the dominoes of wellness? Like, what are the basics or kind of the DNA that what can you have to have to do or can't live without? And sleeping, drinking and breathing are three things. Like, you can go in A lifetime without exercising. You can go almost 30 days without food, right? But I mean, you can't get more than about four, five, maybe seven days without sleep and you start to hallucinate. I mean, you are not in touch with reality. You can only go, I don't know, maybe two days without water and then you're in real trouble. Air. Yeah, yeah, that's a, that one has to happen pretty quick. So I wanted to focus in and see to myself, well, if I could teach people in an easy way to improve all three of those things, what are the domino effects to the rest of their lives and the rest of their health, right? And so when you're sleeping better, you're drinking better, and you're breathing better, everything gets better in your life. Your mood gets better, your ability to focus gets better, your energy gets better. So this is kind of like the basics. Basics, basics. Because I got to be honest with you, wellness is too fucking complicated. Like, I talk to people all the time. They're like, Michael, like, do I have a green drink? Do I get into a sauna? Do I get a cold plunge? Like what do I, what do I do? To be fair, this is what you do. This is, this is where you start. This is kind of like a great starting line. And it's not overwhelming, right? I create a three week plan and a couple times a day I ask you to do some stuff and lo and behold, you're into wellness, right?
B
There you go. I mean, it's so funny you say that because like all these other modalities, right, like the red light and the sauna and the cold plunge, they like maybe like move the needle like itty bitty teeny tiny. Exactly, like 1 to 8%. Okay, if that. But people are not even focusing on the fundamentals, right? This is, and the, and it's been proven and you've, you've taught me this, that sleep is the, the most, the core, the core component of overall health.
A
Like, yeah, no question.
B
When you look into it and like how sleep can really, it can disrupt everything in your body and affect you in terms like. Well, you tell me, like, you can tell us again how does not sleep, sleeping affect your physical health?
A
So it's quite remarkable. We don't know exactly what sleep does to promote health, but we know what happens when you don't get it, right? So it's very interesting. Within 24 hours, you really start to feel a tremendous amount of fatigue, right? So let's talk about acute sleep deprivation. So pulling an all nighter, staying up for a few days because you got caught on an airplane and blah, blah, blah. So within 24 hours, you're feeling some pretty bad fatigue. You are saying, oh, my gosh. Now, some people do get a little bit of an energy burst at. Right. Kind of at that time, because they're like, oh, my gosh, my adrenaline is kicking in. Now all of a sudden, right now, you're at, like, 36 to 48 hours now. You're re. You're actually starting to feel some mild physical pain. Like, you're. You're feeling that physical fatigue. You're feeling all these things when you hit, you know, like 48 to 72 hours, you'll start to hallucinate. You will not be in reality. And by the time you hit four days of no sleep, I could ask you your name, and you wouldn't be able to tell me what it was like. That's how. So what it does is it affects every organ system and every disease state. Everything you do, you do better with a good night's sleep every time. Like, it's unbelievable. But sleep is flexible, so people shouldn't go, oh, my God, sleep is so important. I better get eight hours every night, because that's horseshit too. Right. We got to remember something like, everybody doesn't need the same amount of sleep. You certainly don't need the same amount of sleep throughout your lifetime. And it can also vary based based on the stress levels that are going on in your life, where you are on your menstrual cycle, if you're female, where you are in your pregnancy life journey, where you are in your age. Like, there's so many different factors. So people shouldn't lock into this idea of eight hours, but they should lock into the idea of sleep's important. Right? And so if I can put some very basic parameters around my sleep, I can get it to work really, really well. Let me give you one example. So you like it when I say things that are nice and short and kind of get it in there, right?
B
Yeah.
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So this is the number one hack, and I know you hate that word, but this is the number one habit to that I'm asking people to do. Wake up at the same time, seven days a week. No sleeping in on Saturday, no sleeping in on Sunday. Let me explain why. When you wake up in the morning and your eyes open up, sunlight hits your eye, and there's a melanopsin cell, which is a special cell that sends a signal to your brain to turn off the melatonin faucet in Your head, it sets a timer for 14 hours later. So if you're waking up at 6:00am, 14 hours later is 8:00pm and, and that turns on the internal melatonin, kind of like the internal Ambien, right? And now you're falling asleep on the regular, but now it's Saturday and you slept in until 8 or 9, right? So guess what happened? Your melatonin doesn't kick off at 8, it kicks off at 11. It is a direct relationship. The timing that your melatonin kicks into gear is directly related to what time you woke up that morning. So by being consistent, you can now consistently have your melatonin working. And here's what's cool about that, is when you're consistently sleeping within that schedule, when you do have a bad night, you snap back so much easier than when you don't. I have bad nights. Like the sleep doctor is not immune to all of this stuff. But when I do this one thing, it works so, so, so well for me because yeah, sure, I want to stay up late and watch something on TV or my wife and I go out someplace and we're, and we're doing something fun, right? And so I don't get to bed at whatever my normal time would be. My body can handle that merely because I wake up at the same time every single day.
B
No matter what.
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No matter what.
B
That's a great. Even on the weekends. That's a great tip. By the way though, I think doesn't it happen naturally? Like I so used to waking up at 6:20 during the week with my kid that like I automatically, my eyes won't, my eyes just pop open.
A
But the difference is a lot of people will stay in bed, fall back asleep and then they're lounging and they're doing this thing called bed rotting where they sit in bed for hours and hours and hours. Really stupid idea. Like get out of bed. Like this isn't tough. And what I also like about it is if you, let's say you wake up at 6:20 on Saturday, but you don't have to do anything until nine, you have all that extra time for you.
B
Yeah, no, that's so, so you're saying once. So even if that happens on the weekend, because that happens to me Saturday and Sunday, pop. My eyes go open. I shouldn't just like. So what I would normally do is just like I would like be on my phone checking. Like I'd go on social media until.
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7:15, not get out of bed, do something for you, meditate, stretch, read a book that you've been looking forward to. You now have book.
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Just kidding.
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You now have a time for yourself.
B
Yeah.
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Right. Because your kids are probably still asleep because they don't want to wake up at 6:20.
B
Right, right. Actually, they get up at the same time too.
A
Oh, do they? That's even better. Then do something fun with them.
B
So basically, then that's. That's the trick. To wake up every day, no matter if it's weekend, weekday, doesn't matter.
A
Absolutely. And that's one of the things we talk about in the book. Another thing that's really interesting from an overall sleep perspective, and I think this is relevant here, is sleep disorders do not just go away. Right. So a lot of people say to me, they're like, oh, Michael, you know, I had sleep apnea. I don't have it anymore. Bullshit. That's not how it works.
B
Really. You can't get rid of them.
A
It's not that you can't get rid of them, but they don't just magically disappear. Right. So what a lot of people tell me is they're like, oh, I don't have a sleep disorder. I just have four kids.
B
Yeah, yeah, yeah.
A
And I'm like, that. That's not true. Like, I know lots of people with four kids who get great sleep and aren't exhausted. So, like, really? Absolutely. So the thing that you have to.
B
Understand is, are they a superhero?
A
No, no, no. What they are is they. They have a schedule. They understand the effects of caffeine and alcohol on their sleep. Right. And when there's something going on, they fix it. Here's the reason why I think a sleep disorder becomes so important to recognize, to be fair, in about half the cases, it's something else. And you're seeing it through sleep. Right? So I can't count the number of people I've diagnosed cancer through somebody's sleep before. I have. It's weird how I. I'll tell you the story. But what's interesting, sleep is a window into your overall health. When you are not sleeping well, it is, nine times out of 10, a signal that something else is going on. Right. So you have to start to think about that. Like, if you. If you're waking up day after day exhausted and saying to yourself, wow, Mike, the quality of my sleep stinks. You could very easily have hypertension. You could very easily have depression. You could very easily have a thyroid problem. You could very easily have anemia. Like, there's a lot of things that that could be. Get it checked.
B
I know. Well, you Know what I feel happens now? Like now that I'm in my 40s now, falling asleep is not the problem.
A
Right.
B
The problem is getting up. Like getting up in the middle of the night.
A
Oh, yes.
B
I, that, that happens all like by, by.
A
I can fix that.
B
How? Okay, so this is my problem. So I get fall asleep, no problem.
A
Yeah.
B
3:30, boom, I'm awake. And then once I'm awake, got the answer. Yeah, can't fall asleep again.
A
Got the answer for you. It's going to take me about three and a half to four minutes. Just letting you know, because I know you usually like short answers. This one's going to take a minute.
B
Okay, go ahead.
A
So no, first of all, this is my number one video on YouTube. This video has gotten 5.4 million views at this point. To answer this question, and this question is the number one question that I get asked. The number two question is, what bed should I buy? It's kind of interesting, right?
B
Really, I swear to you, it's crazy. What bed should I buy?
A
I'll talk to you about that. Let's fix your insomnia first.
B
Okay?
A
So when people wake up in the middle of the night, it's actually not your fault. Let me explain. When you wake up in the. I'm sorry. When you go to bed at night, your core body temperature rises, rises, rises until it hits a peak. When it hits that peak, it begins to drop. Usually around 10, 10:30 at night, depending on your chronotype. Remember my animals, that'll change a little bit, but as soon as that happens, your core temperature continues to drop, drop, drop. At some point, your core body temperature has to raise, otherwise you're going to become hypothermic. I'll give you one guess as to what time that usually is for you.
B
3:00 in the morning.
A
That's exactly right. So every human on earth wakes up at some point in time during the night, usually between 1 and 3 o'clock in the morning. That's because of this increase in core body temperature. However, most people don't even know that they've woken up because you have to be awake for about 45 seconds to actually realize that you're awake and they roll over and they're back to sleep. You, however, are not. So let's talk about that situation right there. Okay? So when you look at that situation right there, there's a few different biology aspects that you need to know and understand. So number one, my first thing is I tell people, don't go pee now. I want to Be clear. If you got to go to the bathroom, go to the bathroom. But hold on for a second. 90% of people tell me they wake up and they say, well, I'm up. I might as well go pee. So there's a statistic that people don't know. In order to enter into a state of unconsciousness, you need a heart rate of 60 or below. What do you think happens to your heart rate when you go from a lying position to a seated position to a standing position and go pee?
B
It get. It's much higher, much higher.
A
So when you get back, then you got two issues. You got to get your heart rate down and got to get yourself back to sleep. So don't go pee unless you really have to go pee. Now, a lot of people turn to me and they say, well, Michael, I feel like my bladder is full or something like that. And so I say, number one, are you on your side when you wake up? 75% of people are. I said, roll to your back and count to 20 and see if you still have to pee. Because what happens is a lot of people squanch their bladder right while they're on their side. And when they just kind of stretch out and lie on their back and relax for two seconds, they're like, oh, actually, I don't have to pee. So then they don't have to get up. Then they can move forward with the process of trying to lower their heart rate. I want to be super clear. If you got a pee, go pee. All right?
B
Yeah.
A
Number two, don't look at the clock. Now, this is also another thing that almost everybody does, right? And they instantly do the mental math. And they say, oh, shit, it's 3:30 in the morning and I got to get up at 6:20. Sleep, sleep, sleep. And you try to force yourself to sleep. You gotta be honest with you, jc, in the history of time, no one has ever been able to force themselves to sleep because your energy's going in the wrong way, right? When you're saying sleep, sleep, sleep, your.
B
Heart rate's kicking up and the anxiety kicks in, right?
A
That's the biggest factor is when you do the math and you're like, oh, no, this is going to be a disaster, right? And your heart rate straight up, okay? So if you can avoid it, don't look at the clock. Now, I'm going to be honest with you. Everybody looks at the clock. Everybody looks at the clock. But if you can avoid it, what I do is I tell people, look, charge your phone in another room or charge it in the bathroom. People always say, oh, I can't charge my phone.
B
Another room.
A
What if my kid calls me in the middle of the night? Number one, your kid hasn't ever called you in the middle of the night. And I didn't say turn it off. I said put it in the other room. You can still hear it, but I don't want it to be easily accessible for you to get the piece of information to realize that you're in an anxious situation. Okay, let's say I haven't gone to the bathroom, or I have, and I haven't looked at the clock. Michael, what do I do now? So there's something that I learned a little bit ago to help lower your heart rate, actually quite rapidly. It's called 4, 7, 8 breathing. I did not develop it. It was developed by a very smart doctor, Dr. Andrew Weil, Harvard trained naturalist.
B
Okay, I know him.
A
Yep. Super interesting guy. Right? So he actually created this breathing technique for the Navy seals. So when you're a Navy SEAL and you're shooting downrange, if your heart is beating too fast, you can change the trajectory of the bullet. So he helped all the Navy seals lower their heart rate to a point where they could fire in between heartbeats that happened to be 60, which is our magic number. So we're on. So I teach people how to do four, seven, eight breathing. Now, there's two things that three things that I want you to understand here. Number one, four, seven, eight, is exactly what it sounds like. You breathe in slowly for a count of four. You hold for a count of seven, and you breathe slowly for a count of eight, back out. I'm going to be honest with you. When I first tried it, I couldn't do it. So I modified it, made it a 4, 5, 6 breathing. So my hold was a little shorter and my output was a little shorter. And it took me about a month to be able to kind of get my lungs used to this. But here's why it works so well. When you're counting, you can't think about any else, which turns off monkey mind, which is what you probably get when your mind starts going. So by counting, you are occupying your mind. And when you're breathing and counting, you are occupying your mind, and you are lowering your heart rate at the same time. Pretty cool, right?
B
Wow. So you count, you do four in, four in.
A
Hold for seven, push for eight. Now, it's not a hard push. It's a light push. Now here's where the trick comes in.
B
Okay.
A
You need to do about 10 to 12 cycles of that for your heart rate to get lower. Right? I lose count. Happened to me all the time. So I came up with this crazy method that'll help me. So when I'm lying there with my eyes closed, I put my hands out, like with little fists, like just down by my side. And when I breathe and I do a four, seven, eight, I stick out one finger. Then when I do another four, seven, eight, I stick out a finger. And by the time I get to ten fingers, I know I've done ten cycles. I can either go backwards or I can just stop when I'm there. Okay.
B
Wouldn't you be sleeping by then?
A
Hopefully a lot of people are. Again, it doesn't take that long to do this. Four seconds, seven seconds, eight seconds. Right. But you need to do it nice and slow, nice and relaxed. And the goal is to lower your heart rate.
B
So. Because that. I think what you just said is exactly the thing. Monkey. I get monkey mind, right. I start thinking of all my problems and I get such anxiety.
A
I know.
B
And then, like, it just feeds on. It feeds on itself, of course. And then 3:30 is now like 5:30.
A
And now you're really upset, right, because you got to talk to the sleep doctor for the podcast next day. And you're like, what am I going to say exactly?
B
I'm like, oh my God, I'm going to be so tired. I'm not going to have any energy again. Like, and then like, I. It takes you down a bad rabbit hole, right? Absolutely.
A
Absolutely.
B
So. But there's more, okay, Because I want to know how to get rid of monkey minds in the middle of the night.
A
So by distracting yourself is basically one of the only ways. So the 478 breathing does a really good job of that.
B
Okay.
A
That's number one. Number two is you also want to think about something called yoga nidra. So old from very ancient. Ancient, ancient. But one of the things we know, some people call it non sleep, deep rest. I call it yoga nidra. But there's data to show that it is actually rejuvenative. So lying in your bed with your arms kind of in the corpse pose and relaxed is actually helpful. Now, it's not the same as sleep, but it's probably worth 30% sleep. So an hour of that is probably worth 20 minutes of sleep. So here's another thing to just. Yeah, no, the data's there. Like, I wouldn't say it if there wasn't data. Here's what's fascinating is you could lie there for an hour, chilling out. And your body is rejuvenating for what would have been roughly 20 minutes of sleep. So you're doing yourself some good. So even if you're not doing yourself some good, you're actually doing yourself a little bit of good.
B
All you need to do is just cross your arms and just kind of.
A
Cross them just like this, close your eyes and just breathe. That's it.
B
And you get about 20% of what it would be if you were actually sleeping.
A
Exactly. So that's good to do in the middle of the night because you know, you're. Because what people are freaking out about is they're like, oh my God, I'm not going to feel good. I'm going to not rejuvenate. This isn't going to go well. I'm, I'm going to do this wrong and that wrong. And what I'm telling you is, is while it's not at the same pace, you're still doing yourself some good. And the final aspect of all of this is an idea set that I call acceptance. Right. Here's the deal. You've been in here before. You've actually were here last night. Yes, okay.
B
Exactly.
A
And guess what? Your head didn't pop off. Nothing terrible happened. But you don't make great decisions at 3 o'clock in the morning when you're thinking about those kind of things. So what I try to remind people is trust your, your body, okay? Your body does this thing right before it goes to sleep, is it kind of scans you throughout the daytime and says to itself, okay, this damage has occurred, this emotional situation has happened. Okay, we need about this much of deep sleep, we need about this much of REM sleep. This much is how much we need to get for total, you know, rejuvenation, blah, blah, blah. And it changes every single night.
B
But like if I'm doing, if I'm waking up in the middle of the night five nights in a row, doesn't that just overall ruin my, my, my health?
A
So it, that is a great question. So no. So we, we're going to go from what do I do about it in the middle of the night to what happens if it's happening multiple nights in a row and I can't control it. Right, right.
B
Because I think that's what happens. Right. Because you get what I feel hap. What I think a lot of people do is that if it's happened once or twice in a row, you're, you get nervous to go to bed, it's.
A
Going to Continue to happen. Yeah. You get almost like a foot phobia to going to sleep.
B
Right. Because you're like, oh, my God, I'm going to wake up again.
A
Right.
B
Blah, blah, blah, blah, blah.
A
So this is where people usually use alcohol. Right. Bad idea. Alcohol destroys stage three, four, sleep, which is the physical restoration. So drinking yourself to sleep at this point is never a good idea.
B
I actually think, to be honest, what people are doing more than drinking now or they're taking gummies.
A
Yeah. So let's talk about cannabis and sleep. Right. So especially if you're in a state where it's been legalized, which is Almost all of them, 28 now going on more.
B
Yeah.
A
Here's what you need to think about when you're thinking about cannabis and sleep. And by the way, I've written more about this topic than anybody else in the country. So if you swing over to sleepdoctor.com and type in cannabis and sleep, you'll learn a ton. But here's the basics of it is, number one, there is no data I've looked to show that CBD does almost anything for your sleep. Okay, let me repeat myself. Cbd. CBD does almost nothing for your sleep. However, CBD is good for pain and it's good for anxiety. So if you have anxiety that's preventing you from sleeping or you have pain that's preventing you from sleeping, CBD might actually be a pretty decent tool to use. Cbn, as in nighttime. That's what works for sleep. There's one paper that just got published about three or four months ago that showed that the nighttime awakenings are actually helped by cbn. It slows them down significantly.
B
Now, what's cbn?
A
CBN is one of the constituents within the cannabis plan. So there's thc, there's cbd, there's cbn, there's something called cbg, there's also something called cbc. There's several different components that a lot of people don't know about. But if you're going to the dispensary and you're looking for something to help you with sleep, you really want to be looking for this component called cbn. And you would probably want a ratio of three of those for every one CBD and every one thc. THC is the component that makes you feel buzzed and makes you feel fun and all that kind of stuff. Now, you notice I'm saying it's okay to have some thc. Let me explain. THC at high amounts will lower your REM sleep and increase your heart rate, which we don't want either one of those, but at lower amounts, it will lower anxiety. So I would argue that you want something that's high in cbn because that's what helps with lowering your awakenings. CBD to lower some anxiety and THC to lower some anxiety to help you enter into sleep. Now, I want to be very, very clear. You don't have to take marijuana to help you sleep, but if this is something that is habitual for you or something that you feel comfortable with, that would be a formulation that I would look at. The other thing I think is important to look at here is if this is happening on the regular, you probably want to come and talk to somebody like me, like a sleep specialist who's been trained in something called cognitive behavioral therapy. Because there's a technique called sleep restriction that I would use in that case to be able to consolidate the amount of sleep that you get. So while this is going to sound very, very strange, we talk about it a little bit in the book. This is what we do is if you're normally waking, let's say you Woke up at 3:30, you're up until 5:30, then you fall back asleep for an hour, and you just don't want that. What I would have you do is I'd have you go to bed. What time do you normally go to bed?
B
10.
A
So I'd have you go to bed at 10:30 or 11, so notice later than normal. So build up that sleep debt. Right. And then I would have you get up at probably 5. Okay. I would restrict the amount of time that you have in bed. Now you're going to say, michael, I already don't sleep. You're making this worse. My anxiety is going to be through the roof. What are you talking about? This sounds crazy, but you take no naps during the day and you wait again till that night at 11. What I'm doing is I'm naturally building up your sleep deprivation to use to my advantage. So if you do this for five to seven days in a row, by the way, you shouldn't do this on your own. You should only do this under the supervision of somebody who knows how to do this. Because there's some things that can go wrong. What will happen is your sleep consolidates and now you're no longer awakening in the middle of the night. So then what I do is once I've gotten you six solid hours, I start to stair step you out slowly. I can get you six and a half, seven hours. I can get you to wherever you need to go.
B
Wow. So that that. So you're basically eliminating the time in bed where you're just, like, you know, thinking.
A
Exactly.
B
And like. And basically just like ruminating.
A
Right, Exactly. We take that out.
B
We. So you go to bed later and wake up earlier.
A
Exactly.
B
And then you, over time, expand on it.
A
Exactly.
B
That's what you guys do in, like, sleep clinics.
A
Yeah. Well, so remember, in sleep clinics, we treat all kinds of sleep disorders. So this is how most sleep clinics would look at treating insomnia if they're using a method called cognitive behavioral therapy. To be fair, some sleep clinics would rather use pills and medication. So they might put you on a medication like an Ambien or a Sonata, Restoril, Valium, Xanax. There's lots of medications out there that can be helpful for sleep. However, then you got a sleep problem and a pill problem.
B
Well, that's the thing. Like, anybody I know who's ever taken Ambien, they get addicted to that stuff, and then they can't fall asleep without it.
A
So here's what I'll tell you is I think Ambien and all of the sleeping pills have got pros and they've got cons to them, while some of the newer technology pills don't have a physiological addiction to them. If you haven't slept well in 20 years and I give you a pill, you're going to want that pill again and again and again.
B
100%.
A
Right. So there's a psychological component to it, I believe.
B
What about using Benadryl to fall asleep?
A
Such a good question. So when you see all the PMS out there, all that is is the analgesic plus Benadryl, otherwise known as diphenhydramine. Hold onto your socks. So to be clear, there is direct evidence to show that consistent use of Benadryl on the nightly an anticholinergic leads directly to Alzheimer's. You didn't think I was going there, did you?
B
No, I did not.
A
I know. That's what I'm trying to say. Zquil, the pms, you name it. If you're down in a Benadryl on the regular, you are absolutely positive. The data is very clear. You're walking into the door of Alzheimer's.
B
I've never heard that.
A
I know. Isn't that crazy?
B
That's so scary, isn't it?
A
I'll show you the data. It's nuts.
B
How so? Oh, my gosh. Because that actually is the only thing that works. If I can't fall asleep, like. And it's been days now, I wanna be clear.
A
If you use it once in a while, you're not gonna have Alzheimer's. I'm talking about people who have to have one of these PMs every night.
B
Right.
A
I'd much rather you come see me in my clinic. Right. And let's talk about it and let's figure you out.
B
But wait a minute. So that's crazy.
A
I know.
B
I've never heard. See, every time you're on this show, you, I, I, there's never a, like every time. I learn so many new things. It's unbelievable about sleep. So what about, like, I, I, I heard you talk about vitamin C and sleep. Does vitamin C actually help you? Vitamin D. I heard vitamin C. So.
A
Here'S what I can tell you, what I'd run bloods on. So if somebody was to be part of, like, my clinic or work with me, I would have them go to their doctor and I have them do blood work. So to be clear, I'm not a big supplement guy when it comes to sleep. I'm a big let's fix the body guy.
B
Get to the root cause.
A
Right. So what are you deficient in? There's three things that if you're deficient in, I know for a fact they affect your sleep. Vitamin D, magnesium, and iron. If you are deficient in any one of those three, there's no universe that you're getting a good night's sleep. So I always have everybody talk to their doctor, get their blood work, bring it in, let's fix that first and just see how your body is operating at that point. If you'd be surprised, probably 25, 30% of the time, that's all it takes. And people are sleeping better. Let's say you don't have that. And you're saying to me, okay, Michael, I want to, I need something to help me fall asleep. I don't want to take something like Benadryl. I want something that's a little bit more natural. Kind of not into the cannabis and gummies gummy scene. Or maybe I don't live in a state where that's legal. You've already told me that alcohol is a bad choice. What are we going to do? I can't call a cognitive behavioral therapist in the middle of the night.
B
Right, Right.
A
So there's is there are a few supplements that have been shown to be very helpful for sleep that are pretty gentle, something called gaba. So gaba is kind of like the brakes of the brain. It definitely can help you slow down your thinking, lower your anxiety. Valerian root, specifically valerian combined with hops has been shown to be actually quite effective. As effective as sleeping pills in some cases. So that's kind of interesting as well.
B
What's it called?
A
Valerian root. And like, hops from beer. Hops come in as a combination that's been shown to be effective as well. So there's a couple of things out there that you can figure out and work with. Ashwagandha can be helpful for creating anxiety or lowering anxiety and things of that nature.
B
What about. What about just taking magnesium?
A
So I'm a huge fan of magnesium because roughly 75% of people are deficient in magnesium. And I did a study with a group about magnesium, and they had me test their product. And I gotta be honest with you, I was blown away you told me.
B
That before, that you did that study, that like, it was like, way above any other.
A
Yeah. So it's called upgraded formulas. And this guy came to me and he was like, I want to prove to everybody that my magnesium is the best for sleep. And I was like, that's a pretty tall order. And he was like, let's go. And so we did a double blind, placebo controlled study. So. Exactly. Like a drug trial, but with magnesium. And people acted as their own controls. It was the most. The strongest design of a scientific study that you could have. And all the researchers were blinded. They had no idea what they had given people. So that's why that's double blinded, placebo controlled study. And this guy's magnesium was through the roof. I mean, people were sleeping significantly better, deeper sleep was better, and falling asleep was better just from magnesium.
B
Did you, did you test other magnesium to see or.
A
What we did was we tested against the sham, and then we tested again. Yes. So we tested against another magnesium. We tested against a placebo.
B
Okay, how about melatonin?
A
So melatonin is interesting because there's pros and there's cons. I'll tell you, there's only really three instances, maybe four, where I have a tendency to, like, melatonin. I think melatonin works well for jet lag. I think melatonin works well for shift work. Melatonin is also used in something called REM behavior disorder. By the way, melatonin can actually be helpful with ADD and adhd. There's a, there's a, some new data on that. And then I think melatonin works well in people with a melatonin deficiency. So as we get older, one of the things we know is that the aging brain doesn't make melatonin Nearly as well as it once did. And so a lot of people have less melatonin as they hit the 55, 60, 65 kind of age range. And so that's when melatonin might not be a bad idea to take on the regular.
B
So, like, people like, who are aging, like you were just saying, just to kind of.
A
Can I make one quick comment?
B
Yeah.
A
Melatonin is not for children, period. Full stop. People don't know this in Europe at high dosages, melatonin is a contraceptive.
B
It is?
A
Yep. See, I'm. I'm dropping bombs on you left and right.
B
You really are. What do you mean?
A
So at high dosages, melatonin actually affects the, the entire cycle, like women's entire cycle. So it actually affects birth control. So as an example, if you're taking birth control pills and you decide to take melatonin, your birth control pills could easily become less or ineffective. FYI, melatonin also affects SSRIs, so anti depression medication. So if you're taking Proac, Zoloft, something like that, and you just hop on over to the drugstore and grab yourself some melatonin, you could easily have a problem with that. It also affects your blood pressure medication and diabetes medication. So it's a hormone. It's not just this root that we're getting from somewhere. It's a synthetically produced hormone, which affects lots of things in the body, which is why I don't like it, especially in kids.
B
No kidding.
A
I know.
B
And also, like, it's also not something to be, to get addicted to either.
A
Correct.
B
So, so basically then, magnesium, vitamin D, you say, are two that you're like, comfortable with.
A
Super comfortable. And omegas.
B
And omegas. Well, you. Yeah. So wait, what do you mean? So talk about the omegas. So there's a GABA root and hop.
A
No, I said valerian root.
B
Yeah, valerian root and hops.
A
And then I said gaba is, is one of the ones that I like to use and as terms of overall supplementation.
B
Yeah.
A
So you wanted to know about omegas.
B
Yeah.
A
So one of the things we know is that omegas, they help with a whole host of different functions in our body, which then relate to sleep. So as an example, one of the things that omegas do is they help create the, the membrane around cells that makes them stronger and stronger and stronger. So less bad stuff can kind of get in. Unless bad stuff is in. That means better sleep, especially, especially with mitochondria and things of that nature. There have been a few studies that have looked at, like, if you take an Omega, does it actually improve a particular stage of sleep? We've never been able to focus that. But what we have seen is when people take Omegas regularly, that they actually report higher quality sleep.
B
Higher quality sleep. Okay, and what. Because you told me also that you're now like a dream guy. Like, you know about dreams. Like, you're like a dream therapist.
A
I am. So I just spent a year studying and doing. I had practicum, I had a mentor, I had a person who I did this with, and I became a dream therapist. Now, I want to be clear. This is not dream interpretation. This is dream therapy. Those are two completely different things. Dream therapy is where we use the dream in a therapeutic context. So as an example, you would come into, like, my place of business, or we could even do it on zoom. And I would put you into a mild hypnotic state using some very easy breath work. So in one nostril, out one nostril again, there's no hypnosis involved here. It's just getting you really, really relaxed. Then beforehand, I would have asked you to write down whatever the dream is that you've most recently had or remembered or felt like you wanted to talk about. And then with your eyes closed, I ask you to describe for me. I have you read this before we start the induction. Then I have you describe the scene of the dream. Now, you're welcome to open your eyes or keep your eyes closed. Right? And then I say, let's drop into the dream. And so we kind of go into the dream together, and I become a guide. I'm not there to interpret. I'm just there to be curious and ask questions. And so as you walk along, you come across symbols that mean something to the dreamer that they didn't even realize meant to them because they didn't think to ask it a question. So as an example, I was working with a client, and we were walking in her dream, and she said, oh, there's a lion over there. And I was like, that's interesting. I said, why is there a lion in your dream? And she said, I don't know. And I said, is it friendly? And she was like, yeah, it is friendly. And I was like, does it talk? And she was like, yeah, I think it does. I said, why don't you ask it why it's here? So she did. And it turned out that the lion, Leo, was representing her father, Leo. And they had this. Who had passed away, and they had this communication. It's pretty powerful stuff.
B
This is actually. This is Dream interpretation.
A
Actually it's not dream interpretation in the sense of if you're swimming, you hate your mother. Right? It's a personalized journey through your emotions. The thing that you people have to understand is dreams are emotional metabolism. So you have to dream to be able to process your emotions. You might not remember your dreams, but this is exactly what's going on in REM sleep from a brain chemical standpoint. The only way you can get through your night is if you process what happened during the day. And by the way, when you can't get through your night and you wake up, that's called a nightmare.
B
Really?
A
Isn't that cool?
B
That is so now.
A
And this can be done in a group setting, it can be done on zoom, things like that. And so I've been the dreamer and I've been the therapist. So I have a partner that we work with and she teaches me how to do this, and I teach her how to do this. And then we have a mentor. We did a year long course. There were other therapists there to learn how to do all of this. But it's really opened my eyes. Cause I gotta be honest with you. And you know, when I was becoming a sleep specialist, like nobody ever talked about dreams. Like, I mean, and when I did my fellowship, like you didn't even almost ask about dreams because what are you gonna do, right? Like I've had patients in the past that have had nightmares. And what we historically would do is we would put them on SSRIs, we'd put them on antidepressants because it knocks out REM sleep. And then we would knock out the dreams, but they're not getting REM sleep, which over the course of time is probably not the best idea either.
B
Right?
A
So we didn't have any great real solutions for it at the time. Now I'm starting to feel more confident now that I'm getting some experience. And you know, I literally, I spent a year studying with this and doing all this kind of stuff. It's been pretty fascinating.
B
What if you don't remember? Like me, I don't remember anything I dreamed.
A
So we can teach people how to remember their dreams. It has to do with what time you wake up, it has to do with intention, it has to do with a few things. But what we've discovered, there's a few quick trip tips for remembering your dreams. Number one, don't move. So when you wake up, if you, if you move around for some reason, the movement of muscle or noticing things knocks the dream almost out of your head. So you just sit there. If you've woken up, you just. You kind of peek your eyes open and close your eyes and just continue the thought. Right. Of whatever it was was in your head. And that's nine times out of 10, that's what you were dreaming about. And. And then you'll start to remember the dream. The second thing you do is you want to record it as quickly as possible. So I. I think people could have a dream journal, right? So just like you have a gratitude journal, you can have a green dream journal, and you just scribble down a couple of bullet points from what the dream was or if it's something that you're really starting to remember. And by the way, it gets better and better over time when you do this, you'll be able to start filling in more and more information, and you get more information. It's kind of like a gold mine into your brain.
B
Yeah, well, I. I always want to remember my dream, and I try. When, you know, when you get woken up from your dream. Yes. You try to get back to sleep. Yeah. But it never works.
A
You're like, where's Matthew McConaughey again?
B
Yeah, yeah, yeah, yeah, Exactly. But it never seems to ever work. Would you do that?
A
It's hard to do that. But I will tell you that in the study of dreams, we know that dreams are like chapters in a book. So if we wake somebody up in the beginning of the night and they have a. There's a theme to their dream, and then we wake them up, you know, six hours later, the theme is still there. It's just further down the path.
B
So that's interesting, actually.
A
Yeah, it's cool stuff.
B
Yeah, it is. I want to get back into actual sleep because I think that from the last couple of times you were here, we talked all about, like, different sleep habits that people have. Right.
A
You can.
B
The chronotypes. Right. And if you guys have. You have a book out. What is it called? That book?
A
Sleep, Drink Breathe.
B
No, no, no, no. The new book is called Sleep Drink, Breathe.
A
The old book is called the Power of When W H E N. Right.
B
And you talk about how everybody has a different chronotype and how they sleep. But what I always. I found, I find interesting is that because of people's sleep habits, and if you're married, you've got a boyfriend, a girlfriend, a husband, wife, whatever, and you have different sleep habits.
A
Dog.
B
What?
A
Cat. Dog. They sleep in bed, too. They have very different sleep habits.
B
They're very different sleep habits. How like, how do you. How does it work when. If I say I'm. My habit is I like to wake up really early and go to bed early.
A
Right.
B
If my husband likes to go to bed late, like, how do you do that? Because the reason why I'm asking you is because I saw a statistic that said, like, 25% of. Of relationships sleep apart. No. 25% of relationships break up because of the different sleep habits.
A
Got it, got it, got it. So let's talk about that for half a second. So I want to be super duper clear. The strength of your relationship has nothing to do with where you sleep. Okay? Lots of people think that it does. One of the most common things that I have when I'm working with patients is I say, look, I need you to go to bed later because, you know, we're doing the sleep restriction thing. And he says, no, no, no. My partner and I, we go to bed at the same time. I'm like, well, do you eat the exact same foods together? Do you work out and do the same things together? No, no, no, no. But we go to bed at the same time. Like, people can't get past.
B
Right? They can't get past that part.
A
And it's like, so. So, okay, so break that down for me. Why? Well, my partner says that they can't fall asleep unless they're lying next to me. Okay. So can you watch a pod? Can you listen to a podcast? Could you be on an iPad? Could you. Could they wear an eye mask while you're doing. While you're reading a book? Like, could all. Can any of that happen? Oh, well, you know, maybe some of that could happen. And so we start to negotiate through and we kind of get that some people will completely separate. The statistic I thought you were going to mention was that roughly 25% of people sleep in different beds now.
B
Oh, that. That's. That's another one, though, too. Right. So my. So I guess the reason why I was bringing it up is because I feel like more and more people are sleeping apart.
A
Yeah. So here's the deal is as long as it isn't affecting your intimacy and it's not affecting your relationship, I don't think I care. Like, I'll tell you, there are plenty of times where, like, my wife sleeps, well, you know, this. With big screen TV on and two French bulldogs in the bed every single night. Okay. I have adapted to it. It doesn't really bother me that much. But if I'm, like, gonna go on this podcast or if I'M gonna go do a television show or something like that. I'm in the guest room and she gets it. It's like, I wanna have an uninterrupted night of really solid sleep. And I know how important that is for me, so I go ahead and do that. Could that happen two or three nights a week? Sure, it could. Absolutely. With my schedule, that something like that could happen. But generally speaking, she doesn't feel that our relationship is damaged because I'm not lying next to her in bed. That's the thing that people have to start to understand is don't equate those two things together. And if you're worried about intimacy, because that's usually the thing that most people are worried about. In fact, when you sleep in separate beds, you have more intimacy than. Less.
B
Yeah, I would. I would think so. Right?
A
Because you plan it, you go and have it, and then you go off and you go to sleep and it's like, okay, great.
B
And you sleep better.
A
You do. Absolutely.
B
Right. So. But have you. Have you noticed there has been a. More. Because of the sleep habits? People are breaking up more, though, as opposed to.
A
So I will tell you, I've saved more marriages as a sleep doctor than I ever would have as a marital therapist just by kind of getting people back together in bed. So. So I think there's a balance that we have to play. Right? I think there's gotta be a little give, there's gotta be a little take. But I. I definitely have seen people who have such opposite schedules that. Yeah, it's just. It's just not gonna play itself out.
B
So wait, you also said something earlier that I wanted. I didn't wanna interrupt you. You said something about sleep debt.
A
Yeah.
B
Okay. What is sleep debt?
A
So sleep debt is this concept where. Where you. You take a certain amount of hours out of the sleep bank every night. Right. And then you kind of put them back. My concept surrounding sleep debt is your. Your debt is variable. You don't have this. You don't take out eight hours every night. You don't need eight hours every night. Some nights you need six, Some nights you need eight. Some nights you might even need nine.
B
But what?
A
Probably not.
B
Okay, But. Well, nine's a lot.
A
But when somebody tells me that they need nine hours on the regular, all kinds of red flags are going off in my head. I'm thinking depression, I'm thinking narcolepsy. I'm thinking obstructive sleep apnea.
B
Really?
A
Absolutely.
B
Okay. And also, as you age, I feel like people are Some people's sleep gets worse and worse.
A
So here's what happens is it does, but it doesn't. Like I've got 90 year olds who sleep like a stone and I've got 26 year olds who sleep like crap. So I would say that it's not the, it's probably not the rule. It's more the exception that, that as you get older you get better sleep. But here's what I'll tell you are the factors. You become more medically infirm, so you got more shit wrong with you. You're probably taking medications or changing those habits into medications. And so that becomes problematic as you age. Also, there's something that a lot of people don't know. In the sleep laboratory. When somebody's over age, about 55 or 60, we actually change the criteria to score sleep staging because your brain is different.
B
Oh, okay, right.
A
So we know that physiologically your brain does not output the same waves and as you get older as it did when you were younger. Which by the way, is probably the reason why your ring or your strap is not accurate.
B
Well, that was, that's 100% true. I, I don't find those things accurate.
A
Anyway, the best one out there might be 80, 85% to, to accurate. But to be honest with you, something new just came out that is 100% accurate to a sleep study. It was actually approved by the fda and it's a ring. So like ora ring? No, it's called the Happy ring.
B
Really?
A
Yeah, it's brand new. But they do sleep studies. Right. Aura does something different or does more tracking. Right.
B
That's the thing. This is the thing. The sleep trackers, the wearable sleep sleep trackers. I mean, when I was wearing them, I was like obsessed.
A
That's part of the problem.
B
And that's what most people, people become so obsessed with the numbers.
A
And so it's so funny, when I'm at the gym, people come running up to me with their phone like, I got a 64. What does it mean? I'm like, what the. I don't know what it means, you know, but what I tell people exactly is I say it's about consistency, right? And so if it doesn't matter that they're not accurate, as long as they're consistently not accurate. So when people walk up to me and they say, michael, I only got 14 minutes of deep sleep, my first question is, how much did you get the night before? They say 14 minutes. I say, how much you get the night before? And they say 14 minutes. I said, then you're fine.
B
Right. Because it's consistent.
A
Because it's consistent. Right, Exactly. It's when you get 14, and then when you get 407, and then we get, you know, two. That's what I want to know, what happens in the delta. That's what's interesting.
B
Do you think they're even useful, though? Like, is it better just not to wear them?
A
So I think it depends on the person. So I think, for me, I find them to be useful to track my patients and to. And to keep my patients honest. So as an example, every patient that I have fills out a handwritten sleep diary. Everyone. There's nothing digital. I have lots of rules about that. I've been able to find that my methodology works faster, actually. Having people print things out on a piece of paper and write them in. Yeah, okay. But I use the aura or something like it to make sure. Because people lie all the time. And so.
B
Yeah, all the time.
A
And so you'd be shocked. They feel guilty. They're like, oh, I didn't do what Dr. Bruce told me. I'm gonna. I don't want that. Like. And I. It's rare. Here's the best part, is once I have access to their aura data, they never lie on their sleep diary because I know I'm looking at their aura.
B
You can see it.
A
Right. So it's kind of a nice balance or, like, you know, accuracy checker. So I use it for that. And then I also use aura at times when I've got. So, you know, I deal with a lot of celebrity clients, and so when they're all over the world, it's. It's much easier for me to be. Because I have an open API with aura and I can zoom into their ring, and I can give them information immediately.
B
So you have people that you work with celebrities, for what reason? Because they can't fall asleep?
A
Yeah, yeah. Well, I mean, like, for example, there are a couple of celebrities that have given me the opportunity to talk about our work together. So, for example, Carson Daly.
B
Right?
A
So Carson. I was on the. I was on the Today show one time. He pulled me to the side. He's like, man, I am exhausted. And I was like, well, have you ever done a sleep study? And he was like, no. So we had a sleep study sent to his home. Turns out he had sleep apnea. And so we were able to treat his sleep apnea. We talk about it on air, and he's much. You know, he's significantly better for that. I've treated Paris Hilton. For a while, she had issues surrounding insomnia, and we dealt about that. Her husband Carter and I are good friends.
B
I know Carter.
A
Yeah, you know Carter and Courtney and Carter. I think I met them through you.
B
Yes. So you meet everyone through me. I do.
A
You are so connected. So, like, I helped. I worked with Paris for her insomnia because she's bouncing around all over the globe. At the time, she was still DJing. This was before she had kids.
B
Oh, wow.
A
So she was everywhere. So jet lag was a big issue, things like that. And then the, The. The craziest one was Steve Aoki, so.
B
Oh, that's a good one.
A
Steve's one of my close friends now. I love this guy, but he did 200 shows last year. 200. And he gets on at what, 11, 12 o'clock?
B
Yeah.
A
And he's going till three or four and it's usually a stadium show. Like, 80,000 people are bouncing around.
B
Yeah.
A
Can you imagine trying to get that guy to go to sleep?
B
That's a good one to talk about. Right. So someone like that who has a schedule, who. They're like. They're like obviously night owls.
A
Yeah, he's a shift worker.
B
He's a shift worker. Right. So let's say you get off stage and you're. It's 5:00 in the morning or 4:00 in the morning, you're super amped.
A
Yeah. There's no universe. You're going to bed.
B
Like, how do you get someone like that to go to sleep?
A
So, number one, Steve's great about it. Like, again, he gave me permission to talk about things, but, like, he's not a drug user. Like, he's actually really, like, clean living. Like, you know, because he wants to stay.
B
Yeah.
A
Active. And so the good news is, is I don't have to deal with a lot of that. And to be fair, like, I've dealt with a lot of rock and rollers. And, you know, my first question is, like, who's doing an eight ball before the show? Like, what's like. Like, I need to know the information so I can understand how to, you know, treat it. Like, then all of a sudden, everybody tells me everything. I'm like, wow. But, like, generally, if I don't have any of those drugs and alcohol issues to deal with, because that's part of their performance, then what we actually do is we look at one of the big reasons that they're so amped up is because there's so much energy in. Right. And they're. And they're pulling it in, and they're pulling it in. So what we have to do is give them the opportunity to take energy out. A lot of that help helps with meditation, with breath, work with slowing things down. Music is really big. I can get people from an amp stage and slowly, you know, get their. Whatever their music is that they like and kind of bring them into a different vibe and then slow them down. It can take time, though. Also, hydration becomes a big factor for a lot of my celebrities, especially my rock and rollers, because they blow through the sweat while they're out there. Athletes as well. So I. Hydration becomes a big issue of drink.
B
Is that what you meant?
A
Yeah, well, drinking here is hydration, Right. And so that's the other thing. So I guess we're talking about all of the things that I do with them.
B
Yeah.
A
Is right here in the book. So. Yeah, I mean, that's the type of.
B
Stuff that talk about hydration. How does that affect your sleep?
A
So it's kind of fascinating. A lot of people don't know this, but the body, you know, is made primarily of water. Like, I think it's like 78 or something. 80% water. And so when you look at that, when you are dehydrated, that's part of the reason you get a migraine. Like, your brain is actually shrinking onto itself. Like, your brain shrinks when. When you're dehydrated, and that's called a migraine. Right. And so when you. So if you want to avoid that, right, Hydrate. I mean, to be clear, you can't cure all migraines with hydration. But definitely, if you're getting migraines on the regular, headaches on the regular, it's disrupting your sleep. Hydration turns out to be a really easy fix, Right?
B
That could be a cause that you don't even think about.
A
Exactly, exactly. But people also, like. One of the things I learned, I think I was telling you the story earlier, is hydration is such an interesting thing because, like, when I go to the gym, right? Don't you always see this? There's a person at the water bottle thing, right? They've got their water bottle under there. They look around, it's half full, they pull it and then they put it back in, right? And I am always the kind of the asshole. And I tap them on the shoulder and I say, sip, don't gulp. And I always get the exact same response back. They say, I'm just trying to get as much in as I can to meet my Water kind of quotient, right? And so here's the problem is when you gulp, it doesn't go in, it goes through. Let me explain. When you wake up in the morning and you walk out to your kitchen, right, if you know the sponge that's sitting out there, it's like shriveled up and it's hard as a rock. That's you when you wake up. Most people don't know it. You lose a full liter of water every night just from the humidity in your breath. Okay, wow. Right. So you wake up dehydrated. You're that sponge. Here's the problem. If you take that sponge and you stuck it under the faucet and you wide open the faucet and the water hits it, it doesn't absorb it. It bounces off. That's gulping. But if you just open that a little and you let it drip onto it, it absorbs it, it forms. And now you have a useful tool. Sip, don't gulp.
B
So that's funny you say that too, because I'm trying to get all of my water intake in as well because I hate water.
A
Well, you can't hate water, girl.
B
I hate. I hate it. I mean, I'll drink. I'll drink tea, I'll drink.
A
Well, you can get water and other things. That's okay.
B
But what I mean is because of that, I have this whole, whole system in place. So I can drink a lot of water during the day.
A
What color is your pee like?
B
Whitish yellow.
A
Then you're hydrated.
B
But no, I don't think I am. Because I'll tell you, I'll tell you because I get headaches sometimes I feel my skin looks dehydrated. But what, what I was. But that's. This is not about. It's not about me. But what I was going to say is in the morning, what I will do to try to get my water, my water quotient, I will drink a liter, a liter and a half in the morning. I'll take lemons. I'll squeeze the lemons in.
A
Oh, that's good.
B
And then.
A
And by the way, you can make your own mineral water if you want.
B
My. My own what?
A
Mineral water.
B
Yeah, I know I can.
A
You can add like zinc and little fun stuff. Oh, it's good.
B
So basically what I'm saying is I like take my, my supplements with the big liter and a half of. Of water and I gulp it.
A
Sip, don't gulp. It's going to be so much better for you.
B
So is it better to Drink it over, like an hour period versus here's a 20 minute period.
A
Yeah, 20 minutes. Don't kill yourself over it. But like, as an example, one of my big things that I have people do in the morning is I call it the three 15s. So when you wake up, I ask you to take 15 deep breaths, drink 15 ounces of water, and get 15 minutes of sunshine. If you do all of those at the same time and you span it over the 15 minutes, that's perfect, right? So take a deep breath, drink an ounce of water, enjoy the sunlight. Take a deep breath.
B
But what happens if you don't have access to sunlight? What do you tell?
A
You could use artificial light. So, you know, it's. If it's January and you're in New York City and the sky is gray, turn on every light in the room. It stops the melatonin production. That's how you move brain fog out of the brain.
B
So tell me again how to move brain fog.
A
So a lot of people, they have brain fog in the morning because their melatonin is actually still going. But if you use artificial light and you get it, it'll turn off that melatonin faucet, no problem.
B
So. So say the whole thing again.
A
Sorry. So it's called the 3:15. So when you wake up, have a spot in your place like a chair and a glass of water.
B
Okay.
A
Right. If possible, it would be great for it to be outside so you can get some fresh air and sunshine. But if it can't be, it can be near a window. And if it's just not even sunny outside, it can be artificial light. Okay, so you want to have 15 ounces of water, take 15 deep breaths, and get 15 minutes of light exposure. Now, to be clear, the light doesn't have to be in front of your face. It can be kind of one to one side, but as long as it's going in, it turns off that melatonin faucet, which is what's creating 90% of the brain fog.
B
Wow. What about just drinking a cup of coffee?
A
So coffee is okay, but part of the problem is coffee's a diuretic and makes you pee. So once you get past kind of your second cup of coffee, it's not a good idea. But I do have a hack that I talk about in the book for how to drink coffee. If you wait 90 minutes after you wake up to have your first cup of coffee, you actually get more boost from the caffeine than you would otherwise. I tell people you want to hydrate before you caffeinate, I'll explain. So in order to pull the brain out of a state of unconsciousness, you need two hormones. You need adrenaline and cortisol, and they're pretty high. So when you have adrenaline and cortisol wandering around your brain and then you add caffeine, it does almost no good. When you compare adrenaline and cortisol to caffeine, it's like comparing cocaine to weak tea. Okay, wow.
B
Yeah.
A
But when the cortisol and adrenaline is removed and you add the caffeine, at that point it'll actually lift up the cortisol and the adrenaline. So by waiting just 90 minutes after you wake up. So if you wake up at 7:30, have your hydrate first, then you have your first cup of coffee at 9.
B
That's a long time to wait.
A
It's not. I promise you it is.
B
Because if you want to work out and do all these things, don't you kind of need to have your coffee?
A
I don't think you do. I think you need to hydrate.
B
You think hydrate. Okay. Okay. But can you wait? What's the difference between waiting an hour or 90 minutes?
A
Because this, the adrenaline and cortisol has to drop in order for you to get anything from it. Like you can drink it all you want, but you're not going to get the boost you're looking for.
B
So, and what time is the latest that you would suggest someone drinking coffee?
A
If so, on the other side of it, I would say probably 2:00 is probably where you want to stop caffeine, because remember, caffeine is a half life between six and eight hours. So let's say it's 2 o'clock. Eight hours later is 10, roughly when people are going to bed. You'd have about 50% of it out of your system if you could back it up earlier and earlier into the day. What most of my patients end up with doing is they have their first cup of coffee 90 minutes after they wake up, then they have half of a second cup and then they never have another one.
B
Wow. Okay. What about foods to eat for sleep?
A
So the big thing that I think people to take away here is there's not necessarily. I mean, there are some foods that promote sleep, things with omegas in them like fatty fish and you know, tart cherries and pistachios and blah, blah, blah. That's not what we need to talk about here. I think what we need to talk about is processed food and sugar. So there is now data to show that processed food Specifically, processed food containing sugar actually slows down and in some cases prevents melatonin production. Remember, melatonin is that key that starts the engine for sleep. You ain't sleeping if you ain't got no melatonin. So having high sugar right before bed number one, it's very difficult to fall asleep, but it actually can change the hormonal production of what's going on. So have your dessert at noon, not at midnight.
B
So. And okay, so let's just go over basic hacks for sleeping or habits. Right?
A
How about I give us a five step plan? Okay, step number one, pick one, wake up time.
B
Yeah, we got that one down.
A
Step number two, stop caffeine by 2pm Step number three, stop alcohol three hours before bed. Most people don't know it, but alcohol really disrupts sleep quite a lot. It takes the average human about one hour to digest one alcoholic beverage. So if you have two drinks, which is your limit, right? And then you stop and wait three hours, you usually have peed this out and so you're okay, but please, in between the drinks, have glasses of water. So step number three is to stop alcohol three hours before bed. Step number four, daily exercise. There is nothing better to improve the quality of your sleep than daily exercise. But to be fair, you don't have to run a marathon, 20 minutes of cardio and then move to resistance exercise. If you can do that three to four times a week, you will definitely see a difference in your sleep. And then I would say the, the final thing is know your chronotype, right? If you know what your chronotype is, all of this becomes so much easier. You have the ability to, you know, understand when to go to bed, when to wake up, things of that nature. And then I, I told you my three 15s for the morning.
B
That's a really good one. Actually. I heard you once talk about something about water bottles, like put something.
A
Yes. So when people get too hot in the middle of the night, a lot of people were asking me, oh, you know, should I go out and buy one of those thermoregulators, those things that you can put in the bed that makes it hot or makes it cold because they're expensive.
B
Yeah, those cold mattresses, right? Yeah.
A
And so I said, here's one of the things that you can do on the cheap that really works is you take a bottle, a plastic bottle of water, two of them, stick them in the freezer, and then at night before you go to bed, stick them in like a tube sock, like an athletic sock, and then you put one on the outside of one hip and one on the outside of the other hip. It's like a personal air conditioner. Works like a charm.
B
You put two, basically two frozen.
A
Exactly.
B
Water bottles, one side.
A
On either side of your hips, on the outside of your hips. And you will stay cool as a cuke.
B
Really?
A
Try it.
B
But what if I. What if you're a side sleeper?
A
It's okay.
B
Well, then the other hip will be up. Do you put it like, do you tape it to your thigh?
A
No. Trust me, it'll work either way.
B
Really?
A
Promise.
B
How did you figure that one out?
A
So I had people who didn't want to spend thousands and thousands of dollars for these things, and we started playing around with different ideas. You could have a cool pack, you know, like, for that people have, like when they injure themselves or things like that. But again, it's just. It's literally about having. And what you don't want to do is you don't want to have to be so cold that it's stimulating. That's why I have it down here, towards. Towards this area, because you're going to have more fat down here. So it's going to be actually easier. You're going to feel it less, but it's going to keep your body more regulated.
B
That's right, because up here it's more bony. Right. So it'd be like freezing.
A
Exactly.
B
Okay, give me a few other sleep hacks.
A
In what area?
B
Oh, in sleep.
A
In what area?
B
Okay. Okay. How about give me a few. And how to fall asleep? Not just not, not how to fall back asleep, but how to fall asleep.
A
Sure.
B
And what would you consider? I mean, we all know about the temperature and dark rooms. And what do you. What's your take on mouth tape?
A
Oh, that's a great question. So I'm. I'm not a fan and I'll explain why. Okay, so most people who do mouth tape, it's because of snoring or mild sleep apnea, but they don't know they have mild sleep apnea. And when you tape your mouth, I can't tell that you've got mild sleep apnea. And then it gets worse and you don't know it. So anybody out there who's using mouth tape, if you want to use it, get a sleep study done first and make sure you don't have sleep apnea. Because if you have sleep apnea and you cover your mouth with tape, you'll will. You'll mask all your symptoms and it'll get much worse much faster. It'll be a problem.
B
What's the purpose?
A
The purpose of mouth tape is basically to try to get you to breathe through your nose. And when we, in the book we talk about nose breathing versus mouth mouth breathing, nose breathing is much better. It's like putting, you know, when you're breathing through your mouth, it's like putting leaded gas in the car. It's completely unfiltered. Whereas going through your nose, you've got cilia, you've got mucus, you've got your turbinates. Makes it warmer, it cleans out the air. And then you got clean stuff that's kind of going into your lungs, which is great. When you're mouth breathing, you don't have that. Any particulate that's in your bedroom is sucking in your mouth and going down into your lungs, which ain't so hot. Problematic. That's why the people are going to use the mouth tape. The reason that people sleep with their mouth open, nasal congestion 75, 85% of the time, to be clear, all you have to do is get your sinuses in order. And you probably don't need mouth tape.
B
Because it's a very hot trend right now.
A
Yeah, I think it's terrible. And by the way, there's. There's a mouth tape out there called hostage. I think that's disgusting.
B
Hostage.
A
I think it's disgusting. We have hostage. Like we have hostages in places and these guys are making money off of mouth tape. That's gross.
B
Yeah, I mean, it's. I know, but it's interesting how there's all these fads and people don't know what's what, so. Yeah. How do you know if you have sleep apnea?
A
It's a great question. So if you've got any types of symptoms. So if you snore. But to be fair, lots of people snore. But if you snore in combination with somebody sees you gasping or choking for air, even one time in the middle of the night, you wake up with a headache, you wake up moody, you wake up exhausted. These are a lot of symptoms that we would see in our patients with sleep apnea. For some people, it's if they're a little on the overweight side. For guys, if you have more than a 17 and a half inch neck, you have an 80% chance of having sleep apnea. It's kind of crazy. I mean, I could literally stand outside the Big and Tall store and just pass out my cards.
B
What is it? What is it? I was going to say perfect. That's a great thing for you, for business.
A
I know, right?
B
What about, like, in general, snoring? What does it mean?
A
So snoring is disrupted air and. No, snoring is actually good, by the way. Kids should not snore. If your children snore, I would definitely be talking with your ENT and just trying to discover what's going on because they're not getting enough air in. That's what snoring really is, is there's some form of congestion or some form of obstruction and you're having to suck harder, which causes a vibration, which causes a cadence and causes a snore. It's kind of like if you're in the garden, right? And you're, you know, you're in the garden and you're watering your plants, right. If you stick your thumb over the end of the hose, the water squirts out faster, right? Right. So your nose is the hose. So when your nose is wide open, air goes in, no problem. But if it's congested, like sticking your thumb, guess what? Now the air has to move faster. That causes the vibration, it causes the snore. Also, some people's anatomy is just distant for snoring. You know, deviated septums, enlarged turbinates, things like that. Then also what we have a tendency to see is larger tongues. And so for what. So this is very interesting, but when kids are sucking their thumbs, what they're doing is they're pushing on the roof of their mouth and they're taking the entire skull and they're actually making it in, in, in. And so what ends up happening is the roof of your mouth goes into your sinuses. You can't breathe as much, so your mouth drops open, really. And that's why you snore. If we put palate expanders in every child out there, we could get rid of sleep apnea almost entirely in the next generation.
B
Can you do that? No. You can. Just joking. Okay. Talk about. I think I asked you this earlier, before we even started, about kids and, and sleep.
A
What about them?
B
Are. Are there different rules that apply for kids who have sleeping issues?
A
You know?
B
You ever hear about kids and sleeping issues?
A
Absolutely. Now, to be fair, I am not. I've done some training in pediatrics. I've taken a few courses, but I've not done, like, a formal fellowship in pediatric sleep and sleep medicine. To be clear, there are lots of guys and gals out there that have done that, and I highly, highly, highly recommend them. What I will also tell you is there's a Lot of bullshit out there. So there's a lot of people out there who call themselves a sleep coach, like a child sleep coach. You really want to know what their credentials are if they graduated from some child sleep coaching school. That's bullshit. Right?
B
Right.
A
What you want to have is. You want to have. Because here's the biggest problem with a lot of those coaches is they don't know how to recognize a sleep disorder. So when they think the child is being a mess and not wanting to go to bed, and I think the child actually has undiagnosed sleep apnea, we have a really big problem on our hands. Right. But that person doesn't have enough knowledge to be able to even identify that. So when people are working with coaches for their kids, you really, especially in the medicine universe, like sleep, you really want somebody who knows what they're doing. Also, by the way, I don't like the liability. Right. I don't want some strange person walking into my house putting their hands on my child. You know what I'm saying? Like, there's a lot of weirdness that goes on there. So I think, yes, there's a lot of differences there. Generally speaking though, I think that most childhood sleep problems are behavioral, meaning that it's a behavior that you need to figure out how to extinguish. Now I will tell you that some people have asked me about the cry it out method for small kids where you just let em cry and cry and cry. I think this is a terrible idea. I don't think that you can go in there and capitulate every single time your kid wants a glass of water. But I've seen it where patient parents let their kids cry so much they puke. So now you have a whole different problem on your hands. Right. Because you've revved this kid up so much because they're freaking out. So what you have to do is go in there, let them see you, let them know that they're safe without laying hands on the child. Have them talk them to go back down and lie down. Like you're a parent. You should be able to get your kid to lie down.
B
Yeah, yeah. Well, yeah, you would think you would hope, right? Okay, sorry, I'm just looking through your book here because what I saw was interesting is you say here about. Wait, you talk about all sorts of different waters. Water trails.
A
Yeah. So what's interesting about water is people don't know their water. Right. So a lot of people think distilled water, okay, that's going to have everything out of it. That's going to be the best type of water for me.
B
Right.
A
Actually, it's one of the worst types of water for you. It has almost no nutritional value whatsoever.
B
Yeah. Distilled water is the worst water.
A
It's the worst water. It's something you put in your CPAP machine. It might be something you put in your humidifier. You don't want to drink distilled water.
B
Right, right, right.
A
Mineral water is different than spring water. So there's actually to. By definition, you cannot call it spring water unless it comes from a spring. Right. Mineral water actually has to have water that goes over rocks to be able to collect the minerals that are inside of the rocks. So you kind of want to know your water. Also, to be fair, nowadays you really have to worry about what your water is in, in terms of plastics and things like that. I mean, I gotta be honest with you. There's microplastics in just about everything in the universe.
B
Yeah.
A
So you have to be somewhat thoughtful there. I personally like the. That green bottle. What is it? Mineral water that comes in the green glass bottle.
B
Oh, mountain.
A
Yeah, Mountain. Something or another with a red label.
B
Because the. Because the glass.
A
Yeah, because the glass keeps it. Because the minerals are in it. Because it's got to be. Because it says it right.
B
It's got to be because it says it right.
A
Well, they legally can't do it. Like, their competitors would sue them in a heartbeat.
B
But wasting. The reason why I was bringing it up that you're talking about alkaline water and distilled water and spring water. Is there a particular water that you think is the most hydrating for someone to drink?
A
Wow, what a great question. So I would say that your best bet is if you don't want to think through it and worry about it all, I would say you can definitely have tap water that's run through a filter. So, like, Brita is just fine in 90% of the cases. If you want to buy water, then I would say mineral water is probably where you want to go.
B
Mineral water.
A
Yeah, because most people don't get enough minerals, and so that can be overall helpful for a whole host of immune functions and things like that.
B
But mineral water, like what? Like, give me.
A
So, number one, we teach you in the book how to make your own, but you could have a little lemon zest, a little Himalayan salt. That would actually put in plenty of things.
B
Right. That's what you told me earlier. You said, oh, you can make your own mineral water.
A
Right.
B
That's what you meant.
A
Yeah. So people can make their own if they choose to, or you can go ahead and like, you know, buy whatever the labeled mineral water is.
B
So mineral water is the best water?
A
I think so. And then also I want to talk about these things called hydration multipliers. So you see these powders that people put in that supposedly help you absorb water better. So to be clear, they're almost all salt. So when you start to look at the labels, some of them have got a thousand milligrams of salt in them. So these are not things that you would want to take on the regular. So I tell people, like, if you're a runner and you're doing a long run on Saturdays, that's when you take your liquid iv, your lmnt, your whatever powder it is. I don't, I don't know them all, but whatever. Right. Or if you're going on a three hour hike, that's when you would take a hydration multiplier. If you take it every day, there's a very high likelihood that you create too much sodium in your system and then you have a big problem.
B
Big problem. Like what?
A
Well, so the. So hydration is all based on a sodium, basically sodium, potassium balance. And so when you keep adding more and more sodium, the what ends up happening is your body holds onto water and holds onto water and holds onto water and eventually it's not good.
B
So how does that affect your sleep?
A
Good question.
B
I'm full of them.
A
You are. So when you look at hydration and how does it affect sleep directly? Again, what we talked about is you lose a tremendous amount of water. And so what ends up happening is you become dehydrated. And that is one of the reasons, by the way, that you wake up. So if you're fully hydrated, then you have a tendency to sleep longer than if you're dehydrated. So one of the easy ways for my insomniacs to sleep better is to get hydrated.
B
That's why I wanted to know what's the best water, because I think alkaline water is the water that I've been drinking.
A
I like alkaline water. There's pros and there's cons in different directions. I don't think you can only drink alkaline water.
B
Well, I just. And also I drink. The big trend is hydrogen water.
A
So I talk about hydrogen water in the book. And I'm going to be honest with you, there's very little data on hydrogen water.
B
Of course.
A
Very little. Yeah, there's some guy Going around, who's got some hydration blender thing. I think he's full of shit. Like, Well, I mean, number one, he has no credentials whatsoever. He has, I think he calls himself a biologist, but at the end of the day, right, there have been at least two studies looking at hydrogen water. And hydrogen water can have some positive effects to it, but not nearly to the level that it is being promoted at.
B
That's good to know. So mineral water, like every. This is the thing you give. You, you're very good at giving. Like you're very practical.
A
I am practical.
B
You know, and you give people like the, like truthfully actionable things that people can do today.
A
Yes.
B
To help. Help themselves, like right in the moment.
A
And that's the brand. Like that's what we wanted the Sleep doctor to be like. When we, When I think about it and I try to describe it to people, it's like, this is going to sound crazy, but this is kind of my concept of what I, what I'm trying to accomplish with, with the Sleep doctor is if you walk down into your backyard with a plate full of burgers or whatever, right. And you're about to. And you throw them on the grill and your neighbor happened to be in their backyard with their grill open and throwing some things on there and it turns out your neighbor is a world renowned sleep expert. And you just got these two quick questions. But you got to get back before your burgers burn, so you live. Hey Michael, I got these three questions. Bing, bing. Thanks. Go. That's the brand. Yeah, that's what we're trying to accomplish is you don't have to know all the, like that's my job to know all the theory. I can take hyper complicated stuff and distill it down into actionable bite sized pieces that can be helpful. That's what we're trying to accomplish.
B
But that's what you do better than anybody.
A
Thanks.
B
No, you do like I laugh because I can literally just press record, ask you one question, go pick up my kids at school, come back and you.
A
I'm the three peat. Come on.
B
Exactly. You could just go for two hours. I could be like, okay, Michael, how do you sleep? Better. Bye. Be back in two hours. But it's. It's amazing. Okay, so your new book called Sleep Drink, Breathe, Simple Daily habits for Profound Long Term Health, this is what book number?
A
Five.
B
Five. Yikes.
A
Five non fiction, one fiction.
B
That's amazing. Yeah, that's amazing.
A
That's fun. I'm thinking about a few others. Maybe in the. In the works over the course of time, I probably have at least two more books in me.
B
Really?
A
Yeah.
B
How about a dream book next?
A
Well, that's one of the thoughts, actually. Yeah. Because it would be great to have somebody who's kind of like my practicality break down dreams and start to think about dreaming. And now that I've had this year long course in dream therapy, I feel much more educated in it. There's a lot of different types of dreams. There's lucid dreams, there's something called precognitive dreams. There are nightmares, there are stress dreams. So there's a lot that I've learned that I'm anxious to impart, to get into.
B
Wow. Well, again, it's been a pleasure having you on the podcast. Can you come back again?
A
Hey, I could. I don't know what you call a four Pete. I don't know. But we'll figure it out.
B
We'll figure it out. Okay, guys, pick up. Check out Sleep, Drink, Breathe. You will not be disappointed. Michael is full of so many amazing tips and tricks, as I'm sure you can have just told this from the. From the episode. So thank you, Mr. Sleep Doctor.
A
It is my pleasure, JC. Sweet dreams.
B
Sweet dreams. Bye.
Podcast Summary: Habits and Hustle
Episode 429: Dr. Michael Breus: The Sleep Doctor on Transforming Sleep and Health with Simple Daily Habits
Release Date: March 4, 2025
Hosts: Jen Cohen and Dr. Michael Breus (The Sleep Doctor)
Guest: Dr. Michael Breus
Duration: Approximately 76 minutes
Jen Cohen warmly welcomes Dr. Michael Breus back to the "Habits and Hustle" podcast, celebrating their third consecutive appearance with enthusiasm. Dr. Breus expresses his passion for the ever-evolving field of sleep medicine, highlighting its dynamic nature and continuous discoveries.
Jen Cohen [00:25]: "We have the sleep doctor."
Dr. Michael Breus [00:40]: "Sleep is such a new field in medicine that there's like new things that we learn about all the time."
Dr. Breus discusses recent advancements in sleep medicine, notably the FDA approval of Manjaro (ZepBound), a GLP1 drug, for treating sleep apnea. He explains how this marks a significant shift from traditional CPAP machines, exploring the pros and cons of pharmaceutical interventions versus mechanical devices.
Dr. Breus [01:37]: "Manjaro... is now available for people who have sleep apnea. If you meet certain conditions, like you have a BMI that's a certain amount, but that's the first time something like that has ever happened."
The conversation delves into the implications of prescribing GLP1 drugs like Ozempic and Manjaro for sleep apnea. Dr. Breus weighs the benefits of weight loss against the variable impact on airway obstruction, suggesting a combined approach with CPAP machines and weight management.
Jen Cohen [03:28]: "Ozempic and Monger, these drugs are like taking over the world."
Dr. Breus [03:36]: "They appear to hit the addiction centers in some way, shape or form because of cravings."
Dr. Breus introduces his concept of the "dominoes of wellness," emphasizing sleep, hydration, and breathing as foundational habits that influence overall health. He critiques the complexity of wellness trends and offers a simplified approach to achieving profound health benefits.
Dr. Breus [05:45]: "Wellness is too fucking complicated... This is where you start. This is kind of like a great starting line."
Exploring the connection between sleep quality and various health conditions, Dr. Breus explains how poor sleep can be an indicator of underlying issues like hypertension, depression, thyroid problems, and anemia. He stresses the importance of recognizing and addressing sleep disorders to improve overall well-being.
Dr. Breus [13:10]: "Sleep is a window into your overall health. When you are not sleeping well, it is, nine times out of 10, a signal that something else is going on."
Dr. Breus shares actionable tips to enhance sleep quality, including maintaining a consistent wake-up time, even on weekends, to regulate melatonin production. He introduces the "4-7-8 breathing" technique to manage nighttime awakenings and reduce anxiety.
Dr. Breus [10:02]: "Wake up at the same time, seven days a week. No sleeping in on Saturday, no sleeping in on Sunday."
Dr. Breus [15:00]: "Follow the 4-7-8 breathing technique to lower your heart rate and calm your mind."
The discussion covers the accuracy of wearable sleep trackers like the Aura ring. Dr. Breus acknowledges their limitations but finds them useful for monitoring patient compliance and sleep patterns. He emphasizes consistency over absolute accuracy.
Dr. Breus [47:54]: "The best one out there might be 80-85% accurate. But something new just came out that is 100% accurate to a sleep study. It's called the Happy Ring."
Jen Cohen [48:21]: "I don't find those things accurate."
Addressing the role of hydration and diet in sleep quality, Dr. Breus explains how dehydration can lead to migraines and disrupt sleep. He advises on optimal water intake strategies, the benefits of magnesium and omega supplements, and the impact of sugar and processed foods on melatonin production.
Dr. Breus [53:16]: "When you wake up in the morning... you lose a full liter of water every night just from the humidity in your breath."
Dr. Breus [60:32]: "Processed food containing sugar actually slows down and in some cases prevents melatonin production."
The conversation explores how differing sleep habits can affect relationships. Dr. Breus dispels the notion that sleeping apart weakens intimacy, suggesting that quality over proximity enhances relational bonds.
Dr. Breus [45:31]: "If it isn't affecting your intimacy and it's not affecting your relationship, I don't think I care."
Jen Cohen [45:33]: "When you sleep in separate beds, you have more intimacy than less."
Dr. Breus touches on pediatric sleep problems, cautioning against unqualified sleep coaches and emphasizing the need for professional evaluation to identify disorders like sleep apnea in children. He discusses behavioral approaches to managing childhood insomnia.
Dr. Breus [67:42]: "Most childhood sleep problems are behavioral, meaning that it's a behavior that you need to figure out how to extinguish."
Dr. Breus [68:12]: "There are a lot of people out there who call themselves a sleep coach... you really want to know what their credentials are."
In the final segment, Dr. Breus provides a five-step sleep improvement plan:
He also shares creative solutions for maintaining optimal sleep temperature using frozen water bottles and underscores the importance of hydration over immediate caffeine consumption for morning energy boosts.
Dr. Breus [60:38]: "Step number one, pick one, wake up time."
Dr. Breus [62:04]: "Take two frozen water bottles, place them on either side of your hips to regulate your body temperature naturally."
Dr. Michael Breus offers a comprehensive overview of sleep science, blending medical insights with practical habits to enhance sleep quality and overall health. His emphasis on foundational habits—sleep consistency, hydration, and breathing techniques—provides listeners with actionable steps to transform their sleep and, consequently, their lives.
For more in-depth strategies and tips, listeners are encouraged to read Dr. Breus’s latest book, Sleep, Drink, Breathe: Simple Daily Habits for Profound Long-Term Health.
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