Dr. Allison Brager: Improve Sleep Efficiency & Resilience

Summary

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Podcast Summary

Perform with Dr. Andy Galpin

Episode Title: Dr. Allison Brager: Improve Sleep Efficiency & Resilience
Date: March 26, 2025
Guests: Dr. Andy Galpin (Host), Dr. Alison Brager (Neuroscientist, Military Sleep Researcher)

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Episode Overview

This episode dives deep into the science and practice of sleep efficiency and sleep resilience, with insight from renowned neuroscientist Dr. Allison Brager. Dr. Brager shares practical and research-based perspectives from her years studying sleep in athletes, military personnel, extreme environments (Antarctica, space), and everyday people. The discussion spans chronotype genetics, sex differences in sleep, strategies for shift workers and high performers, napping, sleep extension, jet lag, sleep in extreme environments, and the future potential for genetic interventions to enhance sleep.

The tone is candid, highly informative, and loaded with engaging anecdotes, practical advice, and myth-busting—all with a conversational, sometimes witty, style.

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Key Discussion Points & Insights

1. Debunking Myths: West Coast vs. East Coast Athletic Advantage

• East Coast Bias in Sports: Dr. Galpin asks if East Coast teams have an advantage.
• Brager: "It's actually the opposite. During the regular season, West Coast teams play games more attuned to their circadian peak..." (02:15)
• Circadian Effects: West Coast athletes’ biological clocks are better aligned to game times, leading to fewer injuries, particularly among roles like NFL linemen.

2. Chronotype: Genetics, Habit, and Sports Selection

• Genetic Predisposition: Athletic preferences may correlate to chronotype (morningness/eveningness)—e.g., NBA players often night owls; some sports select for certain types.
• Nature vs. Nurture: Culture and family routines influence chronotype but strong genetic components exist.
• Quote: “The sleep habits that are instilled in you as a child...carry on with you...” (09:35)
• Adaptability: Chronotype is not easily or permanently changed—most people revert to genotype when environmental cues are removed.

3. Is Chronotype Changeable?

• Short-Term Adjustment vs. True Change:
  "As soon as you remove that predictability...the organism will revert back to its genetic natural rhythm." (14:26)
• Practical example: Brager forced herself to a morning routine in the military but “was not thriving, just surviving.” (16:31)
• Work Culture: Military and similar institutions tend to select for morning types, often to the detriment of night owls.

4. Sex Differences and Sleep

• Key Findings:
  • Biological males tend to accumulate sleep pressure faster → more daytime sleepiness and tendency to nap.
  • Females may take longer to fall asleep but achieve restorative stages more efficiently and have better overall sleep quality.
  • “Males are more prone to daytime sleepiness, whereas females are not.” (20:01)
• Mechanisms: Likely due to adenosine accumulation rates, genetics (SRY gene), and evolutionary factors linked to child-rearing and vigilance.
• Practical Impact: Social biases persist; napping and later sleep times often stigmatized.

5. Napping: Who, When, and How

• Effective Napping:
  • “A nap has to be 30 minutes or less...unless you’re a night shift worker.” (33:48)
  • Quick naps (<30 min) improve mood, cognition, and athletic performance.
• Caffeine Nap ('Nappuccino'): Caffeine before a nap can help mitigate post-nap grogginess. (36:00)
• Who Naps?: More common and socially acceptable among athletes; less so in conventional workplaces.
• Historical Context: Polyphasic sleep (multiple sleep periods per day) is how humans evolved to sleep, still common in indigenous lifestyles, and not inherently unhealthy.
• Quote: "That's how humans used to sleep before Thomas Edison commercialized electricity." (39:27)

6. Sleep & Health Risks: Shift Work, Circadian Disruption

• Major Risks:
  • Night/rotating shift work linked to reduced lifespan (~15 years shorter), increased cancers.
  • “World Health Organization has labeled shift work as a level two carcinogen.” (42:19)
• Best Practices:
  • Ideally, pre-select night owls for night shifts.
  • Maintain consistency in routines as much as possible.
  • Chronotype genetic testing (PER2 for evening types, PER1 for morning types) is accessible and can help inform fit for night shift. (47:12)

7. Extreme Environments: Antarctica & Space

• Antarctica Study:
  • Seasonal sleep patterns shift (longer/fewer episodes in winter, more/shorter in summer); total sleep over 24h stays the same.
  • Demonstrates sleep system’s robustness. (54:25)
• Astronauts: Mixed reports—some sleep well, others face issues (esp. with REM sleep) due to microgravity and vestibular-thalamic effects on sleep.
• Mars: Future missions will require both genetic/physiological screening and novel interventions for sleep and health resilience.

8. Sleep Optimization vs. Sleep Resilience

• Resilience: The aim is not perfect routines, but the ability to get restorative sleep under suboptimal circumstances.
• Quote: “I don’t want you to have to have a 90 minute routine...you become super sensitive. Right. We want you to be more resilient against that.” (55:36)

9. Good vs. Great Sleep, Subjective vs. Objective Measures

• Placebo Effect/Optimism: Belief in good sleep provides a performance buffer—but only to a point.
• After 72 hours of sleep deprivation, true deficits (cognitive, hormonal) override optimism or caffeine. (57:39)

10. Sleep Banking & Extension

• Sleep Banking:
  • Sleeping in by 30-60 minutes for ~10 days before anticipated sleep loss provides measurable benefits for cognitive/physical performance during deprivation. (104:10)
  • Sleep extension must be incremental (“30 minutes per week”) to avoid circadian disruption.

11. Tools for Efficient Sleep for High Performers

• Case Example: Six hours sleep limit, business demands, and family life.
  • Key Tactics (87:38 onward):
    • Caffeinate (≤200 mg) promptly after waking, and every 4-6 hours as needed, stopping >6-8h before bed.
    • Morning exercise to leverage peak cortisol.
    • Maintain tightly consistent sleep/wake times and routines.
    • Use blue light blockers in late evening working hours.
    • Consider naturally sleep-promoting foods (e.g., warm milk, kiwi, tart cherry).
    • AVOID chronic melatonin (can reduce sleep quality); magnsium (powdered) is preferable for sleep onset/maintenance.
    • Hot shower before bed, not cold plunge.
    • If using airflow devices, opt for nasal dilators not mouth tape (if untrained).
• Build Patterns: “Patterns are everything.” (94:27)

12. Jet Lag & Travel

• Best Practice: Use 'fly kits'—supplements (fish oil, B-vitamins, tart cherry); blue light blocking glasses on the plane.
• Use melatonin only in small doses (≤3 mg, ideally 1 mg) during first 1-2 nights when shifting time zones. (98:52)
• “I was brain dead for two days” after accidentally taking 20 mg. (100:02-100:32)
• Chronic melatonin use can create daytime sedation and degrade sleep structure.

13. Short Sleepers & Sleep Genetics

• True Short Sleepers: Minor group with genetic variants (DEC gene), can perform well with 4 hours/night—but this can't be “trained,” only genetically inherited. (72:45, 73:39)
• Quote: "It can't be trained. Right. It is...differences...in the architecture of the neuronal circuitry and the neurochemistry." (75:35)
• Hypersomnia: Consistently needing 10+ hours is also a health risk, frequently associated with depression or chronic pain. (77:07-78:55)

14. Culture, Upbringing, and Athletic Talent

• Youngstown, Ohio: Environmental and cultural factors (economic pressure, social norms, “grit mentality”) drive exceptional athletic achievement. (110:01+)

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Notable Quotes & Memorable Moments

• Circadian Advantage Myth Busting:
  “I'm sorry, I can't help you with this...West Coast teams are five times less likely...to get injured compared to the New England Patriots... So I'm sorry, I can't help you with this.”
  — Dr. Allison Brager, (03:23)
• Short Sleepers:
  “That gene was isolated...it's called the DEC gene. Those are individuals who are able to sleep four hours...their sleep pressures dissipate very quickly.”
  — Dr. Allison Brager, (72:45)
• On Sleep Deprivation Buffering:
  “The breaking point is 72 hours...it’s like sleepiness makes you stupid because it’s this false sense that you’re okay, but objectively, you’re performing horribly.”
  — Dr. Allison Brager, (57:39)
• Napping Stigma:
  “We were flabbergasted. [Military leaders] were like, no, if my employees nap, they're lazy... But I feel like the stigma has been reduced.”
  — Dr. Allison Brager, (33:41)
• On Sleep Extension:
  “It is physiologically impossible because the circadian timing system will not let you go from five hours to eight hours. It is not that simple.”
  — Dr. Allison Brager, (102:02)
• Blue Light Blockers & Supplements:
  “Blue light blocking glasses...as you're working...[they] promote that dim light melatonin onset.”
  — Dr. Allison Brager, (91:21)
• On Melatonin Overuse:
  “I took 20...I was fucked up for like two days.”
  — Dr. Allison Brager, (100:02)
• Evolutionary Sleep:
  “That’s how humans used to sleep before Thomas Edison commercialized electricity...polyphasic sleep.”
  — Dr. Allison Brager, (39:27)
• Athlete Culture in Youngstown:
  “I thought I was an average athlete...but in my graduating class alone...40 of them went on to play Division 1 sports...my dad is a butcher and he sold meat to Kelly Pavlik.”
  — Dr. Allison Brager, (110:01, 112:24)

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Timestamps for Major Segments

• Intro and Myth Busting: 00:00–04:56
• Chronotype, Genetics, and Adaptability: 06:43–16:39
• Military Culture & Chronotype: 16:40–18:01
• Sex Differences in Sleep: 20:01–32:26, 34:41
• Napping: Science and Stigma: 32:17–39:27
• Polyphasic Sleep History: 39:27–41:04
• Shift Work and Health Risks: 42:19–46:58
• Genetic Testing for Chronotype: 47:12–49:29
• Managing Sleep in Extreme Environments: 52:25–55:25, 61:41–65:35
• Sleep Resilience and Cognition: 55:36–57:39
• Sleep Banking & Extension: 102:02–104:10
• Practical Case: Efficient Sleep for High Performers: 87:38–95:01
• Melatonin Use and Abuse: 98:52–101:21
• Youngstown & Athlete Culture: 110:01–114:40

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Sleep Strategies & Practical Takeaways

• Chronotype: Know your genetic predisposition and, when possible, align sleep/work schedules accordingly. Don’t force night owls into morning roles.
• Napping: Brief naps (<30 min) are restorative; combine with caffeine (nappuccino) for added benefit if grogginess is an issue.
• Sleep Extension: Add 30 mins/week to sleep duration, not more, to let circadian rhythms adapt.
• Night Shift: Use genetic/survey tools for chronotype alignment; maintain consistent routines; pre-bank sleep where possible.
• Efficient Sleep for Busy People: Tight routines, morning sunlight, blue light blockers in the evening, avoid chronic melatonin, use targeted supplementation (magnesium, sleep-promoting foods), patterns above perfection.
• Jet Lag: Light management, brief melatonin only if needed (max 3 mg), anti-inflammatories (fish oil, B vitamins, tart cherry).
• Polyphasic Sleep: Acceptable if it fits your natural rhythm/cultural context.
• Sex Differences: Females may take longer to fall asleep but get more efficient/restorative sleep.
• Short Sleepers: Rare, genetically determined, not trainable.
• Shift Work = Major Health Hazard: Reduce it if possible, manage it tightly if not.

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Final Reflection

Dr. Allison Brager’s insights blend the rigor of academic science with practical solutions for everyone from elite athletes to shift workers to busy executives. The main message: Sleep efficiency and resilience are the goals—not perfection. Understand your genetics, build consistent routines, use evidence-based strategies (not just trendy hacks), honor your chronotype, and don’t neglect the reality that biology still rules.

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“I embrace being a meathead. Right. Hence my book.”
— Dr. Allison Brager (115:17)

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Transcript

[Dr. Andy Galpin]

The science and practice of enhancing human

[Host (possibly Dan Garner or another co-host)]

performance for sport, play, and Life. Welcome to Perform.

[Dr. Andy Galpin]

I'm Dr. Andy Galpin. I'm a professor and scientist and the executive director of the Human Performance center at Parker University. And today I'm speaking with Dr. Alison Brager. Allison is a neuroscientist who has spent most of her career focusing on sleep and specifically sleep resilience, which is one way of thinking about how to become more efficient and effective with sleep, regardless of the situation. Classic examples of that.

[Host (possibly Dan Garner or another co-host)]

Her research has looked at everything from athletes traveling from one coast to the other coast. Military individuals sleep on Antarctica and in

[Dr. Andy Galpin]

space, as well as just a ton of research for regular people.

[Host (possibly Dan Garner or another co-host)]

And how do we just become the most effective we can. What effective sleep is is actually something I learned a lot about today and something that you will pick up on as Allison shared.

[Dr. Andy Galpin]

What that actually means, how you determine

[Host (possibly Dan Garner or another co-host)]

it, how you can actually become more specific and precise to your individual sleep needs and overall, how to better think about sleep for not only surviving, but thriving. Allison is a fantastic scientist. Her publications are numerous. But she spent so much time in the field dealing with individuals that I

[Dr. Andy Galpin]

think the true value you're going to

[Host (possibly Dan Garner or another co-host)]

get out of this episode is understanding how that information that she has gleaned from her research actually manifests itself in the practical, real world scenario. And so I learned a ton. I know you're going to learn a ton about becoming a resilient and highly effective sleeper. So with that all said, I hope you enjoyed Today's episode with Dr. Alison Brager. Dr. Alyson Brager. Thank you so much for coming out. There's a lot of cool stuff I want to get into today. I was hoping we could start off actually with dispelling a huge sleep myth. I'm from the west coast. You're from the Midwest. As you are well aware, there is a huge east coast bias for sports teams. We all know that the west coast gets no love. We get unfair placements and things. Can you please confirm and share with the rest of the world that there is, in fact, a huge advantage for east coast teams? That it is easier, that they win more, that everything is better and the west coast teams are truly at a disadvantage?

[Dr. Alison Brager]

It's actually the opposite.

[Host (possibly Dan Garner or another co-host)]

No, no.

[Dr. Alison Brager]

During the regular season, it's actually the opposite.

[Host (possibly Dan Garner or another co-host)]

Okay, what's going.

[Dr. Alison Brager]

That's the classic NFL study that was done by some famous Stanford sleep physicians in the 90s that we sort of reconfirmed in the late 2000s. But this idea that west coast teams, at least during the regular season are playing games that are more attune to their circadian peak than their circadian trail. So basically what that means is if you just control for biological time, they're playing games more in their mid morning or early evening. And so that's what gives them this advantage in terms of performance, which has been correlated with injury risk. So they're five times less likely, especially if you look at like defensive linemen, offensive linemen less likely to get injured compared to the New England Patriots and the Philadelphia Eagles and all the above. So I'm sorry, I can't help you with this.

[Host (possibly Dan Garner or another co-host)]

All lies. I refuse to believe your data. You're clearly bought by Big East Coast Sports. I get it. I don't trust it.

[Dr. Alison Brager]

I'm actually a huge San Francisco 49ers fan myself. Even worse.

[Host (possibly Dan Garner or another co-host)]

Even worse. Get out. I coach Fred Warner.

[Dr. Andy Galpin]

He's a good friend of mine, but outside.

[Host (possibly Dan Garner or another co-host)]

And I tell him, he knows this. He knows I hope he loses every game of the year, but that he wins the mvp. Just like I'm open with my rooting on that one. In terms of the injuries, actually, this is sort of interesting. Is there a particular type of injury? Is it brain injuries or soft tissue or hamstrings? Or did it sort of just be across the board with.

[Dr. Alison Brager]

So we just.

[Host (possibly Dan Garner or another co-host)]

For something like that.

[Dr. Alison Brager]

That's a great question. So we more or less just looked at number of weeks spent on injury reserve. Yeah, uh, that was the only available to us at the time. Um, but we actually were able recently to get some of the concussion data because that was something that came out of the NFL lawsuit is they had to start publicly recording when players had gotten concussed during a game and stuff. So we're. My. No pressure to my wife. She's trying to help me with those types of analyses now. She's much better at statistics than I am.

[Host (possibly Dan Garner or another co-host)]

Well, I hope she doesn't screw it. And I hope she's not bought by big east coast like. Like you are. We get some real data out of this.

[Dr. Alison Brager]

She's a Miami Dolphins fan, so I don't know.

[Host (possibly Dan Garner or another co-host)]

She can have it. She can. No one's scared of the Dolphins. Why. Why does it actually matter? How much of a winning advantage is it? Like, what are we talking about? And any insights into. We don't have to necessarily go into like, deep molecular mechanism, but you're welcome to.

[Dr. Alison Brager]

Sure.

[Host (possibly Dan Garner or another co-host)]

But like, why in the world would someone playing a few hours outside of their optimal range actually matter? How does that transfer, I guess, into winning a game? That's a big leap from small thing to winning a football game, right?

[Dr. Alison Brager]

I mean, that's a great question, because these are correlative, they're not causative relationships, but it does speak to the robustness of the circadian clock. Right. So in general, regardless of if you're a morning person, an evening person, for the most part, the circadian clock and the daily rhythms of endocrine function, behavior and all the physiological processes associated with the circadian clock are predictable. And a lot of these performance attributes have to do with rising levels of cortisol in the morning. Right. When we, upon awakening, that's when cortisol begins to rise and the circadian clock begins to reach peak levels of alertness. And then peak levels of alertness are reached roughly around 11am to 1pm, depending on who you are. And so if you are training, if you are competing during that time, you're capitalizing on that peak of cortisol, which is obviously going to mobilize energy reserves and contribute to those aspects of attention, vigilance, focus and all the above.

[Host (possibly Dan Garner or another co-host)]

So it's probably a combination of every physiological factor, physical performance, recovery, cognitive, that's all combining. And I appreciate you saying that was just correlation, but those correlations have been shown in the NBA, the NHL, Major League Baseball. I think it's pretty well established at this point that that is a real phenomenon.

[Dr. Alison Brager]

Yeah, I mean I also think too, right, there's a huge genetic component and that's a lot of what I've studied my whole life is the genetics of sleep physiology and circadian physiology is. I do believe people select for their sport based on if they're a morning person or evening person. Interesting.

[Host (possibly Dan Garner or another co-host)]

Interesting.

[Dr. Alison Brager]

I grew up a gymnast. We always practice at night. We didn't necessarily compete at night, but I was always coming home from gymnastics practice at 9pm, doing my homework, going to bed. My parents are both night owls and I know I did the 23andMe raw data analysis, I'm a night owl. But I, I bet it's like that with other sports as well, like right, Boxing, MMA probably pre select for night owls. Same with NBA and NHL players.

[Host (possibly Dan Garner or another co-host)]

You know, how much of an effect does it have if you are mismatched?

[Dr. Alison Brager]

So there actually is data to show that there is a significant effect. There was a study that came out, I can't remember how many years ago, but it was in current biology and they were looking at rugby players and they were looking at it in relation to chronotype and they essentially found that if you had greater Inter individual variability and chronotype on a team, you were more likely those to win rugby matches

[Host (possibly Dan Garner or another co-host)]

because you weren't as sensitive. I get it.

[Dr. Alison Brager]

Yeah, yeah. Because you're not just playing games at night like an NBA or an NHL team. You're playing games either in the morning, the afternoon or the evening. Now, I imagine it would probably be the opposite for NBA or NHL teams. I don't know if anyone's actually done this analysis. You probably want less inter individual variability in chronotype and you want to pre select for more evening types.

[Host (possibly Dan Garner or another co-host)]

So we gotta start genetically screening people for our draft process.

[Dr. Alison Brager]

I mean, you know, Gattaca is one of my favorite movies. I'm not gonna say it's like the be all, end all, but every, you know, I try to. Every student that I teach, I always try to explain, expose them to that movie for that reason.

[Host (possibly Dan Garner or another co-host)]

Yeah, it's super interesting. When it comes to chronotype, there's clearly, as you talked about, there are some known genetic components to that. I've always been interested though of how much of that do we know at this point, we may not know much regarding habituation throughout life. So if your parents were night owls, you simply become a night owl because of genetic components or because you just simply got brought up in a culture that was like that language that was like that. You know, your parents say, oh, I'm just a night person, things like that. Do we have any insights into like how much play is genetically predetermined versus systemically grown into the person's behavior?

[Dr. Alison Brager]

I don't know of any data that exists, but I mean, I could say that would make sense. Right. Because if you're used to being in a household who eats dinner extremely late, I mean, my parents are Eastern European, so like we never do anything on time or early. Right. So like dinner was around 8:39. And guess what? I'm still an 8:39pm eater. Like I go to the gym and then I eat really late, but I also go to bed really late and then sleep in and, you know, wake up late too. And whether or not that's nature versus nurture. Yeah. I mean, we do know, at least from adult sleep habits, for example, that the sleep habits that are instilled in you as a child, whether good, bad or ugly, do carry on with you into college. And then when you are an adult and able to make your full decision. So a lot of behavioral sleep physicians will tell you that that's why it's so important for parents to establish bedtime routines and be the examples of good hygiene for their children because that will have a lasting impression when those kids do become of age and can make their own decisions.

[Dr. Andy Galpin]

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[Host (possibly Dan Garner or another co-host)]

any insights on how changeable chronotype is? Right. So if you say got a job and said Allison, you have to be into work at 7 and whatever the case is and you had to change that, how long would it take you to shift into a position where you didn't feel horrible getting up at 5am versus 8am or wherever it went to overtime? You normally are you like a midnight to eight sort of person?

[Dr. Alison Brager]

I am, yep. My preferred is 11:30 wake up between 7:30 and 8.

[Host (possibly Dan Garner or another co-host)]

So if that got shifted by two or three hours I guess two part question, can you actually change your chronotype and then obviously you can adjust that time independent of changing chronotype. So the second question then is how long would it take you to truly, I mean it'd probably take you a few days or a week to where you're like not waking up feeling terrible, but you would not be optimized would be my assumption. How long would that take?

[Dr. Alison Brager]

So I come from the camp of researchers, you know, nature over nurture and I'll use preclinical animal models as an example. We have engineer transgenic mice to be extreme early morning owls or extreme early morning larks or extreme night owls, all through manipulation of the circadian molecular clock. And you can present them with different stimuli in the environment. You know, in the circadian world we call them zeitgebers. So you can present them with repeatable predictable photic information or non photic information such as food, some type of rewarding stimulus, exercise, social stimulation, et cetera. But as soon as you remove that predictability of that zeitgeber or time cue, then the organism will revert back to its genetic natural rhythm. And I think the same is true in humans. Again, anecdotal evidence, but being in the military at one point I was a company commander in a leadership position. And in order to establish rapport and camaraderie with my brigade commander, he is an extreme morning person and he works out at 5am so what that meant is I had to wake up every day at 4am to then get to the gym to work out with him at 5am Again, it wasn't mandatory, but I knew it's, you know, just part of the process of being his subordinate. And during that time I would find myself, if I didn't go to bed exactly at 8pm, if I didn't keep all those other non phoenic things in my life stable, such as when I ate, how much I was hydrating throughout the day, et cetera. Like I got sick pretty often because my body just biologically fights against being a morning person.

[Host (possibly Dan Garner or another co-host)]

So in that particular case, again, you're able to get through it, but you are not thriving.

[Dr. Alison Brager]

Exactly. Oh, I was not thriving. I wasn't even optimizing. I was just trying to stabilize, surviving, survive. Exactly.

[Host (possibly Dan Garner or another co-host)]

Through the day.

[Dr. Alison Brager]

Exactly. I mean, that's why I tell people like at the end of the day, I will never be anyone important ever in the military, even if I wanted to, because I am a night person and things such as the military pre select for morning people and I am not that person and I will never be.

[Host (possibly Dan Garner or another co-host)]

One of the issues with those historical organizations, academia is its own little thing.

[Dr. Alison Brager]

Right. That's why I thrived actually in academia. Right. Land of night owls.

[Host (possibly Dan Garner or another co-host)]

Yeah. I'm the opposite. Like I'm a morning person big time.

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

And I would hate, I'd hate the 11pm meetings. I hate just all that stuff. Right.

[Dr. Andy Galpin]

I'm like.

[Host (possibly Dan Garner or another co-host)]

But I'm actually wondering if we've done ourselves quite the disservice in those organizations of saying no. Like, I mean, obviously we're, hopefully we're past the point where waking up early as a badge of honor and do those things. But is that actually, is that culture still pretty true in the military?

[Dr. Alison Brager]

I would say it's pretty true. I think people who are night owls are considered to be lazy. Yeah. I still, I know I get judged for being a night owl in the

[Host (possibly Dan Garner or another co-host)]

military, but you hold your ground pretty good, right?

[Dr. Alison Brager]

I do. Well, I mean I, it's. Mine's supported by science, you know, I take no prisoners. I'm not gonna, I don't care what other people think, you know, so you're

[Host (possibly Dan Garner or another co-host)]

gonna, you're gonna roll in four hours after everybody else, but you'll stay there four hours later.

[Dr. Alison Brager]

Exactly. Exactly.

[Host (possibly Dan Garner or another co-host)]

And get your stuff done.

[Dr. Alison Brager]

Yep, yep.

[Host (possibly Dan Garner or another co-host)]

Going back to your. Your mouse studies, we were laughing early this morning about how you got a little bit of a. A shout out during the State of the Union. Yeah, yeah. Maybe it'd be easier. Would you mind sharing a little bit about what I'm talking about? Because it's quite funny.

[Dr. Alison Brager]

Yeah. So one of the transgenic mouse models I worked on as a postdoc at Morehouse School of Medicine was the four core genotype mouse line. It was a mouse line created by Art Arnold out here, actually, in ucla. And what it is, is it's a divergence of chromosomal sex with hormonal, sexual. And the purpose of developing this mouse line is it presents a unique way to look at the influence of chromosomes, so sex chromosomes versus hormonal release of testosterone and estrogen on just physiology and behavior. So it actually worked out to be an elegant mouse model. It's very elegant, exactly. To look at sex differences in sleep. So to understand how sleep pressure builds differently amongst biological males versus biological females. And, you know, bottom line of doing, using this sophisticated mouse model is we know that a lot of sleep traits are due to this. It's called the SRY gene. So the testes determining gene that is responsible for sex differences in the accumulation of sleep pressure across the waking day and then the presentation of daytime sleepiness. So bottom line being that biological males are more prone to daytime sleepiness, whereas females are not. And then biological females, although they have greater difficulties entering sleep itself at night, the quality and the efficiency of their sleep is greater than males.

[Host (possibly Dan Garner or another co-host)]

How could you have answered that question without that model?

[Dr. Alison Brager]

I mean, we are only answering the hormonal piece of it, really.

[Host (possibly Dan Garner or another co-host)]

How would you do without it?

[Dr. Alison Brager]

So my postdoc mentor, that was his, I guess, landmark study as a postdoc at Northwestern with Dr. Fred Turek. So Dr. Katema Paul, that's who I worked with as a postdoc, he essentially would remove the gonads of these adults, mice. Right. So stopping circulation of estrogen and testosterone. But you couldn't see these nuanced differences. And like, that's why you needed the chromosomal sex and the genetic manipulation piece of it. And it's important to realize that, like, biological sex differences are really complicated. It's not just hormonal sex, it is also chromosomal sex that seems to play the greatest role on physiology and behavior.

[Host (possibly Dan Garner or another co-host)]

I actually want to go back to some of those findings, right. About sleep pressure and sex differences. But the reason this came up, I guess, in that speech Was this was one of the examples of wasteful spending. Is that a fair way that it was characterized?

[Dr. Alison Brager]

Correct. Yes.

[Host (possibly Dan Garner or another co-host)]

And, and you and I, and I'm sure many people on your team had a good laugh at that.

[Dr. Andy Galpin]

Right.

[Host (possibly Dan Garner or another co-host)]

Like, it's really unfortunate, and we're not going to spend too much time here, but it's very unfortunate that a title of a paper, a title of a study section can get cut when really there is tremendous value for all of us behind that, with very little attention paid to who's doing it, what's happening, and what category is.

[Dr. Alison Brager]

So, I mean, you know, social political norms aside, men and women are different. And these animal models exist to understand biologically why men and women are different. And then when it comes to treating things such as sleep disorders or managing sleep disturbances, which, you know, 70% of the world, if not more, suffer from, that's how you target and to address them is through the lens of biology. But, I mean, that's just my own humble opinion.

[Host (possibly Dan Garner or another co-host)]

And now you can't even study it.

[Dr. Alison Brager]

Yeah, because.

[Dr. Andy Galpin]

Great.

[Host (possibly Dan Garner or another co-host)]

Okay, let's get back to some of those findings. That was an animal model. How do we know anything about how much or how little that is actually going to transfer over into human models? Do we have any data on sleep pressure, sleep inertia, some of those other things you brought up that look like they're different based on chromosomes alone. What do we know about the impact on humans?

[Dr. Alison Brager]

So, honestly, I haven't really seen much in the literature. I mean, I'm sure you can look at, like, single nucleotide polymorphisms, um, in the SR Y gene, for example, but honestly, I don't know if anyone has investigated that per se. I mean, I guess you can look at, like, intersex individuals in individuals. So someone who has like, for example, androgen deficiency syndrome, something like that, But I don't think that's been characterized enough in humans. Tough study to pull off, I will say so. A few months ago. When was that? It was about a year ago, I presented at the NSCA conference that's geared towards tactical populations, and I did this whole deep dive lecture. I'm sure some people appreciated it, but a lot of people were like, okay, where's she going with this? But I was. I started with the four core genotype model and then I transitioned into the studies we know about women and sleep. And what's crazy is, like, all this work that was done by Dr. Rachel Manber at Stanford University and Dr. Terry Lee at Yale University is like, it was done in the 80s and it just stayed in this vault for like 45 years until quite honestly wearable companies and you know, I'll give a shout out to whoop, like recognize that we need to focus on, focused on like female differences in sleep. And a lot of people think that that research is unknown or unheard of, but actually it was done in the 80s.

[Dr. Andy Galpin]

Yeah.

[Dr. Alison Brager]

And it was done in a very robust, controlled nature. But you know, it was just forgotten for like 45 years.

[Host (possibly Dan Garner or another co-host)]

What do we actually know about sleep differences between men and women? And what I actually want to know about is chromosomally. So when you tease out the hormones, how is it that a particular, whether it's a polymorphism or some other activity at the level of the genome, how is that actually manipulating, manifesting itself into sleep? Any idea what mechanisms could possibly be there if it's not endocrine?

[Dr. Alison Brager]

So in terms of mechanism of action, we know that again, there's differences in sleep pressure. And if you unpack the onion, sleep pressure is manifest from increasing levels of adenosine production, extracellular adenosine production within the brain, particularly the basal forebrain, which is a wake promoting area. So if sleep pressure is accumulating quickly, which seems to be the case in biological males by way of the testes determining gene, then there's more rapid accumulation of extracellular adenosine. And the only way to pay off that increasing sleep pressure is through daytime sleep.

[Host (possibly Dan Garner or another co-host)]

Yeah.

[Dr. Alison Brager]

And so with females, right, it just essentially means their rate of accumulation of sleep pressure is lower, which means that the production of extracellular adenosine would be lower. Now whether that's been studied, it hasn't. But like, hypothetically, just knowing, with all the, you know, myriad of studies around accumulating sleep pressure and extracellular denosine, we predict that's the mechanism of action.

[Host (possibly Dan Garner or another co-host)]

I mean, that's the closest we can come right, at this point. Right. Is it fair? Is it a trope? I certainly know that it feels like the guys that I know versus the girls that I know, you guys fall asleep fast.

[Dr. Alison Brager]

Yep. Oh yeah.

[Host (possibly Dan Garner or another co-host)]

Is that actually been demonstrated? Do we know that?

[Dr. Alison Brager]

So that's been demonstrated again in these preclinical transgenic mouse models using the four core genotype. It's also been demonstrated in, in human studies. So in those studies that were done in the 80s by Terry Lee and Rachel Manber, that's exactly what they found is sleep onset for men is much quicker. But then when you look at time to restorative sleep, so that entry into stage three non REM and Then REM sleep it is. The latency is quicker for females, so it might take them longer to fall asleep, but to get that restorative sleep, it's much quicker and then much more efficient across the night.

[Host (possibly Dan Garner or another co-host)]

Do we have any teleological or evolutionary guess as to why that setup is there?

[Dr. Alison Brager]

I mean, I think it all goes back to child rearing. Right. Like who's responsible for children? Right. Men are responsible for propagating children, but women, they are the caretakers. And I think these are these built in neurochemical neuroanatomical circuits that exist because of relationships between who actually takes care of the child, how much of it is.

[Host (possibly Dan Garner or another co-host)]

If you know, psychology versus biology, there's Right. So the classic thing you'll hear is like, oh, women ruminate more, they think about stuff more, they're paying attention. Or is it simply any host of cascades haven't kicked off yet, the pressure isn't high enough. Do we have any idea what. I'm sure it's both are contributing, but.

[Dr. Alison Brager]

Well, I think that's the psychological aspect from my lens is a part of that biological blueprint. Right. Is because females are going to have greater vigilance across the day. Well, what neurochemically is vigilance, it's increased acetylcholine release and activation of acetylcholine areas of the brain like the basal forebrain that are going to lead to that. But again, I see the world from the lens of nature versus nurture. So I'm not a very good colleague in departments of psychology.

[Dr. Andy Galpin]

Well, you have a degree in psychology.

[Dr. Alison Brager]

I have an undergraduate degree in psychology, but really it's neuroscience. It's all neuroscience. I was fortunate enough that I did go to a university that really thrived on its neuroscience curriculum.

[Host (possibly Dan Garner or another co-host)]

Well, nonetheless, I heard you're a psychologist and what I just heard you say was psychology has just misunderstood physiology. I get it, I get it. That's what you said. Dr. Breger said it hold my stamp to that. Acetylcholine. Is that a total concentration issue that generally is higher or is it a receptor density or is it both? Do we have any idea what are actually the sex differences between acetylcholine?

[Dr. Alison Brager]

That's a good question. I mean the studies that I know exist on sex differences focus on one particular area, which is the basal forebrain. Right. That is the, the seat of major acetylcholinergic production and release and activation within the brain. And then there's like cascading effects on other areas. But no, I, I Actually think this is the land of great unknown. I mean there haven't been a lot of studies on sex differences and physiology and behavior. And if there were, they were done again in the 80s and 90s and now, you know, you got me curious about going back onto PubMed and Google Scholar and looking this up.

[Host (possibly Dan Garner or another co-host)]

But yeah, I mean the stuff that has been done since then, a lot of it is questionnaires, right? It is, it's like pretty low fidelity stuff.

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

Which is good, helpful.

[Dr. Alison Brager]

But I mean you need self report. I mean with our sleep studies that we do in humans now. Right. We always have an objective endpoint, endocrine or even behavioral cognitive measure. But it's always paired with self report. And sometimes the self report data is what lends to more interesting findings.

[Host (possibly Dan Garner or another co-host)]

So women, men fall asleep differently. We get that. What about total duration and waking up time? Any sex differences that are notable there?

[Dr. Alison Brager]

So I'm happy you asked that because I feel like there have been. That data has been taken a little bit too far on social media that men that. Excuse me. That women need more sleep than men. There is a difference in total sleep time between men and women that was found again in these studies in 1980s and it's about 25 minutes to 30 minutes different. But I come from this lens. Is that clinically significant and that. I can't answer that. But I feel like in social media that has been. People have taken that information and have run with it that, you know, women need to spend. I think I saw something recently like because women take this long to fall asleep, they need to be in bed for nine and a half hours versus a guy who, you know, falls asleep quickly. They only need to be in bed for eight. And I think at a certain point like that's just going to create anxiety around the act of sleeping. That it's going to be more harmful than helpful.

[Host (possibly Dan Garner or another co-host)]

I assume then also based on this, men nap more than women do. Yep.

[Dr. Alison Brager]

Yeah, yeah. No, we know that like we know that experimentally. We know that anecdotally. You know, you just look at cultures around the world that have siestas and are, you know, it's adopted and celebrated that like people nap during the day is we know that men in general cross cultures are more prone to daytime sleepiness.

[Host (possibly Dan Garner or another co-host)]

Do you know if.

[Dr. Alison Brager]

And transgenic mice too.

[Host (possibly Dan Garner or another co-host)]

Oh yeah. Named There are people napping more or less or the same than we have historically.

[Dr. Alison Brager]

That I don't know. I mean I feel like at least in the last 10 years that stigma around napping has been Reduced, I would say. I mean, it still exists in the military. I don't think it's. It's going away. We actually, my colleagues and I from Walter Reed, we have a paper that we published in the flagship Journal of Sleep about. It's called the Stigma of Workplace Napping. And we strategically, anonymously took quotes from senior leaders in the military. And I mean, we were flabbergasted. They were like, no, if my employees snap, they're lazy, like, they're not productive. And I'm like, you're okay. I just whatever, you know, no comment there. But, yeah, I, I feel like the stigma has been reduced. But I would say, I would argue that earlier in, you know, generations, decades earlier, that napping was still more celebrated than it is today. I mean, I know, for example, President Eisenhower or then General Eisenhower used to nap, like in the middle of worldwide conflict In World War II, he took a nap every day.

[Host (possibly Dan Garner or another co-host)]

Probably very beneficial.

[Dr. Alison Brager]

Yeah, for sure. Absolutely.

[Host (possibly Dan Garner or another co-host)]

What do we know about successful versus unsuccessful napping?

[Dr. Alison Brager]

In terms of a nap, it has to be 30 minutes or less. We do know that with the exception being a night shift worker or, or someone who has chronic insufficient sleep. Right. The Recommendation There is 90 minutes to complete a full sleep cycle. But historically, what the clinical data has shown is if you are someone who normally gets sufficient sleep and you take a nap that is longer than 30 minutes, then you're more likely to have issues with sleep onset that night or just have issues with regularity in your sleep. But there's also data to show that a 20 to 30 minute nap is sufficient for immediate improvements in mood, athletic performance, even cognitive performance.

[Host (possibly Dan Garner or another co-host)]

Do you have any sense of what percentage of people nap?

[Dr. Alison Brager]

I don't.

[Host (possibly Dan Garner or another co-host)]

I would imagine it's fairly low, right?

[Dr. Alison Brager]

Yeah, I would think it's fairly low. Except when you're talking about these microcosms of cultures. Right. Like professional athletes. It seems to be completely acceptable and celebrated of napping.

[Host (possibly Dan Garner or another co-host)]

Yeah.

[Dr. Alison Brager]

And I'm sure there's a few ring leaders, like, you know, I know LeBron James, you were just talking about that he's a huge proponent of daytime naps. And I, I've heard that he takes multiple naps across the. The waking day. But it depends on the culture. Right. I can tell you, in my workplace, very, very few people nap.

[Host (possibly Dan Garner or another co-host)]

You know, I struggle napping, like, it just does not work for me.

[Dr. Alison Brager]

Yeah, it doesn't work for me either. If I have had a string of nights of insufficient sleep or if I'm traveling, I will lie down and like close my eyes for a bit. But I think it's just the nature of being like a highly functional ADHD person.

[Host (possibly Dan Garner or another co-host)]

I can't, if I happen to fall asleep accidentally or even on purpose during the day, I'm going to just feel horrific. The whole rest of the day, I'm going to feel terrible. Is that just a good indication I just shouldn't do it, or are there ways that I could change that so I feel better when I wake up, or should I just avoid it?

[Dr. Alison Brager]

So it's interesting you say that because one of the things that has become more popular is this idea of napuccino or having caffeine prior to a nap. And I learned anecdotally that this was adopted by the trucking industry in the 1970s. And the reason behind it is. Right, like a cup of coffee or any caffeine, preferably not an energy drink before a nap. It takes about 20 minutes for the adenosine receptors in your brain to be impacted. So in that 20 minutes you can take a nap and then wake up feeling boosted or less groggy than you otherwise would without the caffeine. And that has been experimentally tested in the lab too.

[Host (possibly Dan Garner or another co-host)]

What circumstances need to happen for somebody for you to say, hey, you should consider napping? Right. How does somebody know that they should think about napping? Is there anything that you say, hey, if A, B and C is going on, you might be a good candidate for napping? Well, is this something they just need to go figure out?

[Dr. Alison Brager]

So, I mean, in the populations I work with, right, Like I work in a world where most people, I'd like to think I'm a good example. But again, that's also why I'll never really amount to any, you know, position.

[Host (possibly Dan Garner or another co-host)]

Well, I, I think you've already, I think you've already amounted to plenty of pretty good positions within the military, but most of which we can't even talk about. So.

[Dr. Alison Brager]

Yeah, exactly. Is chronic insufficient sleep, right. If you are not getting sufficient sleep, so most people between seven and nine hours a night, depending on who you are, you need to nap or you should nap or engaged in some sort of like 20 minute non activity throughout the waking day to help offset that accumulating sleep pressure, right? Because you're already waking up in the morning with a high level of sleep pressure because you weren't able to effectively release it at night when you sleep. While we do recommend in those populations, like, hey, try to get 20 to 30 minutes, I understand that some people can't get in that mental head space, but that's why we have things like technology now to assist. I mean, I'll give a shout out to our dear friends at shiftwave. I think that is going to be a great tool, especially for the tactical populations I work with, to help them get into that headspace of just turning their brain off and getting into that meditative deep breath state. Even if it's for like 10 to 15 minutes.

[Host (possibly Dan Garner or another co-host)]

I spend most of my recreational time paying attention to wildlife. It's a huge passion of mine. If we can go out and where I live, black tail deer and elk and like that's what I spend most of my passion time on. If you hang around people that do that, hunters and conservationists and outdoors and biologists and stuff, they can take a three hour nap in the middle of the day. Like nothing, just nothing. They can go lay down and they're just gone for hours. Every time I try that, I lay there on the side of a mountain, I'm just rolling around. It's like zero chance this happening. I think I know your answer here, but I would assume that not a healthy behavior that they have was sleeping for three hours a day in the middle of the day. Is, is that a fair characterization of a poor sleep strategy?

[Dr. Alison Brager]

So I'm gonna actually challenge you on that because that's how human, that's how humans used to sleep before Thomas Edison commercialized electricity. So that was like multiphasic sleep, was what, through the course of human evolution used to practice. And honestly, if you look at indigenous communities, they still practice that where they have like four hours of sleep at night and then there's four hours of wakefulness and then they have morning, you know, sunrise activity and then they have a three, four hour period in the middle of the afternoon. Now it makes sense when you look at the circadian clock, right? Because there's two circadian peaks and two circadian troughs throughout the 24 hour period. The first dip obviously is in the middle of the night. That's when you know, core body temperature driven by the circadian clock is its lowest between 2 and 4am but then there's a second dip in the circadian alertness signal in the middle of the afternoon for most people between two and four. And so that's why it is good to push people towards sleeping or napping during this time. But and people who, you know, live off the land and live a more indigenous lifestyle, they're just catering to their natural circadian rhythm. Pre industrialized exposure.

[Host (possibly Dan Garner or another co-host)]

And do we think that those people can be perfectly healthy? Is there Any reason to think that that is actually a problem?

[Dr. Alison Brager]

No, I don't think there's an issue at all, to be honest with you. I mean, it's. You're not fighting against human evolution and biology, right? Because if you look at most chronic disease states in the country, it's because of fighting against evolution and biology. And also too like, it goes back to your point of. I think there is evidence for as limited as there is between people who are one chronotype and then try to be the other chronotype. And looking at morbidity and mortality, perfect example, shift workers, right? The people who do night shift work have an estimate of 15 years decrease in their lifespan. 15, 15 years. So there's a large scale epidemiological study that looked at cancer rates as well as longitudinal study of lifespan of night shift workers or rotating shift workers, and their lifespan was reduced by 15 years. They had significant increases in cancers across the board. So not just a particular cancer, but all different types of bodily cancers. And then even the World Health Organization has labeled shift work as a level two carcinogen.

[Host (possibly Dan Garner or another co-host)]

Ooh.

[Dr. Alison Brager]

And it goes back to fighting against our, you know, evolution in biology and what our genetic program is.

[Host (possibly Dan Garner or another co-host)]

How do they generally define shift work? What hours of work? Is it overnight or is it like swing shift? Like what counts as shift?

[Dr. Alison Brager]

When we say shift work, we're usually talking about people who start work at 11pm Work the graveyard shift, right?

[Dr. Andy Galpin]

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[Host (possibly Dan Garner or another co-host)]

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[Dr. Andy Galpin]

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[Host (possibly Dan Garner or another co-host)]

it's also my new academic home. I first heard of Parker after attending their neurocon seminar and was stunned.

[Dr. Andy Galpin]

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[Host (possibly Dan Garner or another co-host)]

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[Host (possibly Dan Garner or another co-host)]

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[Host (possibly Dan Garner or another co-host)]

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[Host (possibly Dan Garner or another co-host)]

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[Host (possibly Dan Garner or another co-host)]

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[Host (possibly Dan Garner or another co-host)]

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[Dr. Andy Galpin]

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[Host (possibly Dan Garner or another co-host)]

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[Host (possibly Dan Garner or another co-host)]

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[Dr. Andy Galpin]

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[Host (possibly Dan Garner or another co-host)]

of speakers and get signed up, visit parkerseminars.com one more time. That's parkerseminars.com I can't wait to see you there. We have dealt actually in our a number of our companies we've dealt with a lot of surgeons, emergency medicine, nurses, firefighters, police. And they have to work.

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

At some point there are better and there are worse policies for that. We've seen some people where they like four days day shift, four days night shift.

[Dr. Alison Brager]

Right? Yeah.

[Host (possibly Dan Garner or another co-host)]

You can't design a worst possible setup for those individuals. So if somebody has to work night shift because we have to, we need it.

[Dr. Andy Galpin]

Right.

[Host (possibly Dan Garner or another co-host)]

We need surgeons, we need physicians and nurses and military.

[Dr. Alison Brager]

Right?

[Host (possibly Dan Garner or another co-host)]

Military.

[Dr. Alison Brager]

We win our nation's wars at night. We need people who can operate at night.

[Dr. Andy Galpin]

How do.

[Host (possibly Dan Garner or another co-host)]

How do you then set them up for least amount of failure if they have to work night shift so that

[Dr. Alison Brager]

it's funny you Asked that because I feel like I'm back in my dissertation defense in graduate school do it. But I think that's where the power of genetics and like are these genetic screening tools come into play is in this circumstance, why not pre select people who are more optimal at night for these types of positions? I know in medicine that might be a little bit more controversial, but again, going back to communities, the ones I work in is I would want to have people who are good at operating at night to win our nation's wars, to reduce casualties, to increase combat effectiveness, things like that.

[Dr. Andy Galpin]

Are there tools to screen for that? Do you know?

[Host (possibly Dan Garner or another co-host)]

Are there, are there markers? Are there tests? Can we do where if somebody wants to just do this on their own so they want to figure out, hey, I'm considering taking this job, it's a night shift job or not. Like I want to know if I'm there. Do you know of any effective tools for that stuff?

[Dr. Alison Brager]

I mean you just spit in the tube and send it off to the lab for analysis. That's all it is. I mean there's robust known genetic markers, you know, single nucleotide polymorphisms that are linked to being a morning person, an evening person. I mean we know those PER2 SNP's. That's the gene, the circadian clock gene. PER2.

[Host (possibly Dan Garner or another co-host)]

PER2. And that can be any genetic company or is there a particular ones that sell kits that test for these that are better than others?

[Dr. Alison Brager]

To the best of my knowledge, most of these genetic screening companies will test for this snp.

[Host (possibly Dan Garner or another co-host)]

Okay. And it's almost as simple as that. One marker that is.

[Dr. Alison Brager]

Yeah, well it is because that's what's been identified in preclinical animal models and again has been shown in large scale genomic wide studies in humans is changes in the circadian clock genes.

[Host (possibly Dan Garner or another co-host)]

Which one was that one again?

[Dr. Alison Brager]

Just per two.

[Host (possibly Dan Garner or another co-host)]

Per two.

[Dr. Alison Brager]

Okay. So per two is associated with an evening chronotype and per one is associated with a morning chronotype.

[Host (possibly Dan Garner or another co-host)]

What percentage of people are evening versus morning versus somewhere in the middle.

[Dr. Alison Brager]

So we know most of this not from the genetic work, but from this robust questionnaire that's been around for honestly 40 years. It's called the morning Eveningness Questionnaire. I mean there's a newer modified version of this that Dr. Till Ronenberg has created to include social influences, but based on just again large scale epidemiological population based studies of this questionnaire, about 80% of us are intermediate types. Meaning. Right. We normally go to bed or prefer to go to bed around 10pm, wake up around 6am you have 10% of the population who are like me who are more evening types. Now I'm not an extreme evening type. I feel like I used to be but as I've gotten older. Right. My clock is now phase advancing. Like most people when they age who prefer to go to bed around midnight, 12:30, wake up 8, 8:30. And then the other 10% are these people like you who are the morning types who prefer to go to bed at 9 and wake up at 4am yeah, that's how my wife is. I would like to definitely.

[Host (possibly Dan Garner or another co-host)]

Yeah.

[Dr. Andy Galpin]

Nine o'.

[Host (possibly Dan Garner or another co-host)]

Clock. We'll just say nine o'. Clock.

[Dr. Alison Brager]

Yeah, yeah.

[Host (possibly Dan Garner or another co-host)]

If you ask my wife she'd be like.

[Dr. Alison Brager]

Is your wife a night owl?

[Host (possibly Dan Garner or another co-host)]

No, she's more of a night owl. Yeah, she was when like when we first met she was 11:30. Like 11 right. Wake up at 6 sort of thing.

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

And now over the years like she's drifted way down towards me.

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

Where she's there. I'm definitely like if I, especially if I didn't have kids, like 8 o', clock, I'm in bed.

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

Like a thousand percent.

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

And she's just like no, like not gonna happen. Like get up, we have to go do whatever. But the, the likelihood of us like watching a movie or something after the kids go to bed, zero. Like it's just like not gonna happen.

[Dr. Alison Brager]

It's funny because well I'm a Geo bachelor but like when I do get to spend some time with my wife it's the same way. It's just I have to like she's done motivate her to. I am your wife essentially. Like I have to motivate my wife

[Dr. Andy Galpin]

to like a four hour shift between you guys.

[Dr. Alison Brager]

Exactly.

[Host (possibly Dan Garner or another co-host)]

When you want to get up and do stuff.

[Dr. Alison Brager]

Yeah. Where I am in North Carolina and she's in Florida. By the time she's going to bed I am which is around like 7:45 8. I am just leaving the gym to go home and eat dinner and have an extra two, two and a half hours of my day before I go to bed.

[Host (possibly Dan Garner or another co-host)]

Are you like my wife where we will be silent for like 30 minutes like in bed or whatever and I'm like finally like time to go to sleep and then some like there has to be some deep conversation happen. Like it's just like talk about some big thing.

[Dr. Andy Galpin]

I'm like oh my God.

[Host (possibly Dan Garner or another co-host)]

But she's like always does that. It's a bad cliche, you know. Are you like that now?

[Dr. Alison Brager]

I am, yes.

[Host (possibly Dan Garner or another co-host)]

And she's just like, stop. Like, stop talking to me.

[Dr. Alison Brager]

Yeah. And then I'll just like drift off into sleep in the middle of the conversation.

[Dr. Andy Galpin]

Oh, I'm gone.

[Host (possibly Dan Garner or another co-host)]

Like, I'm definitely gone in that conversation.

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

So many times I've fallen asleep in the middle of her story. Cause I'm just like, I can't. Yeah, I'm done for.

[Dr. Alison Brager]

Yep. No, that's. Yeah, that's me too.

[Host (possibly Dan Garner or another co-host)]

All right.

[Dr. Alison Brager]

I fit that stereotype fantastic. Yeah.

[Host (possibly Dan Garner or another co-host)]

I was asking you earlier about people that have this not quite polyphasic, but multiple sleep, several hours of sleep throughout the day.

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

In the world I come from, that's often because of sunlight. Right. Where you're out doing stuff, you head back towards camp and then by the time you get back and do stuff, and then you only have four hours or five hours where you gotta get back up again, feed the horses, do things so you can get out before sunrise, right?

[Dr. Alison Brager]

Yep.

[Host (possibly Dan Garner or another co-host)]

So then you have three to four hours of sleep and you're gonna sleep more there.

[Dr. Alison Brager]

Yeah.

[Dr. Andy Galpin]

I know you've done a bunch of

[Host (possibly Dan Garner or another co-host)]

work in, of course, the military, tons of groups in there. You've done stuff with astronauts. Right. You've done stuff in Antarctica. Right. So how do you handle it when you have. When light is either not the cue, it's not there at all times, you're up in space, it's there at all times. How do you manage a sleep schedule when light is completely eliminated from the equation? Or maybe not eliminated, but you know what I mean, like, it's completely off a schedule.

[Dr. Alison Brager]

Yeah. So. So that's actually what speaks to the robustness of the sleep system is like work in these extreme environments. And I'll use our study in Antarctica as an example. So honestly, to date, that is probably the coolest project that I got to be a part of. How could it not be? So we did essentially a year long longitudinal assessment of sleep down. It was actually in collaboration with the Argentinian Navy. So they have this navy base down there called Belgrano 2. And it's actually the southernmost point in the world. And what's interesting is six months of the year, like they have access. It's kind of like being stationed on the International Space Station is you have access to food, water resources, and then medevac. But the other six months of the year, if something happens medically, they have to figure it out. Right. So there's a lot of stress during the winter because they don't have access to food resources or any contact with the outside human body.

[Host (possibly Dan Garner or another co-host)]

You can't get a plane in and out because of weather.

[Dr. Alison Brager]

You can't. Yeah, because of the weather. And so what we did was we used actigraphs, which, you know, still are clinical grade measures of sleep. Two weeks worth of actigraph data translates to a night of in a sleep lab. So a night of polysomnography.

[Host (possibly Dan Garner or another co-host)]

Yeah. This is a wrist wearable.

[Dr. Alison Brager]

Exactly. And it's extremely durable. I mean, we've taken these wearables out into combat zones and they've come back working completely fine. So they're made to withstand these extreme conditions. And what we found is the structure of sleep across this time. Being stationed in Antarctica does change from the summer to the winter. So for example, in the winter there's fewer sleep episodes, but the sleep episodes are longer. And then in the summer there's more sleep episodes, but the sleep episodes are shorter. But when you look at overall daily 24 hour sleep amounts, they're the same winter versus summer. And what's really interesting is that also lends to changes in physiology, blood pressure and cognitive performance too. So we also measured blood pressure down there so that we did four times a day. They did blood pressure measurements because they wanted to catch like, you know, predicted times at the circadian peak versus circadian trough. And then same with the gold standard for vigilance, which is the psychomotor vigilance test.

[Host (possibly Dan Garner or another co-host)]

Oh yeah, yeah, yeah.

[Dr. Alison Brager]

Like none of these parameters change seasonally. And I do believe it's because of the fact that like under, you know, complete observational study that the sleep system didn't change regardless of what was changing in the environment. Like that's just how robust our sleep system is.

[Host (possibly Dan Garner or another co-host)]

Biology figured it out.

[Dr. Alison Brager]

Exactly.

[Host (possibly Dan Garner or another co-host)]

Yeah, it got there. Right?

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

We talk a lot about when we coach people, we try to avoid using sleep optimization. Right. What we really try to go after is sleep resilience.

[Dr. Andy Galpin]

I want you to be able to

[Host (possibly Dan Garner or another co-host)]

have effective quality sleep independent of all these things. I think one of the things, things we have helped people with a lot is I don't want you to have to have a 90 minute routine and a 45 minute breathwork session and have everything perfect for you to have a reasonable night of sleep. You become super sensitive. Right. We want you to be more resilient against that. Sounds like that's exactly what you're talking about, that NIR system.

[Dr. Alison Brager]

Yeah. And so, I mean, so back in the military sleep lab, we've done these types of studies too. Right. Because we've done very well controlled either acute sleep deprivation to mimic Combat operations like what we're exposed to when we're deployed, or chronic sleep loss. And we actually find. When you go back to self report, even if someone had a really poor night of sleep, objectively. Right. But they are convinced that they got restorative sleep or that they have high sleep resiliency, their next day performance on objective tasks, such as the psychomotor vigilance tests will be better than someone who rates themselves as not being resilient to sleep deprivation. So, you know, you go back to that debate of biology versus psychology. I mean, I. Yes, I still sit in the biological camp, but I understand there are psychological influences.

[Host (possibly Dan Garner or another co-host)]

Don't you waver on me, Dr. Prager. No, no, no, no. How long is that tail gonna last, in other words? I mean, you've been outspoken about this. There's a difference between clinical deficiencies. Right. Whether this is because you have a sleep disorder or because you're in a special situation where you legitimately have sleep restriction. Whatever's going on, going from that to okay sleep is not the same thing as going from good to great sleep.

[Dr. Andy Galpin]

And there's huge performance advantages of going

[Host (possibly Dan Garner or another co-host)]

from good to great sleep.

[Dr. Alison Brager]

Yep.

[Host (possibly Dan Garner or another co-host)]

But at the same time, you've also just told me even if I have a terrible night of sleep, if I think I'm okay, I perform the best. So if I sleep like shit all the time, if I just think I'm fine, am I going to be okay? Like, where.

[Dr. Andy Galpin]

Where's the line here?

[Host (possibly Dan Garner or another co-host)]

You know what I mean? Like, what's the. Where's the breaking point?

[Dr. Alison Brager]

I will say with confidence, just from the studies we've done, the breaking point is 72 hours. No kidding. Yeah. Yeah. It is a very short term effect. I will say, and you know, to quote like the godfather of sleep medicine at Stanford University, Dr. William C. Dement, who passed away two years ago at the age of 98, he used to say, like, sleepiness makes you stupid because it is true. It's like this false sense that you're okay, but objectively, you're performing horribly. And that's really what we see, like, in studies we've done, and then even those endocrine studies where you're getting insufficient sleep and there's an immediate drop off in circulating levels of testosterone by day three, the system is at its max. I mean, we even found that with a study my. My colleague, Dr. Tracy G. Doty, did back at Walter Reed, where essentially caffeine will help stabilize your cognitive performance under insufficient sleep up to three days. And then after that, caffeine stops working. Like there's no amount of caffeine that can replace lost sleep. Only sleep can replace lost sleep.

[Dr. Andy Galpin]

So it would be fair then to

[Host (possibly Dan Garner or another co-host)]

characterize it as saying, have, if you have a bad night of sleep or two, don't worry about it. Yeah, past that though, we need to start making changes.

[Dr. Alison Brager]

Exactly. Yep. And that's, you know, I get asked this question all the time, is it good to keep the same sleep schedule? Like say you're getting insufficient sleep on the weekdays versus, you know, keeping that same schedule on the weekends? I come from the camp that like, I believe in sleep banking and trying to replace sleep pressure or build up on anticipated sleep pressure as much as possible. So for me, I work with populations where they're getting insufficient sleep during the work week and so they need to disrupt their circadian rhythm on the weekend to bank on that sleep to make up for lost sleep, but also prepare them for the week ahead. Um, and there is some data now, I know there's a study that came out a few months ago, again, large scale population study, that found that people who sleep in on weekends, if they are getting insufficient sleep on weekdays, have a 20% reduction in risk for cardiovascular disease.

[Host (possibly Dan Garner or another co-host)]

Are there frameworks in which you can do it where it doesn't mess up circadian rhythm? So the obvious example would be, and you're not saying this to be clear, if you wake up at five in the morning during the week, then, hey, it's okay to stay up till 4 o' clock at night on the weekends as long as you sleep till noon. That's not what you're saying.

[Dr. Alison Brager]

No, no, I'm not what it is, no.

[Host (possibly Dan Garner or another co-host)]

Clarify what you mean by like banking or extending out on the weekend so we don't get misinterpretations here.

[Dr. Alison Brager]

Yeah, that is true. So what I mean is you're gonna keep one of those things the same usually, right?

[Host (possibly Dan Garner or another co-host)]

Fall asleep, wakes up.

[Dr. Alison Brager]

You hope so wake up. Yeah. So in this circumstance, if you're going, if you're waking up at 5am and say you're going to bed at 11pm on the weekdays, then if you go to bed at 11pm on Friday night and Saturday night, but now you're sleeping in until 8 or 9. That's what I'm talking about. So you're keeping one of the two things consistent. Now I don't think this would probably work in people who, you know, use Friday night, go to the club, stay up really late and then try to sleep in. I mean, I know in the clinical world, when you look at like cognitive behavioral therapy for insomnia, for example, when those behavioral sleep medicine physicians are trying to extend sleep, they do it in 30 minute intervals. So that is something we do know about the circadian clock is that you can do things in 30 minute increments over an extended period of time to reduce the amount of physiological stress on the system.

[Host (possibly Dan Garner or another co-host)]

I wanted to actually ask about, on a similar note, sleep in space.

[Dr. Alison Brager]

Okay.

[Host (possibly Dan Garner or another co-host)]

I know you're in the process of hopefully becoming an astronaut yourself.

[Dr. Alison Brager]

Hopefully, yes.

[Host (possibly Dan Garner or another co-host)]

You're waiting back on that? We'll see. Maybe we'll have you back after you spend a year in space. But, um, how do you think about how do, how do we handle sleep and spacing and when we've lost not only light, but a thousand other cues?

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

So first question on this. Do people in space sleep? Okay? Is it a huge problem? What's it look like up there?

[Dr. Alison Brager]

So anecdotally, from what I've heard it, it depends. So, for example, Colonel Frank Rubio, we had him, he actually gave a, a leadership lecture to those of us at work from the International Space Station when he was waiting to come home. Because as you know, he was up in space for the longest of any human ever at the, in the International Space Station. He said he slept great.

[Host (possibly Dan Garner or another co-host)]

How long was he up there for?

[Dr. Alison Brager]

It was over a year.

[Host (possibly Dan Garner or another co-host)]

Way over a year.

[Dr. Alison Brager]

Yeah, yeah. Like, I understand, like that the psychological demands the current astronauts are facing right now is difficult. But he talks about that as well, just missing important family events and whatnot. But he said that he slept great in space. I've met a few other astronauts who said that it was the opposite for them. And then there's lingering effects back on planet Earth, such as difficulties with entries and maintenance of REM sleep, for example. It makes sense to me in terms of a microgravity environment impacting sleep, because just like with other sensory systems of the nervous system, what is the epicenter of sleep maintenance and sleep continuity is the thalamus. Right. The thalamus is the gateway for sensory information. And there's a direct connection between your vestibular balance system and the thalamus that's going to influence sleep states. I mean, again, this hasn't really been studied at a deep physiological level in space. But hypothetically, what we know about the circuitry of the vestibular system and how it synapses on the thalamus, that's what I predict is what's influencing these changes in sleep architecture. With microgravity, they have light taken care

[Host (possibly Dan Garner or another co-host)]

of for the most part.

[Dr. Alison Brager]

Correct. Yeah, they have. I mean that's one thing is a lot of what we know about the influence of light and photic information on human physiology, behavior and performance actually comes from honestly, NASA. They have a really fantastic crew and they always have of like sleep and circadian fatigue scientists. My friend, Dr. Erin Flynn Evans, she's one of the main fatigue scientists for NASA and she comes from that body of training at Stanford and Harvard who have been the founding fathers and mothers of sleep physiology and medicine.

[Host (possibly Dan Garner or another co-host)]

What do they do for physical sleep? Are they tying them down to the side of the space station so they're not floating around? What is actually happening? Because to your point about the thalamus, when you just look at pressure differences, right, There's a physical pressure that changes when you spend your entire day erect and you go horizontally. Right. Fluid shifting. You have a whole host of things that are happening. This is one of the things that's actually I've seen in the research recently about problems with sleep related to obesity that are not just airway blockage. Right. You have fluid shifting, you have other things that are going on that are real problems. So how do they handle that stuff? Do they sleep horizontally? That wouldn't matter. Right.

[Dr. Alison Brager]

So my understanding is they're sleeping vertically and it's like you're velcroed in essentially. So it's, that's, that's my understanding of it. So I don't know. I'll report back to you once I'm up there.

[Dr. Andy Galpin]

I want direct report.

[Host (possibly Dan Garner or another co-host)]

We want to actually do a follow up episode from the.

[Dr. Alison Brager]

Well, they do. So when I went for selection the first time and we went to mission control, there is a phone and you know, their day is very structured and scheduled, but they do have time where they can use this phone in the space station and call down to like their family and they'll use it to like watch a movie and stuff with their family. So.

[Host (possibly Dan Garner or another co-host)]

Nice.

[Dr. Alison Brager]

Yeah, I'll use that time for a podcast.

[Host (possibly Dan Garner or another co-host)]

Perfect. Well, I'm going to hold you to that. Have you thought at all about sleep in Mars?

[Dr. Alison Brager]

Yeah, I mean I have. So that's, that's why I think it's going to be personally like more important than ever for NASA. If we want Mars to actually be a viable, feasible thing, you are going to need physicians and you are going to need scientists and obviously engineers. Right. Makes sense behind that to lead that mission because you know, physiology and extreme environments, as we just talked about with the work we've done in Antarctica even all the work we've done in active combat zones in the military is, it is very different. And we need to understand those nuanced differences and also understand nuance differences between men and women. Right. Because it's going to have an impact there.

[Host (possibly Dan Garner or another co-host)]

Do you think it could be part of the screening process for those folks that go out there?

[Dr. Alison Brager]

Oh, absolutely. I mean, I think when it comes for training for Mars, and in full disclosure, so the class of astronauts that I was part of in 2020, like that first class selected, is hypothetically the first class to prepare for Martian exploration. I think they're going to look at health above all else. I mean, skill set and talent is important, but I feel as if the talent is less important than finding an incredibly healthy person who does not have any family history of any disease whatsoever or injustice is, you know, genetically very healthy.

[Host (possibly Dan Garner or another co-host)]

So I've been saying for a long time Mars is not going to be a rocket problem, it's a physiology problem.

[Dr. Alison Brager]

It's a physiology problem. Absolutely. Yep.

[Host (possibly Dan Garner or another co-host)]

What would you do personally to prepare for that? Would you just figure it out along the way or is there any sleep Brazilian stuff you could do? Is there any different training or any other stuff you would do in preparation for Mars?

[Dr. Alison Brager]

I don't know if this sounds far fetched, but I wouldn't treat it any differently than these, you know, pre clinical mouse model transgenic studies we used to do. Right. Or I have done is you have to first understand the physiology and behavior, you have to break it down and then again study sex differences in this behavior because it's going to impact males and females differently. And then that's where you use the power of pharmaceutical nutraceutical and genetic interventions. I mean, even to the point of, I think it's necessary and sufficient at this point to use things like CRISPR and gene editing to like, I mean it, it becomes like the ultimate biology physiology problem, having that opportunity to explore Mars. I mean sure, you want these people to live long, healthy lives after they're done with the space program, but at the end of the day you also have this person who has this mentality that they're willing to be like yeeted off the planet into the unknown. So, you know, I feel like people like me who are willing to, you know, who have wanted to be an astronaut like their whole life, you know, we're willing to accept some pharmaceutical or nutraceutical or genetic interventions in order to get the job done.

[Host (possibly Dan Garner or another co-host)]

Yeah, I mean, I guess what you're saying is if you're 95 of the way there. And there's just a couple of things that are stopping you. Why not exactly take those and get all the way out there?

[Dr. Alison Brager]

Exactly.

[Host (possibly Dan Garner or another co-host)]

Well, I fully support that. Do you know of any animal models that are doing things like that, like gene editing? Probably. Obviously not for Mars, but for other aspects of sleep. Are you aware of any clinical trials happening or people tinkering with that or labs that are working on stuff?

[Dr. Alison Brager]

So, in regards to space exploration, I don't know that, but I will say, like, CRISPR and gene editing to better understand sleep physiology has been a thing. I think that's really what you see now when you look at, like, the evolution of using preclinical animal models to understand mammalian physiology as behavior. Right. It's like I came from the generation where we were still working with these transgenic mouse models, you know, just through sophisticated breeding of heterozygous and homozygous mice, to hope and pray you get the genotype based on Darwinian, you know, hereditary genetics that you're hoping for. But now we can actually go in and directly manipulate the genome through gene editing or like, as a postdoc, when we were doing that skeletal muscle physiology project, we were using a transgenic mouse model where we just had to give the mouse doxycycline, so the antibiotic to either turn on or turn off genes.

[Host (possibly Dan Garner or another co-host)]

Oh, because you had already put something in there and you just had to activate it.

[Dr. Alison Brager]

I didn't put it in there, but the, you know, the group at Southwestern that had created these genetic mouse models. Yeah. That's a whole nother world of, like, molecular genetics that I don't understand. And I just really appreciate that they're clever and intelligent enough to do something like that.

[Host (possibly Dan Garner or another co-host)]

But, you know, there are a number of people who sleep poorly, and there's a select number of people who sleep horribly but somehow get away with it. Right. And you talked about earlier in. I know that there's plenty of studies that look at a lot of people who think they're getting away with it. Aren't. So cognitive function is way lower, even despite people's perception.

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

Of their cognitive performance. Right. They're, like, significantly lower. That's been shown many, many times. Right.

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

So we argue this all the time. When you're like, if we look at your data and your numbers are not great, but you think and your perception is high, there's a good chance that it's not actually as high as you think.

[Dr. Alison Brager]

Yep.

[Host (possibly Dan Garner or another co-host)]

But there are those select few. Right. Those people who can get away With a few hours of sleep per night. Right. Four or five or probably is probably more appropriate. Do you think it's realistic at all for us to be able to engineer something like that? So could we figure how much do we know about the genes behind those? Is there a phrase for people that sleep for four hours a night and actually get away with.

[Dr. Andy Galpin]

What do we call them?

[Dr. Alison Brager]

I mean, we could. So they're short sleepers. Short sleepers, yeah. So that gene was isolated and discovered in a preclinical mouse model. And again, population genome, one study in humans, I'd say 10, 15 years ago. It's called the DEC gene. DEC. So those are individuals who are able to sleep four hours, again, hypothetically. What I think is going on is they're reducing their extracellular adenosine really quickly, because that's really what it is. How quickly can you reduce sleep pressure? That's what determines your physiological set point for sleep. So I need, for example, myself, I'm like an 8.2, probably eight and a half hour sleeper. So I know my sleep pressure dissipates very, very slowly. But in these individuals, it dissipates very quickly.

[Host (possibly Dan Garner or another co-host)]

How much actual work has been done on those individuals in terms of physical performance? Obviously we know like long term they don't die earlier. That's like the clinical markers we have. But are they really physically performing at their best? Are their cognitive function as high? Like, has there actually been reasonable research on that?

[Dr. Alison Brager]

No, there hasn't. I mean, I would love, if I had money to do that work, I would. I mean, like US Presidents are a great example. Like just historically, anecdotally, what we know about most US Presidents is they don't really sleep a lot. But again, they were sort of, you know, self selected. It just, I would say the same with military leaders. Right. They're self selecting because of genetics. Like when you get to that level. I think we know this in sports too. Right. That's why one of my favorite books is the Sports Gene, because it really talks about how your genetic blueprint can sort of guide you into what sport you play and what sport you excel in.

[Host (possibly Dan Garner or another co-host)]

I know that there was actually some stuff that came out recently on President Trump and they were able to assess his sleep duration simply by his online activity.

[Dr. Alison Brager]

Oh yeah, I do remember that. Yeah.

[Host (possibly Dan Garner or another co-host)]

Right. So like he's one of these guys that apparently legitimately does. And I know there's, there's lots of. Yeah, lots of people talked about President Obama as well as like working these.

[Dr. Alison Brager]

Right. Stanley McChrystal Like Admiral McChrystal, he was known to be a two, three hour sleeper. I mean, I see that even in my own workplace too.

[Host (possibly Dan Garner or another co-host)]

Right. Like folks you work with.

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

Is there a way that you could get to that? Right. So kind of what I'm getting at on the back of that thing is saying, like, hey, can we, number one, be more resilient, be more efficient? And then. Well, that'll actually allow me to shorten my hour demands down to a reasonable. Is that what's happening with these presidents? Are they just hyper efficient? Is their sleep architecture? Is their sleep resilience? Is there sleep stability just way higher? Or are they kind of the same and it doesn't matter? It's actual presidents. Right. It's just people that get away with it, or are they just the same and they just can get away with way less hours?

[Dr. Alison Brager]

No, it's more efficient. Right. Because that's what, again, these preclinical animal models that we can glean into is like the sleep pressures dissipated really quickly. So there's significant increase in slow wave activity very quickly, and it's extended for a period of time because that at the end of the day, that's the manifestation of dissipated sleep pressure is stage 3 non REM sleep or slow wave activity. But I do think it's one of those things. Again, it has to be guided through the lens of biology. And it can't be trained. Right. It is, because it breaks down to differences and the architecture of the neuronal circuitry and the neurochemistry. And I don't think any amount of training or, you know, behavioral intervention could lead to a physiological change of that significant capacity.

[Host (possibly Dan Garner or another co-host)]

Too much. Just endogenous natural function.

[Dr. Alison Brager]

Exactly.

[Host (possibly Dan Garner or another co-host)]

That have to be manipulated. Let's go the opposite direction.

[Dr. Alison Brager]

Okay.

[Host (possibly Dan Garner or another co-host)]

Sleeping a lot. You have made the case. I have made the case that high performers are probably looking at more like eight and a half to nine, maybe nine and a half hours of sleep. Right. And that's been shown many, many times.

[Dr. Alison Brager]

Yep.

[Host (possibly Dan Garner or another co-host)]

I'm gonna spend a lot of time on that. But before we get there really quickly, what about past that point? What do we know about people sleeping routinely? 9 and a half hours, 10 hours? Assumption is that's not a good thing.

[Dr. Alison Brager]

Yeah. So actually, my buddy Michael Granier at the University of Arizona, he's looked at that. Right. It's like, it's not good to be on either tail end. So insomnia, hypersomnia, as it's called, is just as bad as insomnia. And if you look at Morbidity and mortality. And those individuals who get, who need 10, 11 hours of sleep because their rate of dissipating sleep pressure is just so low, like they suffer from the same health outcomes as someone who obviously willingly shortchanges their sleep because of life.

[Host (possibly Dan Garner or another co-host)]

Why does somebody need 10, 10 and a half, 11 hours of sleep? Is that a insanely inefficient sleep pattern or are they sleeping that because of other reasons? I guess another way to think about it is when they wake up the next day and they still feel tired. Right. It's like, I slept nine hours, I still feel tired.

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

Probably something's happening, I assume, right?

[Dr. Alison Brager]

Yeah. I mean, my assumption is there's, there's a physiological disruption there mixed with, for example, we know people who are clinically depressed, for example, do fall in this category of hyperinsomnia. And so, and, and some of that, again, can be. Is physiologically rooted, but, you know, compounded by life trauma too, that could be contributing to that clinical depression. But that's where I think we most oftentimes see these issues with hypersomnia is they're usually also associated with some sort of mental health condition as well, particularly clinical depression.

[Host (possibly Dan Garner or another co-host)]

Interesting.

[Dr. Alison Brager]

Or someone with chronic pain like fibromyalgia, for example.

[Host (possibly Dan Garner or another co-host)]

Yeah, that makes sense. How much do we know, if any, about cause and effect there? Which direction?

[Dr. Alison Brager]

Oh, that is like, that is still to this date a constant debate in the sleep medicine community. So I've been going to the annual sleep medicine conference now since 2006. I've only missed one. That was the year I was competing in the CrossFit Games. But besides that, like, that's still one of the centerpieces of the meeting is like, is chicken or the egg? Is it the sleep manifestation of then depressive symptoms or do the depressive symptoms contribute to the sleep symptoms? And every year there's new data presented, not just in preclinical animal models, but in human studies as well, that. No, it's so complicated and nuanced. And even with the ability to effectively treat clinical depression now, not just with pharmaceuticals, but also with, for example, transcranial electrical stimulation or transmedic stimulation, there's still just not a consensus in terms of, you know, is it the sleep or is it the depression? More than likely it's a combination of both.

[Host (possibly Dan Garner or another co-host)]

It's gotta be, right?

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

In some people you could certainly see a bunch of chronic poor sleep led to poor health effects, and certainly can see the opposite. Something else happened in life, created mental health concerns, and then because of that you can't sleep. Like you could certainly see the only reality here is there's room for both.

[Dr. Alison Brager]

Yep.

[Host (possibly Dan Garner or another co-host)]

Like both are potential causes. So trying to isolate and say one is always driving the other one is, it's honestly, it's quite nonsensical right now. Where we're gonna go.

[Dr. Alison Brager]

Yeah, I mean, we see the same thing. You know, use in my community with traumatic brain injury is like, we know from the clinical studies, like this one study we did at Walter Reed, that if you have a mild, even just a mild traumatic brain injury, it's going to lead to long term changes in sleep architecture. But then you have all the lifestyle factors that also are influenced by that. Right. Like using alcohol to cope with the lack of sleep or difficulties with sleep now that weren't in existence prior to traumatic brain injury, the inability to regulate stress and how because of that inability to regulate stress, that's going to impact sleep. It's right. You can never have things in isolation.

[Dr. Andy Galpin]

Today's episode is sponsored by Momentous. Momentous makes the highest quality supplements on the market, period. Many of you know me and you know that I do not trust the vast majority of supplement companies and for good reason. Many studies have shown that anywhere between 10 to up to 40% of supplements have accidental contaminants, intentional alterations, mislabeling or other serious issues. But Momentous is different. I literally spent years vetting the company, their products and leadership team before personally officially partnering with them in 2023. Every single one of Momentous products is third party tested to ensure quality and many are even NSF certified for sport. Now, while I love all of their products, the ones I use the most, both personally and with my clients are what I call the big three. And these are the omega three fish oil, creatine and newly improved whey protein formula. These three supplements have fantastic data supporting their benefits. Whey protein for lean muscle mass, omega 3s for brain health, and creatine for both muscle and brain support. And they have been shown to be very safe across basically all populations of people, young, old, men, women, etc. Now, nobody has to use supplements and I hope you never feel pressured to do so. But if you're interested in supplements, it's important that you get them from the highest quality providers. You don't want mercury in your fish oil or lead in your whey protein or anything like that. So that's why I stick exclusively to Momentous. If you'd like to give Momentous a try, go to livemomentous.com perform to get 20% off your order. Again, that's livemomentous.com perform to get 20% off.

[Host (possibly Dan Garner or another co-host)]

How do we create more efficient sleep? So when somebody says, allison, I've got A and B job, whether it's going on like six and a half, seven is just the most realistic thing. Can I get more efficient in that time?

[Dr. Alison Brager]

Yep.

[Dr. Andy Galpin]

And I'll give you a little bit

[Host (possibly Dan Garner or another co-host)]

of a pass here. You can skip past all the basic hygiene stuff.

[Dr. Alison Brager]

Right?

[Host (possibly Dan Garner or another co-host)]

Like cold, dark room. Yeah, we get it all that.

[Dr. Alison Brager]

Yeah, yeah.

[Host (possibly Dan Garner or another co-host)]

What past that can we do?

[Dr. Alison Brager]

I mean, I think that's where the circadian system really takes over. Right. Like I talked earlier about these time cues or zeitgebers.

[Host (possibly Dan Garner or another co-host)]

Yeah.

[Dr. Alison Brager]

When you have predictable time cues in your environment, and this isn't just a human. I mean, we see this in mouse and rodent models as well. Once that time cue is presented, that behavior will then follow that time cue. So if you are eating at a particular time, if you are engaged in social stimuli at a particular time, if you're viewing sunlight at a particular time, then at night, if you're now exposed to dimmer light at a particular time, you have eaten dinner at a particular time, and then whether you have a sleep hygiene routine or not, but you are now going to bed at a particular time, your brain will now consolidate sleep into that period of time.

[Host (possibly Dan Garner or another co-host)]

I work with a bunch of entrepreneurs, a bunch of business owners, executives for sport teams and things like this. Right. We get this question constantly. So let me frame you with a theoretical. That's actually not at all theoretical. I just don't want to say the person's name example.

[Dr. Andy Galpin]

And I'm going to give you a

[Host (possibly Dan Garner or another co-host)]

ton of incomplete information.

[Dr. Alison Brager]

Okay.

[Host (possibly Dan Garner or another co-host)]

But just do your best to what something could look like. I will also give you more caveats for you. This is maybe not the optimal system or best system, but hopefully what you'll provide for us is just one example of what it could look like.

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

Fair game.

[Dr. Alison Brager]

Sure.

[Host (possibly Dan Garner or another co-host)]

All right, awesome.

[Dr. Andy Galpin]

So you got an individual and they're

[Host (possibly Dan Garner or another co-host)]

going to flat out say midnight is when I'm gonna go to bed. And I gotta be up at 6.

[Dr. Alison Brager]

Okay.

[Host (possibly Dan Garner or another co-host)]

That's the rules of the game, period. Right. Whatever it takes. I will get into bed at about 11:50 and the alarm is off at 6 and I'm getting up and out of bed, period.

[Dr. Alison Brager]

Yep.

[Host (possibly Dan Garner or another co-host)]

I have hundreds of millions of dollars, closer to billions actually on the line. So I need my cognitive function to be at its highest. I want to perform well physically, but that's my second year Priority, Right?

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

So cognitive function is this person's top. But will not accept low energy, will not accept terrible physical performance in the gym.

[Dr. Alison Brager]

Yep.

[Host (possibly Dan Garner or another co-host)]

Is going to train every day. We'll do some conditioning, we'll do some lifting, do a variety of stuff. Right. Also has children. Right. So we'll pay attention to children from like three to eight o' clock or so. And then because he's working with kids from 3 to 8 or playing with his kids and being very present, he's definitely gonna go back to work at 8 o'. Clock. Yeah, it's gonna happen. Right. 8 to 10:30 or so, maybe up to 11 is back to work and then 11 to midnight is shower wife situation. Before I start asking you questions, any more critical information you have to know

[Dr. Alison Brager]

about this person, I do wanna know if they think they're a morning or evening person.

[Host (possibly Dan Garner or another co-host)]

This person will tell you. Doesn't matter.

[Dr. Alison Brager]

Doesn't matter. Okay.

[Host (possibly Dan Garner or another co-host)]

Whatever is going to take to make this is the schedule. But I would say has he certainly self induced himself to be a morning person whether he is there or not.

[Dr. Alison Brager]

Like gotcha.

[Host (possibly Dan Garner or another co-host)]

That's the thing very much military business. Like yeah, you got to be in the office by seven. Like that's just what you sort of do.

[Dr. Alison Brager]

Yeah. Gotcha.

[Host (possibly Dan Garner or another co-host)]

Stimulants are on board, Pharmaceuticals are on board. Don't care. Doesn't drink alcohol excessively. But whatever it takes to perform the best. Doesn't want to compromise long term health, doesn't want to die earlier, any of those things.

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

But if you say take a take melatonin, great. If you say don't take melatonin, great. You say drink caffeine, great. Like doesn't care. Whatever it's going to take to get the job done.

[Dr. Alison Brager]

Okay.

[Host (possibly Dan Garner or another co-host)]

So that said, let me just do like a theoretical kind of high level thing. Waking up at 6, anything that he should particularly take, do, don't do for the first, I'd say he'd give you 45 minutes in the morning. Right. Anything that would jump out on your list of like critical stuff to do at that timeframe to get going cognitively.

[Dr. Alison Brager]

Well, since stimulants are allowed, I mean caffeinate. Right. Because what we know from our clinical studies is the easiest way to reduce sleep inertia in the morning, that grogginess, is to caffeinate as soon as possible.

[Host (possibly Dan Garner or another co-host)]

As soon as possible.

[Dr. Alison Brager]

Less than 200 milligrams. Cause 200 milligrams. We know from our randomized clinical trials we've done numerous circumstances under conditions of acute Sleep deprivation, chronic sleep deprivation. Even looking at genotype, for example, 200 milligrams is the ceiling effect for caffeine. So like two cups of black coffee.

[Host (possibly Dan Garner or another co-host)]

So if you go to three or 400, you're just hitting the gas pedal, you're not going down.

[Dr. Alison Brager]

Exactly. Yeah, it's right.

[Host (possibly Dan Garner or another co-host)]

Okay, so 200 within the first few minutes of getting up.

[Dr. Alison Brager]

Correct.

[Host (possibly Dan Garner or another co-host)]

Anything else?

[Dr. Alison Brager]

I mean, obviously sunlight.

[Host (possibly Dan Garner or another co-host)]

Yep.

[Dr. Alison Brager]

Right. That's a, that's a given.

[Host (possibly Dan Garner or another co-host)]

Um, he'll work out whatever time. He'll work out in the morning, he'll work in the afternoon, whatever. When should he train?

[Dr. Alison Brager]

So that's why I asked if morning person, evening person, um, I mean, if I was him, I would probably train in the morning. Right. Because now you're capitalizing on that rise in cortisol. So you're going to optimize your training more so than you would in the afternoon. And then you're gonna get that extended, you know, cognitive, mood energy to be more productive in the latter half of your, your morning as your cortisol continues to rise.

[Host (possibly Dan Garner or another co-host)]

Okay, makes sense. Anything else we should consider in the morning or should we move throughout the day?

[Dr. Alison Brager]

I would say during that time too. It's, you know, depending on where this individual lives, like vitamin D supplementation. I mean, even if you are getting natural sunlight, you know, if you're up in Boston or New York like a lot of Wall street executives, it's not, you know, it's good to supplement with vitamin D. Okay.

[Host (possibly Dan Garner or another co-host)]

Anything he should be doing specifically throughout the day or not doing until that three o' clock goes, gets kids and sort of all there.

[Dr. Alison Brager]

So again, with strategic caffeine dosing, that's why, you know, we had done all those studies in randomized clinical trials, so you can supplement with 200 milligrams of caffeine every four to six hours as needed. You can even do two to four hours as needed, stopping at least six to eight hours before bedtime.

[Host (possibly Dan Garner or another co-host)]

Okay, so he'd be good to take, he could have his six o' clock caffeine and then maybe have it again

[Dr. Alison Brager]

at noon or even like 9 o' clock in the morning if he wants. And do it again at noon. Right.

[Host (possibly Dan Garner or another co-host)]

And then maybe, maybe even again at like three or four.

[Dr. Alison Brager]

Yep. As long as. Yeah, because that's within the eight hour time window. Before, before midnight. Yeah, before midnight.

[Host (possibly Dan Garner or another co-host)]

Okay. He's going throughout the day. He's going to go back to work, like I said, at 8 o'. Clock.

[Dr. Alison Brager]

Yep.

[Host (possibly Dan Garner or another co-host)]

And he's not going to stop until an hour before he goes to bed, are there any best practices, any things he can do either during that three hour work window or right after it? What can he do to make sure that when he gets into bed at 11:50 he is asleep by midnight or close to it and has the highest quality six hours possible?

[Dr. Alison Brager]

Well, so that's why like he's not gonna have it like a full on sleep hygiene routine. And here's the thing, that sleep hygiene routine, that 90 minute routine isn't necessary if you are keeping everything else in your environment consistent. But in order to help facilitate that sleep. So you have like a 10 minute sleep onset. That's where I. Blue light blocking glasses. Right. As you're working. That's what I would have this individual wear. Because now you're still promoting that dim light melatonin onset to then let that individual go to sleep.

[Host (possibly Dan Garner or another co-host)]

So while he's still aroused from work activity, he can mitigate some.

[Dr. Alison Brager]

Exactly right. Because you're still gonna have brain activity and gamma beta activity. It's not gonna be anywhere close to alpha, but at least you're not disrupting the dim light melatonin onset through not having blue light blocking glasses.

[Host (possibly Dan Garner or another co-host)]

Anything that he should take from a food or a supplementation or drug or anything. Maybe you don't have to go too far in the drug without knowing more medical history there. But like anything that you should take either, you know, 8 o', clock, 9 o', clock, midnight or right before bed, or just sort of stay away as much as you possibly can.

[Dr. Alison Brager]

So it is okay to eat. There are, believe it or not, sleep promoting foods. So very recently there was isolated a protein factor in, believe it or not, warm milk.

[Host (possibly Dan Garner or another co-host)]

Warm milk.

[Dr. Alison Brager]

Warm milk. That is sleep promoting. Other sleep promoting foods that have been studied in randomized clinical trials include things like kiwis. Well, we already talked about tart cherry extract that's good for skeletal muscle recovery. So that's something I would, I would take in addition to working. Right?

[Host (possibly Dan Garner or another co-host)]

Yep.

[Dr. Alison Brager]

Or what do you call slow release protein, like a case and wave protein.

[Host (possibly Dan Garner or another co-host)]

Yeah, yeah. Okay. And any other maybe, are there any common mistakes that they're making that are, that are maybe disrupting the sleep? You know we talked about melatonin earlier, right? So what about chronic use of melatonin for someone like this? It's like, hey, I want to make sure I get to sleep quickly, so I'm going to take 10mgs of melatonin every night.

[Dr. Alison Brager]

Yeah, you don't need melatonin. And actually that melatonin will prevent you from entering the restorative stages of sleep. So not a good idea. So yeah, at night, like, if you want to take anything to help influence sleep maintenance, it would be magnesium biocarbonate. So a powdered form of magnesium, it's going to have greater bioavailability, but that would be a good thing. That also helps offset loading of the central nervous system throughout the day, especially if this individual is, you know, doing strength and conditioning as part of their physical fitness routine. But no, melatonin does not work as a nighttime sleep aid. It acts as a phase shifter, but not as a nighttime sleep aid. And it can have negative impacts on sleep architecture if not dosed appropriately.

[Host (possibly Dan Garner or another co-host)]

What about any tools or technologies? Any brainwave stuff he could do or not do? You mentioned the shiftwave chair earlier, but anything else like that or you feel like as long as you're like, this would be a pretty good setup for

[Dr. Alison Brager]

this person if they keep having these time cues and keep working in this environment environment night after night, like again, the brain will remember and consolidate those time cues to then help promote efficient sleep.

[Host (possibly Dan Garner or another co-host)]

So just build the pattern.

[Dr. Alison Brager]

Yep, exactly. Patterns are everything. Um, I mean, I would say the last hack, right? Like we talk about the cool, dark, quiet room, um, but believe it or not, taking a hot shower before even like a five minute hot shower before bed, that's gonna, right? Compensatory mechanism is to cool you. So yeah, right. Don't cold plunge before bed. I always tell people that that is one social norm that has become popular. And you know that mouth taping.

[Host (possibly Dan Garner or another co-host)]

So tell me about the cold plunging and mouth taping.

[Dr. Alison Brager]

Big fan of it. But it has to be the right time of day if you think about it, right? You take a hot shower. Compensatory mechanism is your body wants to cool down, right? If you cold plunge, compensatory mechanism is your body wants to warm up. You don't want to go into bed warm. You want to think of sleep as a state of hibernation. And essentially that's what happens at sleep, right? Is like there's a significant drop in core body temperature. And the greater the drop in core body temperature, the greater the propensity to spend in deep restorative non REM and REM sleep, right? So mouth taping, like general consensus American Academy of Sleep Medicine, like, understand that nasal breathing is pretty promoting the parasympathetic nervous system. That's fine. But if you're going to mouth tape, like do it during the day to train your diaphragm to activate appropriately to then be able to Breathe through your nose at night and not your mouth when you're asleep. The idea is right when you're asleep, I mean, you're not unconscious, but you're in a subconscious state and you need every bit of air you can get into your system. And depending on what sleeping position you're in, especially if you're sleeping on your back or if you're sleeping on your stomach, you're not going to have the cool, the full capacity to activate your diaphragm to take in air. So if you're limiting the ability to take in air through your mouth because you don't have a well trained and strong diaphragm, then you're setting yourself up for risk of apnea like episodes.

[Host (possibly Dan Garner or another co-host)]

Right.

[Dr. Andy Galpin]

What about nasal dilators?

[Dr. Alison Brager]

Oh, those are great. Yeah. Any reduction in mouth breathing and increase in nasal breathing will promote restorative sleep and nasal dilators can help with that process.

[Dr. Andy Galpin]

Okay, so if you're going to use

[Host (possibly Dan Garner or another co-host)]

something up there, opt more towards just helping airflow through the nose rather than blocking it through your mouth.

[Dr. Alison Brager]

That's a better approach.

[Host (possibly Dan Garner or another co-host)]

How did you handle the jet lag last night? Right. How, how would this guy or anybody else when we're. Let's just say that the normal person is, you know, traveling once a month or so for two or three days, right. And let's just assume at least a three hour change. Obviously if you're going a one hour difference, it's not a big deal, but what can we do best to enhance? If you don't want to call it jet lag, fine. Like, because it's probably not that, but you get a time shifting like that, multiple hours and I still got to do my business meeting, I got to do my work, I got to do whatever I perform the next day.

[Dr. Alison Brager]

Well, it's a whole process. Right. And I'll give a shout out to my friend Andy, who is the CEO of FlyKit or Fountain Bio. Actually his chief science officer, Clayton and I, we started in the same sleep lab as undergraduates at Brown University. Yeah, it's always such a small world in human performance, but it was an intentional process, right? Like, so what's in this fly kit is there are a certain pack of supplements that promote or that reduce inflammation. So combination of fish oil, high dose vitamin B, part cherry extract, things like that. I also wore the blue light blocking glasses that are in the kit on the plane. Um, you know, I don't really watch TV or movies. That's. I know that seems like I'm a weird like psychopath. But I just use them. And I was reading. Right. And then when I got to LAX on the way to the hotel, that's when I took the melatonin. But I only ever take melatonin when I travel. And that's only within the first day or two to help coax my system into adjusting. But once I'm adjusted, I stop taking melatonin.

[Host (possibly Dan Garner or another co-host)]

How much do you take typically? What's an effective dose for you?

[Dr. Alison Brager]

So effective dose for me, honestly is 1 milligram. But like, anything over 3 is. Is that we find to like, not. It's the ceiling effect, really. Yeah.

[Host (possibly Dan Garner or another co-host)]

We've seen a lot of people. You'll see a lot of recommendations of like 5 to 10.

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

When we use it, one would be about the high end as well. Like it actually really much more than that. You're not getting.

[Dr. Alison Brager]

Right.

[Host (possibly Dan Garner or another co-host)]

Really anything. We stay pretty low. It also stays around. It's supposed to have a half life. Like everything does. But when you consistently dose it, it stays around for a long time.

[Dr. Alison Brager]

Yeah. Oh, well, I will tell you. So I'm one of those believers. Like, I think Oliver Sacks is like this. Like, he always. In order to believe the things he studied neurochemically, he would take them themselves. So I went into. Since you went out to North Carolina, I went into one of those country dollar general stores, you know, on the drive to work, and I found a 20. Oh, a 20 block of melatonin. Oh, I took it. Oh, my God. I was fucked up for like two days.

[Host (possibly Dan Garner or another co-host)]

Oh, I believe it.

[Dr. Andy Galpin]

I don't. Yeah. I do not care.

[Dr. Alison Brager]

I was worried. I was actually worried at first about taking it because I again, I live alone. So I called my wife. I was like, oh, honey, if I don't wake up in the morning, like, call 91 1. But I. But they literally, it was a two block pack too. So like some idiot could have taken 40.

[Host (possibly Dan Garner or another co-host)]

Yeah, like 40. That's so much.

[Dr. Alison Brager]

But I took the 20 and I was. It took me. I was like brain dead for two days.

[Host (possibly Dan Garner or another co-host)]

We used to measure. I was telling you this morning, like, we used to measure urinary melatonin. So this is a metabolite, right? It should be metabolized. It should be very minimum. We don't need more. But we did it. And I would probably say, I don't know, over 10 times we saw people that were 20 to 30 x upper range reference range values for melatonin. And you're like, whoa, like, we don't have any sleep problems to fix here. The reason you feel Like a zombie all day is because you're sedated.

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

Like you were sedated with melatonin constantly. And just removing melatonin from them all of a sudden, all their years of sleep testing issues.

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

Gone.

[Dr. Alison Brager]

Right.

[Host (possibly Dan Garner or another co-host)]

It's like just gone. They're like, oh, you're just walking around sedated.

[Dr. Alison Brager]

Yeah. And plus too, they probably weren't getting the effective entries into deep restorative non REM sleep, you know, nothing. Yeah, yeah.

[Host (possibly Dan Garner or another co-host)]

Like they were on the classic stimulant sleep drug cycle.

[Dr. Alison Brager]

Yep.

[Host (possibly Dan Garner or another co-host)]

Feel like terrible.

[Dr. Alison Brager]

Oh, yeah.

[Host (possibly Dan Garner or another co-host)]

Take a load of stimulants, then you can't get to bed. So you take a load of sleep alcohol or.

[Dr. Alison Brager]

Yeah, yeah.

[Host (possibly Dan Garner or another co-host)]

Just break that cycle. So, yeah. Let's talk about sleep extension.

[Dr. Alison Brager]

Sure.

[Host (possibly Dan Garner or another co-host)]

Sleep banking. What's the proper way to think about this? Why do I even care about it? When is the best way to use it? Who should be thinking about it? Obviously all of us want to extend our sleep. Right?

[Dr. Alison Brager]

Right. Yeah.

[Dr. Andy Galpin]

You have parents.

[Host (possibly Dan Garner or another co-host)]

It's like, yes, I would love to sleep more. Not gonna happen. So make your most convincing argument for how much do I need here and what are the best principles around sleep extension?

[Dr. Alison Brager]

So again, it's that 20 to 30 minute rule. Right. Because that if you're extending sleep within a 20 to 30 minute period, then it's not providing additional physiological stress to the circadian system. Right. Because that's a delicate balance of maintaining or satisfying the sleep homeostatic system, which is sleep amount and then circadian system, which obviously influences sleep quality. So that's the one way to start. Now, sleep extension, we use it in many different forms. So napping serves as a form of sleep extension. Right. You use napping essentially to repay off sleep debt. Um, so if you're in an insufficient sleep state, typically we'd start with, okay, take a 20 to 30 minute nap. Now, if you can't nap because you aren't that person, then that's when we go to. Okay, let's either put you to bed 30 minutes earlier or extend your sleep by 30 minutes earlier or later in the morning. Again, that's done in a 30 minute interval. So typically what's practiced and folks who do cognitive behavioral therapy for insomnia who are trying to extend somebody's sleep is they'll have that individual go to bed earlier, 30 minutes or wake up later 30 minutes for a period of a week or two, and then after that period of time, they extend it by 30 minutes here and there. I know you've talked about this before on the protocol, it's physiologically impossible because the circadian timing system will not let you go from five hours to eight hours. It is not that simple. You know, I see this a lot with soldiers who I've commanded and stuff, who are now out of the army. And that's the question they usually hit me up the most about, is like, hey, ma', am, like I'm trying to get eight or nine hours, I know I need that. And like, why can't I just get eight or nine hours? And so I have to like explain to them this whole gradual process. And they're there now, but it took, you know, months, you know, six, seven months for them to get there.

[Host (possibly Dan Garner or another co-host)]

So usually is it fair to say 30 minutes per four weeks or 30 minutes per week? Like how 30 minutes per week.

[Dr. Alison Brager]

Yep.

[Host (possibly Dan Garner or another co-host)]

Is.

[Dr. Alison Brager]

Yeah, yeah, that's. Yeah. But even to that, that's going to have a ceiling effect where at most you're probably looking at extending sleep by two hours at most. The other form of sleep extension, and this is something that we've studied in the lab, again, like we do lab studies to mimic what possibly could happen in combat situations, is letting people sleep in for as long as they want past their normal bedtime. So usually we find that most people, if they have like a two week period to be on their own, you know, or essentially like say they're on vacation or the equivalent of being in a scientific study on vacation, um, they'll sleep for about anywhere from 45 minutes to an hour past their normal bedtime. Um, and then when you put those individuals through a period of full on sleep deprivation, so we're talking about 40 hours of wakefulness all the way up to 62 hours of wakefulness sustained. The rate of decline in their cognitive performance, even their physical performance, the rate of decline is less because they had that sleep on the front end to help offset the, the sleep pressure.

[Host (possibly Dan Garner or another co-host)]

How long do they have to bank that for? Is that a two week?

[Dr. Alison Brager]

It's a two, it's a, it's a ten day protocol we are using.

[Host (possibly Dan Garner or another co-host)]

Yeah. So sleep an extra hour or so for 10 days and then if you were then to go into a situation when you are literally awake for 40 or 50 or 60 straight hours, that sleep deprivation is gonna have consequences. But what you're saying is that sleep extension prior to means you won't drop as far.

[Dr. Alison Brager]

Exactly. Now if you're chronically, insufficiently slept before that point, you're definitely gonna drop. I can tell you that from when I was deployed. So we Did. The longest I was awake was, it was almost three days. But yeah, we were outside the wire with some people. Um, and I was awake for legitimately two days. So. But that's where I used the strategic caffeine dosing strategy for the most part. I mean, I still felt like I was completely drunk.

[Host (possibly Dan Garner or another co-host)]

Right.

[Dr. Alison Brager]

You know, the last 24 hours of being awake. But I used caffeine, gum and yeah, even tried dipping for the first time, which is disgusting. I hate that habit.

[Host (possibly Dan Garner or another co-host)]

I remember hearing old stories of people, pilots, I think this was in World War II, where they would take tobacco and put it like in their eyes.

[Dr. Alison Brager]

Oh, wow. But you know what I mean? I'm not gonna lie. I felt like slightly ill after I dipped for the first time and I felt I had like a little buzz. But then that sleep deprivation kicked in.

[Host (possibly Dan Garner or another co-host)]

Yeah, yeah, yeah. How does the military handle it in situations like that? Is just get through it, just do it.

[Dr. Alison Brager]

It is just get through it. You know, they are getting smarter about it. I think that that's great about, you know, the team of individuals I've worked with over the years is that knowledge has now been taken out to the field. And I mean, there's commanders out there who are now using all these, you know, evidence based, science based, DoD backed science principles to like be more effective in combat. So it is, it's been really cool.

[Host (possibly Dan Garner or another co-host)]

When it comes to sleep extension, do people typically have an easier time sleeping in or going to bed earlier?

[Dr. Alison Brager]

So that's actually where I think chronotype comes into play. Right. Is so for me, my sleep extension would be. Right, sleep in later for you, you might want to go to bed early.

[Host (possibly Dan Garner or another co-host)]

I would pick that a thousand times over a thousand every time. Sleeping in is a struggle to me now, albeit one of the things you just mentioned earlier is something we hear consistently, which is when people say, oh, I can't sleep in, it's usually because they think that that's going to happen tomorrow.

[Dr. Alison Brager]

Yeah, right.

[Host (possibly Dan Garner or another co-host)]

It's just like, oh, this thing happened, I'm on vacation. Then like I woke up early. Well, of course you did because you've been sleeping, you've been waking up at that time for 400 consecutive days.

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

That's going to take a few weeks for you to really consistently be able to sleep in.

[Dr. Alison Brager]

Right, right. Yeah.

[Host (possibly Dan Garner or another co-host)]

So sleep extension protocol is unlikely to be like, again, sleep in tomorrow.

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

When we worked with people and we're trying to truly extend their baseline sleep so say they're getting an average of six and a half hours. Yeah, we Want to get them to an average of seven. That is a, at least a two week thing that it takes to get to the discipline. Totally.

[Dr. Alison Brager]

Night after night. As soon as you get off that schedule, you gotta restart, you know, we

[Host (possibly Dan Garner or another co-host)]

have yet to find anybody who couldn't do it. If they zoom out on timeframe, it is usually. I tried it. Couldn't sleep in. I tried it again today.

[Dr. Andy Galpin]

Didn't work at all.

[Host (possibly Dan Garner or another co-host)]

I just can't sleep in.

[Dr. Alison Brager]

Like.

[Host (possibly Dan Garner or another co-host)]

No, no, your, your, your physiology takes some time, right?

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

To adjust.

[Dr. Alison Brager]

I mean, that's the thing, right. A lot of people want the quick fix, right. You know, just like it takes dedicated time to build muscle. You just, you have to trust the process.

[Host (possibly Dan Garner or another co-host)]

Right. Excellent. I got one more question for you, if you'd be so kind.

[Dr. Alison Brager]

Sure.

[Host (possibly Dan Garner or another co-host)]

Maurice Claret.

[Dr. Alison Brager]

Oh, okay.

[Host (possibly Dan Garner or another co-host)]

Tumbo Mancini. I could go on and on. What the hell is in the water, in the air? What is it about Youngstown? Like, you come from this place. You were. I mean, you're still active. You still do the CrossFit competitions. First pole vault.

[Dr. Alison Brager]

Female pole vaulter in the state of Ohio.

[Host (possibly Dan Garner or another co-host)]

In the state of Ohio, I'm assuming, then first to go compete collegiately. Knocked on the door of the Olympics. What is it in that city? You guys just produce super athletes for this random little city in Ohio? What's going on there?

[Dr. Alison Brager]

It's so funny you say that. Well. Cause you know, there's that 30 for 30 documentary young sound boys, right, With Jim Trestle. And I don't think I realized the community of athletics I grew up in until I went to college. Like, I thought I was an average athlete, right? But then. Okay, let's unpack my high school. Like, I went to a big football feeder school. Youngstown Boardman Bernie Kozar went to my high school. Right?

[Host (possibly Dan Garner or another co-host)]

Yep, yep.

[Dr. Alison Brager]

Quarterback in our strength and conditioning room in high school. And we didn't have like really phenomenal strength and conditioning and equipment. And in fact, I would say it was kind of like very bare bones equipment. But you go into that strength and conditioning room and you'll see like 50 people from my high school who played in the NFL. I mean, my graduating class alone, I graduated with 711 kids. I would say 40 of them went on to play Division 1 sports, male and female. Actually, that's an underestimate. Probably like 60 or 71 almost made it to the Olympics in swimming. We had a WNBA player. And then, oh, we had three kids in my graduating class who did actually play in the NFL and won super bowl rings yeah, it's outrageous. My brother's class had an NFL player. I mean my. So my great uncle was a Golden Gloves boxer. He actually, he reft a Mike Tyson fight years ago. My other great uncle, Loose Slaby, he's a linebacker for the Giants. But yeah, it's like one of those things you don't realize until you go to college. You're like, shit. I actually, I guess I am an elite athlete, but I always thought I was average because of growing up there. It's. It's insane how what you think could be your baseline. You go out into the world and you're like, wow. I guess I. You know, in this one capacity I am better than other people. And I had no idea.

[Host (possibly Dan Garner or another co-host)]

I'm. I'm demanding more answers here. My wife went to Long Beach Poly.

[Dr. Andy Galpin]

Right.

[Host (possibly Dan Garner or another co-host)]

Modern day there's these schools in different areas in Florida stuff. Oh yeah. They put out 40 or 50 division one athletes every year.

[Dr. Andy Galpin]

Great.

[Host (possibly Dan Garner or another co-host)]

Well, you're in LA. There's three million people in a 20 mile radius.

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

Youngstown, Ohio. Like, what in the world? How is it Kelly Pavlick. Like the list goes on and on.

[Dr. Alison Brager]

So my dad is a butcher and he used to sell meat to Kelly Pavlik. So that's my Kelly Pavlik got all his meat from my dad.

[Host (possibly Dan Garner or another co-host)]

There you go. I want genetic tracing. I want some answers out of that city.

[Dr. Alison Brager]

You know what? It's the grit mentality, right?

[Host (possibly Dan Garner or another co-host)]

No, it's not.

[Dr. Andy Galpin]

No, it's not. You are drugging kids.

[Host (possibly Dan Garner or another co-host)]

You're genetically crispr ing them. You're doing something I don't care what you say about. I grew up in the country. I grew up, my graduating class was like 70 kids, not 700. And we probably had, I don't know, three or four kids ever in my high school play college football.

[Dr. Alison Brager]

Oh yeah.

[Host (possibly Dan Garner or another co-host)]

I was like the second, probably the first or second person to ever do it. Or second or third. You got 50 NFL players every year at your school.

[Dr. Alison Brager]

Yeah.

[Host (possibly Dan Garner or another co-host)]

It's unbelievable.

[Dr. Alison Brager]

Well, in the area, right? You know, ridiculous, because that's just Youngstown boardmen where I went. There's you know, five other schools. Maurice Claret. Right. There's like Warren Harding, Colonel Mooney also produce phenomenal athletes. I mean, that's what I think you're taught early on growing up there. Probably still now. But back when I was in high school, we had the highest murder rate in the country. Like people never believe me, but when I was a sophomore in high school, we literally had the highest murder rate in the country. And My mother, she worked for welfare, so she was like in the center of that. On the east side of Youngstown.

[Host (possibly Dan Garner or another co-host)]

Yeah.

[Dr. Alison Brager]

In this plaza she worked in is like, that's where most of these murders happened. So I think you learned early on that, like, your ticket out of, I mean, because really to that area too. I mean, what is considered middle class in Youngstown is considered considered poverty everywhere else. So, like, I, you know, in all honesty, like, grew up like lower middle class. And so you learn that your ticket out of town is being good at sports. Like it? Yes. I love school, and so that helped. But at the end of the day, like, my goal in life was to be an astronaut or an athlete. Right. And I was able to at one point accomplish that and be an athlete. But that's all you think about growing up there is like, well, LeBron too, right? Just that, that whole, man, you know, sports is king there.

[Host (possibly Dan Garner or another co-host)]

I get it. Well, I, I, when next time when you tap in here from Mars or wherever else you come in, I, I want answers about Youngstown. I'm not letting you up this so.

[Dr. Alison Brager]

Well, just ask what's his name? Bruce Springsteen, since he has that song.

[Dr. Andy Galpin]

Of course he is.

[Host (possibly Dan Garner or another co-host)]

Yeah. Thank you so much for coming out here. I know it was a, A long trek and really appreciate everything. It's fascinating stuff and it's been a long time. We've known each other for many, many, many years.

[Dr. Alison Brager]

Oh, my gosh. Yeah. I mean, it's all through science. Right. And then we all went our separate ways in academia and then outside of academia and.

[Host (possibly Dan Garner or another co-host)]

And it's always nice to see another scientist who's a true meathead.

[Dr. Alison Brager]

Yeah, exactly. Oh, I, I embrace being a meathead. Right. Hence my book.

[Host (possibly Dan Garner or another co-host)]

Thank you so much.

[Dr. Alison Brager]

Of course.

[Dr. Andy Galpin]

I hope you enjoyed that conversation today

[Host (possibly Dan Garner or another co-host)]

with Dr. Allison Breger.

[Dr. Andy Galpin]

If you want to see more about

[Host (possibly Dan Garner or another co-host)]

Allison, read more of her work, grab

[Dr. Andy Galpin]

her book, or follow along with any of her resources.

[Host (possibly Dan Garner or another co-host)]

Please check out the show notes for direct links.

[Dr. Andy Galpin]

Thank you for joining for today's episode. My goal, as always, is to share exciting scientific insights that help you perform at your best. If the show resonates with you and you want to help ensure this information remains free and accessible to anyone in the world, there are a few ways that you can support. First, you can subscribe to the show on YouTube, Spotify and Apple. And on Apple and Spotify, you can leave us up to a five star review. Subscribing and leaving a review really does help us a lot. Also, please check out our sponsors. The show would not exist without them and their exceptional products and services. Finally, you can share today's episode with a friend who you think would enjoy it. If you have any content, questions or suggestions please put those in the comments section on YouTube. I really do try my best to read them all and to see what you have to say. I use my Instagram and X profiles also exclusively for scientific communication so those are great places to follow along for more learning. My handle is rndygalpin on both platforms. We also have an email newsletter that distills all of our episodes in the most actionable takeaways. We have newsletters on how to improve fitness in VO2 Max, how to build muscle and strength and much more. To subscribe to the newsletter just go to performpodcast.com and click newsletter. It's completely free and we do not share your email with anybody. Thank you for listening and never forget in the famous words of Bill Bowerman, if you have a body you are an athlete.