The Truth About Sleep: Myths, Tips, and Longevity Secrets with Dr. Rebecca Robbins

One of our biggest myths is that when our head hits the pillow, our brain just kind of checks out for the night. If

0:05

you're falling asleep right away, you're probably starved for sleep.

0:10

Do you have tips or tricks? I mean, I want to share mine that I think will solve everybody's sleep problems. Number

0:15

one, sleep is just the ultimate accelerator of good health. The quality and quantity

0:21

of our sleep is one of the strongest predictors of our longevity. You have talked a lot in the past about cognitive

0:28

health, Alzheimer's, mortality. Are there sleep biomarkers? The truth is sleep is not going to be perfect every

0:35

night. But the key is getting back on track towards those four components. Sleep is a product of two processes. The

0:43

first is called the homeostatic sleep drive. For the the risks of circadian desynchrony, the difficulties for our

0:49

bodies to really repair and get good sleep, shift work has been named a a probable carcinogen. Do you have a

0:56

position on sleep medications? The research that pits those two treatments head-to-head, pharmacological

1:02

intervention and behavior change, those two patients, sufferers of insomnia, and

1:07

we compare them over time, the behavioral treatment wins out.

1:18

Why should we sleep? Well, sleep is one of the most important parts of a typical 24-hour day. But unfortunately so many

1:24

of us whether we choose on our own valition to curtail sleep whether it's watching Netflix staying up for another

1:30

hour to do another report or something a professional obligation a personal obligation or out of necessity if you're

1:37

working multiple jobs your time to sleep is going to be crunched but sleep is one of the most vitally important parts of

1:43

our typical 24-hour day. Over the course of our sleep at night our blood pressure drops to its lowest point in the 24-hour

1:49

day is just one example. And that natural dipping of blood pressure is vitally important for us to wake up and

1:55

maintain a healthy blood pressure. Our emotional regulation gets out of sync. Our ability to maintain a healthy

2:01

appetite is thrown off when we're not getting enough sleep. But when we can reverse that, when we can put sleep at

2:08

the forefront and higher on our to-do list, higher on our priority list, so many positive things fall in line. Our

2:15

emotions, our relationships, our productivity. Um, so often I laugh. People say, you know, what's the best

2:21

productivity hack in the afternoon when I'm sleepy? I'm like, just take a nap. It's so interesting that we we push back

2:28

so hard against the idea of a good night's rest. But couple that with the fact that in at least the United States,

2:34

we really don't have proper education about sleep. We're really not informed about evidence-based principles when it

2:41

comes to sleep. For instance, I don't know if your mother ever told you this growing up. We love your mother, but uh my mom would always say, "If you're

2:47

struggling with to sleep at night, stay in bed. You'll get some sleep. Stay in bed." But wrong. If you're experiencing

2:55

insomnia, we want you out of bed. We want you to reset to go do something

3:00

relaxing and build up what we call sleep pressure and get back into bed when

3:05

you're ready and give it a shot again. It should take you about 15 minutes to fall asleep and much longer than that.

3:10

We want to break the cycle. We want to get you out and then trying again when you're ready. We do hear a lot about sleep now,

3:16

probably more than we ever have. How long have you been in sleep science? I

3:21

admittedly was interested in other areas of medicine. Earlier on in my career, exercise physiology, nutrition,

3:27

nutritional sciences, um or or other broadly really interested in health behaviors and how to promote health

3:33

behaviors in a western society where we are taught to treat diseases. Um so that

3:38

really was a big driver of my going to graduate school and I just became amazed by the research in sleep and I took a

3:45

class by um that was taught by Dr. James Moss. We tragically just lost him. He was um older and has had an amazing

3:51

career um but he was larger than life at Cornell where I went to undergrad and he was known as the sleep professor and he

3:57

ed the term power naps in the: 1980

4:03

nap in the afternoon to boost your productivity." And he was just an incredible guy. He taught psych 101 and promoted awareness about sleep in the

4:10

context of this course. Definitely when I was in my fellowship training and when I was in my residency training, we don't

4:16

talk about sleep. Mhm. So, oh, you're tired. Too bad you're going to work the night shift. Sorry for you. I was there. I did it for, you know, 5

4:23

years. Now it's your turn. Right. Yeah. There seems to have been a turning point in our understanding about sleep,

4:31

brain function, sleep metabolism that at least for the general population as well

4:38

as medical providers, there's been a turning point and I'm curious is if you've seen that

4:46

from before to now and if you see us still moving forward.

4:52

Sleep medicine is a really exciting field. It seems as though we're advancing our understanding of what

4:57

happens in the body and in the brain almost every week. There are fascinating exciting new discoveries and it it's a

5:04

really exciting field to be. It hasn't always been as hot admittedly as it is now. Um I think only recently have we

5:10

really collectively woken up to the importance of sleep. Um and sleep is also a relatively new field compared to

5:17

other areas of medicine. Some of our seinal discoveries were in the late '7s 40 45 years ago. We didn't know what

5:24

contributed to our circadian rhythms. We didn't know the importance of blue spectrum light as the strongest input to

5:29

our circadian rhythms. We thought it was behavioral patterns and that helped us align our sleep and wake cycles in a

5:35

typical 24-hour day. A lot of our discoveries have only recently taken place. And it seems as though we're

5:40

uncovering new and fascinating insights. Virtually every every week almost are

5:45

new exciting findings coming out about the connection between sleep and any number of areas of our waking lives.

5:52

curious as to how much we actually should sleep because there seems to be a wide range

6:00

and I also have heard that there is a genetic mutation that some people need

6:05

less sleep. Have you heard this? And they of course and it's so funny because it always seems to be someone who's not it's not you personally or you know

6:12

someone you know often it's this person who's a friend of a friend and they did you know that they can sleep for four or

6:18

five hours but our community the military community M. Oh yes. That the operators

6:24

they seem to function. I I know it's not great, but they it it's almost as if

6:30

there is a natural pattern, maybe 4 to 5 hours of sleep. There are so many aspects of active duty that makes sleep

6:36

difficult. You know, of course, you're sleeping in an uncertain environment with threats around you. And those are

6:42

two of the biggest culprits of sleep difficulties. When you're in an environment or you're kind of um you're

6:48

nervous, you're on edge. If you think about maybe before a big deadline for any of us, you get stressed and worried.

6:53

There are so many profound and very real barriers to sleep in the military

6:58

population. If you think about active duty and all the number of stressors that are so real and so profound, they

7:04

of course take an enormous toll on sleep. And then sometimes there are

7:09

patrols that you have to go on in the middle of the night. And so in many ways you might be on kind of a shift work like schedule which can dramatically

7:16

disrupt your circadian rhythm because sleep at the end of the day is all about feeling at peace about feeling you know

7:24

at peace with your surroundings safe and comfortable. And when those pieces aren't there it's very difficult to calm

7:31

your mind and be able to drift off into sleep. If you were to convince me that I

7:36

need to sleep what is the average American sleep? Adults need somewhere between seven and nine hours for optimal

7:43

health, alertness, well-being, and not, you know, well-being today, tomorrow, and into the future. The quality and

7:50

quantity of our sleep is one of the strongest predictors of our longevity. Not only how long we're going to live,

7:56

but the quality of those years. And that sweet spot for sleep for adults is

8:01

somewhere between 7 and 9 hours. And now, it's a range because you might have, it's in large part genetically

8:06

determined. If you've had two parents that are shorter sleepers, and I say shorter meaning about 7 hours, you might

8:12

be lucky and be fine on 7 hours of sleep. But there are many people who have a little bit of a longer sleep

8:19

need, physiological hardwired sleep need to meet that night in and night out. And

8:24

if that's 9 hours, and again, if you had two parents who are longer sleepers, you might be on that longer end of the

8:30

spectrum. Now, we recommend a range. And finding where you are in that range is vitally important. And if you're

8:36

listening, you might be far from that range. And so, think about where you are right now. If you're really getting five

8:42

or six hours of sleep, we don't want to move in sweeping changes towards a new sleep duration. Uh because

8:49

our sleep is all about routine. Sleep is a product of two processes. The first is

8:54

called the homeostatic sleep drive. Now, if you imagine having a backpack on and you wake up in the morning and each

9:00

additional hour, I put another brick in that backpack such that by the end of the day, you are dragging. That's the

9:06

idea of homeostatic sleep pressure. It's the feeling of sleepiness. But that's not all. And anyone who's traveled

9:13

internationally to a new time zone, you could have been traveling for 12, 14, 24 hours, be physically exhausted, but not

9:20

be able to sleep. And that's because the second opposing or synergistic process

9:25

is the circadian rhythm. Now, humans have evolved over hundreds of thousands of years of life on Earth to an

9:32

approximately 24-hour day. Other planets have different durations. Haven't been there. Yeah.

9:38

But on Earth, we have evolved to to operating around on a 24-hour cycle.

9:43

Now, it serves us from an evolutionary standpoint to match our surroundings, have periods of time where we are off,

9:51

our cells are repairing, our body is repairing and regenerating itself over the course of our sleep at night. And then when we're awake, our ancestors

9:59

were looking for food. We're defending the village from predators. So, and it

10:04

serves us to not simply kind of operate in a linear fashion. Our performance increasing with each additional hour

10:10

awake, but instead there's a real rhythm to our lives. And we refer to this as

10:15

our circadian rhythm because virtually every cell in the body operates in this circadian fashion. Circadian is Latin

10:22

for about a day, referring to processes that eb and flow around an approximate

10:28

24-hour day. Our sleep is one such circadian rhythm. And the hormones underlying our fundamental ability to be

10:35

awake or be asleep also oscillate around that 24-hour cycle. And the best thing

10:40

for that cycle is routine. So falling asleep at the same time, eating your meals at the same time, exercising

10:46

around the same time every day, and then having a time where you enter a cold, dark room ideally, and you fall asleep.

10:55

And the hormone melatonin plays a large role in that. And that hormone melatonin is secreted in the brain when we

11:02

approach our habitual bedtime. The sun sets in our environment and we slip into our bedroom and we fall asleep and we

11:08

wake up and the melatonin stops in the morning and then we're able to go about our day. But those two processes

11:15

interact and result in our fundamental ability to sleep. Wait, uh $3,000?

11:23

Three Wait, wait, is that number right? I have spent more money on skincare. My

11:28

pores should be taxdeductible and maybe even have their own trust fund. And thank goodness that I found One Skin

11:35

because One Skin doesn't just make empty promises. It's researchdriven, minimalistic, and tested for beauty,

11:42

skin health, and longevity. One Skin is the first topical skin care backed by

11:47

peptide science that targets skin aging at the molecular level. I slather this

11:54

on all day. They have a peptide that is designed to reduce the accumulation of

12:00

dead cells or zombie cells that drive inflammation, tissue breakdown as we age. Now, this isn't about cosmetic

12:07

quick fixes. It's about changing the biology of your skin, strengthening the barrier, improving firmness, hydration,

12:13

elasticity with clinically tested ingredients. So, if you are focused on

12:19

aging well from the inside out, it's time also to think about your skin. and

12:24

it should get the same level of care. Go to oneskin.co for 15% off. Use the code Dr. Lion. It

12:32

is amazing and it will not break the bank. We are very much either in

12:38

alignment or out of alignment with that circadian rhythm. Mhm. When we think about rhythm, in my mind,

12:45

it sounds very delicate. Is this circadian rhythm disruption delicate or

12:52

does it take a lot for us to be able to get off track from a rhythm standpoint then affecting

12:59

sleep? It really is a sensitive system and if we for instance one of the most common uh mistakes that a lot of people make is

13:06

sleeping in on the weekends and I think we um are kind of enamored with this as a society actually. Oh, the idea of

13:11

sleeping in or the British um you know, oh lion. I think this you know it's interesting almost every society has a

13:17

term for this and it's always cast in a very positive light. So what that does unfortunately from a circadian rhythm

13:22

standpoint is delaying your rising time by more than an hour will start to give your circadian system information that

13:29

you have hopped in an airplane and you've flown to a new time zone and that your so your body is then going to be

13:35

working actively against you the next night because it thinks that you're shifting to a later time zone. Your

13:42

regular bedtime is going to roll around and you're going to experience insomnia and you're going to stay awake and

13:47

you're going to watch that movie because you have this burst of energy. So many people in our society fall victim of this because they, you know, think

13:52

sleeping in is a good thing. You know, I'm going to do that. I'm going to catch up on lost sleep. And up until a point, if you maybe want to add 30 or 45

13:59

minutes to your your your wake up time, that's fine. But really much longer than that does put you in the kind of in the

14:06

risk area for what we refer to as social jet lag where we self-impose jet lag

14:12

like symptoms because we've in essence given our body our physiological cues

14:17

that we're trying to adjust and we're kind of experiencing then jet lag symptoms often for social reasons cuz we

14:24

often are staying up late to go out to a movie to you know spend time with our loved ones which are all wonderful

14:30

things but then resultingly we'll wake up later in the next day and then maybe suffer from some insomnia symptoms the

14:36

next night. What about this idea that I'll take u my

14:42

husband as an example? He's a thirdyear urology resident. Wasn't on call last

14:47

night but he finished at 1:00. All the surgeries got pushed later in the day. He was exhausted but he still had to get

14:54

up at 5:30 this morning. He'll go, he'll do that now for the next 5 days.

15:01

Mhm. At some point, as we just think about our lives, is there a way to repay that

15:07

sleep debt? And if so, how does someone do that? Medical residents are some of the most sleepd deprived in our society, but they

15:14

are being trained to go out into the medical field and save our lives. You

15:19

know, in the case of your husband or surgeons or, you know, do life-saving treatments. Um, but so often our medical

15:25

professionals are trained in these environments that are fraught with sleep deprivation. And if you're a general

15:30

health health care provider and you've come of age in the system, you know, you're probably struggling with sleep

15:36

yourself if you were on a series of of rotating night shifts. And that is a

15:41

huge risk factor for insomnia. In many cases, we find patients who are struggling with sleep difficulties. is

15:46

they go speak to their doctor and their doctors are prescribing sleep medications because they might be on them themselves or they're struggling

15:52

and there is a time and place for sleep medication but the front line for sleep difficulties is according to the

15:58

American Academy of Sleep Medicine behavior change. So for example he wants to sleep he wants to sleep in after that after

16:04

having four or five hours of sleep a night would he then be able to recoup

16:10

that? Well your husband is doing something that is really challenging. It sounds like it's rotating shift work, which is

16:16

the case for many medical residents, and it's part of the fabric of our medical education, but but my team has published

16:22

research in the New England Medical Journal to show that those types of schedules and sleep disruptions for medical residents are a significant

16:29

predictor of medical errors. And so, we really have to ask ourselves, you know, how can we set our young people up, our,

16:35

you know, the people who are getting their training, especially in the medical field to for success, not only

16:40

for their health and their well-being, but the health of their patients also. And so what he's doing right now is

16:46

rotating shift work which is the most difficult type of shift work because your circadian rhythm can't align itself

16:53

uh with any pattern of normaly in a typical week. So in the case of your husband it is going to be making up for

16:59

lost sleep whenever and wherever he can. And so happy to hear that. Yes, please fully endorse this. Um

17:05

sleeping in and also making up for loss sleep with naps. They're uh shorter nap if he's you know he got a little bit of

17:11

sleep the night before. he's not, you know, too much in the dangerous zone of, you know, really falling asleep, being just absolutely exhausted. And if he has

17:17

time for a longer nap, then a 90-minute nap is wonderful in the afternoon, say on a weekend if he's off to to make up

17:24

for lost sleep. It's interesting in the way that on one hand, you want a consistent sleepwake

17:30

cycle is what I'm hearing you say. And that is almost separate if you

17:36

cannot have that. If you are someone who does not have a consistent sleepwake

17:42

cycle, you want to sleep. That would be an indication to sleep in or an indication

17:47

to sleep when you can. Totally. And we work with a lot of shift worker

17:52

populations, whether it's truck drivers or medical professionals.

17:57

And in those situations, the best recommendation is to try to find to look at periods where you're maybe on a

18:03

rotating shift schedule is a shorter term situation and moving into at least patterns of shifts that are predictable.

18:10

That is the best case scenario because our society is really powered by individuals on shift schedules outside

18:16

the traditional 9 to5. It's how we have 24/7 access to food or customer service

18:22

hotlines or medical help and attention. And so we owe our shift workers a debt of gratitude in our society. Um but

18:29

their sleep really suffers. And unfortunately we have determined that for the the risks of circadian

18:34

desynchrony, the difficulties for our bodies to really repair and get good sleep, shift work has been named a

18:41

probable carcinogen. So really moving off these schedules as as quickly as possible and into a schedule at least of

18:47

consistent shifts or ideally shifts that that emulate the pattern of light and darkness around us where possible. I

18:54

would love to hear what happens to the brain when we sleep. One of our biggest myths is that when

18:59

our head hits the pillow, our brain just kind of checks out for the night and our body and we're in this monolithic state

19:05

of sleep. Wrong. There's so much rich and diverse activity in the body and the

19:10

brain and it changes over the course of our sleep at night. Sleep is characterized by patterns of

19:16

electrofphysiological activity and each of those are nuanced across sleep stages. We distinguish um over the

19:22

course of a typical episode of sleep at night between rapid eye movement sleep and nonrapid eye movement sleep. Rapid

19:29

eye movement sleep is where as the name suggests our eyes are darting back and forth back and forth and there's a

19:36

tremendous amount of activity in the brain as much if not more so than when we're awake. It's fascinating and we

19:42

call it really and we call it paradoxical sleep because there's so much activity happening in the brain and

19:48

very little activity happening in the body. You're essentially immobile during rapid eye movement sleep. Other health

19:54

behaviors, you have to get on a treadmill. You have to buy healthy food. But sleep can be free and start tonight.

20:00

There are sleep disorders. There are more than 80 differentially diagnosible sleep disorders that are limiting many

20:05

millions of Americans from getting good quality sleep. But once we can remove barriers, occupational barriers,

20:12

personal barriers, cultivate healthy sleep habits, we're able to make significant gains, not only in sleep,

20:18

but in daytime success, which is what we're all about. If I we were to welcome you into our laboratory in Boston, we

20:24

would hook you up with electrodes. And the gold standard of sleep measurement is what we call polyomnography. So we

20:30

would be able to measure your brain waves, your respiratory effort, and a number of other things, bodily movements, etc. And what we would see as

20:36

your brain starts to slowly enter some of the lighter stages of sleep. You're drifting off into sleep is the pens of

20:42

the electrodes start to slow and the amplitude of your brain wave starts to increase. The amplitudes being the space

20:49

between a peak and a trough of a brain wave start to lengthen indicating that you're starting to slow down the brain

20:55

activity. And then the frequency slows and then in stage one sleep is kind of a weigh station between the awake and the

21:02

asleep state. And then as you slowly drift into stage two sleep and then stage three is the deepest sleep of the

21:08

night. I think it's what we think of stereotypically when we think of sleep very long spaces between the peak and

21:15

trough of a brain wave. So very slow very high amplitude brain waves

21:22

really looking and sounding like you're asleep. Now during stage three deep sleep is where we get a lot of the

21:28

benefits from the standpoint of muscular regeneration. Then something fascinating happens. After about 20 minutes in a

21:34

healthy sleeper, I will start to see signs of rapid eye movement sleep. As the name suggests, your eyes are darting

21:40

back and forth under your eyelids. And that movement in your eyes is indicating a rich amount of activity in your brain.

21:47

Your brain during rapid eye movement sleep is as active, if not more so, than the waking brain, which is fascinating.

21:54

And then we cycle in and out of those different stages several times over the course of the the night with two kind of

21:59

highle differences in the first half of the night in a healthy sleeper will see that period of time rich in deep sleep

22:06

and then the second half of the night we see rich in rapid eye movement sleep. So when people come to us and say h you

22:13

know I'm getting three or four hours of sleep at night or five and I you know I feel okay but you know I think I'm I'm

22:18

doing all right and you might feel okay but you're virtually robbing yourself of

22:23

your potential because rapid eye movement sleep is where we get so many benefits cognitively from our sleep

22:29

memory consolidation etc. And that period is predominating right before we

22:35

wake up. If we're getting 7 to 9 hours, they REM sleep is the consolidation of memory. These software updates, however

22:43

you want to call it, software, hardware updates of the brain, do they happen in other stages? Is it as bifurcated as it

22:50

sounds? Well, if you think about it, that's kind of a difficult study to do to really isolate each unique stage. Um, but we do

22:56

see the more rapid eye movement sleep you get, the more likely you are to achieve insights. So if I teach you

23:02

something before you fall asleep and then quiz you on it the next day, the more rapid eye movement sleep you get,

23:07

the stronger those connections and the better your performance the next day on cognitive tests. The gold standard of

23:13

measurement of sleep is polyomnography. But I do think that there's an important qualitative piece to sleep that

23:18

sometimes we forget. And now the development of sleep trackers gives us such an amazing insight into the

23:24

quantitative component of our sleep. How long did you sleep? How long did it take you to fall asleep? Did you wake up? Did

23:30

you spend much time in deep sleep or rapid eye movement sleep? This is amazing information that a typical

23:36

consumer didn't have access to, you know, five, you know, 10 years ago. Um, but I think that the quantitative piece

23:42

is ideally coupled with a qualitative evaluation of our sleep. Quite simply asking yourself, how do I feel in the

23:49

morning? Tired. I feel restored. And then if that's the

23:55

answer, you know, truly, you know, we need to add a little bit more time. And I hope that you know you call me after

24:01

and you're like, "Rebecca, we did it. I got more sleep. I feel great." How much sleep do children need?

24:08

So, our sleep duration need does eb and flow across the lifespan. Very little babies need virtually to be sleeping

24:14

almost all day long as you remember. And then as children age, they need a little bit less. And up until the kind of

24:20

school age um period or time of a of a child's life, they need somewhere between 6 and 12 hours of sleep. But

24:27

there are a lot of individual differences. Some kids will do well on that lower end of the spectrum and other

24:33

kids will do well on the higher end. And this is where I love to think about N of one experiments. What works for you for

24:39

your kid after a night of 8 hours of sleep? Do you find that they are brighteyed and bushy tailed as the

24:45

saying goes when they wake up? Or do you find that they're dragging and maybe in the car in the afternoon? Do they fall

24:50

asleep? Those would be signs that they're just not getting quite enough. and then maybe start that next night and

24:55

try to start the bedtime process a little bit earlier and the bedtime routine a little bit earlier. Do you

25:02

think there is a time that is universally good for kids? And what do I

25:07

mean by this? Meaning we talked a little bit about this circadian rhythm which is this 24hour cycle here in Texas. The sun goes

25:16

down let's say six o'clock. Let's say the sun goes down in Boston or New York.

25:23

I'm just making this up. At 8:00, does the location dictate the time we should

25:28

begin to think about putting our children to sleep? Because listen, mine didn't come with a manual.

25:34

It would be so much easier, wouldn't it? So much easier. But perhaps if at 6 p.m.

25:40

when the sun is going down, even though it's not convenient, maybe that's the time that we begin to wind them down. Do

25:47

you know what I'm saying in terms of like what if we're kind of doing it wrong? It's not our children. They can't

25:53

regulate. They don't. My kid, she'll want to stay up and read princess books and literally one f like one eye

26:01

is falling asleep, you know. Well, I love that. I love it. Sounds like a great bedtime routine, but young

26:07

kids are very susceptible to light is one thing to keep in mind. So, make sure and this does not have to be expensive

26:12

for everyone listening. You can get great blackout shades at Target for very little, but do make sure your children

26:19

have sleep proofed environment. And an environment, you just showed me your daughter's bedroom. It's so amazing and

26:25

so cozy and so fabulous. Um, you want children just like all of us to walk in and feel soothed, have elements that

26:31

comfort them, their favorite stuffy, their favorite lovey, and the book that helps them also feel, you know, at peace

26:37

and safe. And that's going to change as they grow, of course. But I think this is where kind of back to the end of one

26:42

experiments, thinking about workshopping your kids sleep until you find the sweet spot and whether that's a 6 p.m. fall

26:49

asleep time or if that's a 9:00 p.m. fall asleep time. And one of the the key things is your children are young, but

26:56

what might be happening is all of us have in large part genetically predetermined preferences for

27:02

chronotypes. Now, this is a term that refers to each of our personal preference for being alert or asleep

27:09

within a 24-hour day. What is yours? I am a very severe morning type. How

27:14

about you? Same. Same, right? I was like, this morning at 5 a.m.

27:20

I I was at the gym um by 7. I love it. So, that is a kind of part of

27:26

this equation also. And your children, those types might be presenting themselves. What are the other types? there is a

27:32

morning person. We generally model it on a spectrum from what we call morningness to eveningness.

27:38

And the biggest question, the best question for figuring out where you are within that spectrum is when do you do

27:43

your best work? And if you would probably tell me first thing in the morning, right? Would you

27:49

say or how would you answer that question? That in a month I can tell you that because I don't sleep well. I have the

27:55

two little kids, you know, whether my husband is on call or not. But I'm hoping finish this episode and I'm going

28:02

to implement same sleep wake cycle blackout shades. I'm not exactly sure what I'm going to

28:08

do with my kids, but then I'm going to call you and tell you I can't wait and let's text along the way until you get there. Because all of

28:14

this is really all about workshopping and finding the sweet spot for you, for your kids, for your your partner and

28:21

factoring in also your professional obligations, your personal obligations, and maybe also unwinding, you know,

28:27

yourself as a mom because we do stuff for everyone around us, you know, all day long as moms. The fascinating thing

28:32

that you said is there is a genetic predetermination for amount and

28:39

chronotype. How much movement can we make when people have disregulated sleep from a

28:45

nutritional science standpoint? Again, we see people all the time in in our clinic that have abnormal lipids,

28:51

abnormal blood pressure, glucose partially because they're either doing shift work or

28:57

It's so interesting how this appears in blood work, right? Oh, what's that? Oh, that's uh my heart.

29:05

How many of you miss that overcaffeinated feeling of your heart pounding out of your chest? Or you maybe

29:11

you're on another caffeine detox. Maybe you miss feeling really tired. I'm so grateful to Mudwater, one of the

29:17

sponsors of the show. And I have two little kids. Therefore, I don't have a

29:22

perfectly structured morning routine. Sometimes I need something that supports focus, clarity, and energy without

29:28

wrecking my nervous system. That's where Mudwater comes in. It's not coffee. It is something different. And it makes me

29:36

feel great throughout the day. I use it in the afternoon so I get good sleep.

29:41

Mud water is made from functional mushrooms. Nope, not that kind. Adaptogenic and organic ingredients like

29:47

cacao and turmeric. No sugar, no artificial junk, just clean, focused energy. It gives me that mental lift

29:54

without the crash. I love that it supports my mood, immunity, and focus. But what I really appreciate it is that

30:02

I'm not Is that my pulse at 200? Almost everyone has experienced too much

30:07

caffeine. Go to mudwater.com if only you are interested in cutting

30:14

back your caffeine and want something that works and use the code drl to get

30:19

up to, you guessed it, 43% off your starter kit. mudwater.com code drlion.

30:26

You'll feel the difference. When do we consider jet lag? Is it a 2hour

30:32

time difference, 3 hours? Would there be a time that we say, "Okay, this is jet lag." When you're traveling, one of the

30:38

big questions is how long is the trip going to be? If you're going to London for a 24-hour trip and coming back, I

30:43

don't know that you have to adjust. I'd say just rip off the band-aid, do your best. Um, but if it's a longer period of time and you want to really align, then

30:49

the best thing to do is in the week before you travel, and it's really more than three, maybe three time zones away.

30:56

But look, New York to to California can be difficult. And if you have a big important meeting, I'd say I'd say

31:02

consider these protocols. And the way you do that is in the week leading up to your trip, you think about where you're traveling and you start to move your

31:08

fall asleep and wake up times in the direction of that new time zone. Just 15 minutes. So if you're going to London,

31:14

push your bedtime, you know, just 15 minutes later, the first night in the week before and then another 15 and then

31:20

another 15. So that'll get you just over an hour to California. You are flying back. You're going to go

31:27

there. You're going to be there for a week. Would you move up bedtime

31:32

from 8 to 8:15 or you move it the opposite 7:45?

31:38

Well, when you're moving to the, you know, backward to California, New York to California, you're going to try to

31:44

push your schedules to be a little bit later. So, I'd wear sunglasses in the morning if you live in New York City and

31:50

you're going for a big work trip to California. In the week beforehand, you're trying to move small increments,

31:56

15 minutes in the direction of your new time zone. And that's sleep times and

32:01

wake times, but it's also meals. So maybe try to push your dinner to be a little bit later. If you're taking a red

32:07

eye, for instance, from New York to London, they're going to be serving you food. I try to avoid them, but there are

32:13

situations where it's possible red eye, I think of you. I'm just like, oh, I know this isn't good. If you have

32:21

the luxury or the ability to to choose, flying during the day is ideal and then getting to your new destination. And

32:27

when you're there, do you know again live, eat, and sleep on your new destination time zone and realize that

32:33

sleep is not going to be perfect. I don't have a cure for jet lag. I wouldn't be a professor if I had a cure for jet lag. Uh but so you might

32:40

experience some sleep difficulties. So when you're on your new destination, you land and maybe you experience some

32:46

insomnia. You wake up at 2 3:00 in the morning. The protocol is the same. if we experience that in the US in our home

32:52

time zone. Take it in stride. Try not to beat yourself up. It's so easy to look at the alarm clock and just be like,

32:57

"No, I'm up." Um, but try to have I think selft talk is actually really important here. You know, no big deal.

33:03

I'm up, but it's okay. Of course, I'm up. It makes sense. Do something that will hopefully make you sleepy. Reading

33:10

a book, gentle po uh yoga poses. The best use case for melatonin is travel and

33:15

combating jet lag. So, uh, we do recommend melatonin for that specific use case. And taking it as you prepare

33:23

for your trip could be a good idea to facilitate the transition of melatonin in the direction of your new time zone

33:28

and when you land at your new destination. Do keep a couple things in mind as it comes to melatonin. Number

33:34

one, if you can find it, pharmaceutical grade melatonin is critical. There have been research studies that decompose

33:40

melatonin tablets that you can find that are not regulated in the neutrautical category in drugstores. And they found

33:46

that what's stated on the le the label varies up to 300% than what's actually in the supplement. So keep in mind that

33:53

purity varies widely. So pharmaceutical grade will allow you to be confident that what you're getting is pure and it

33:59

is not more the better. So look for something that's 500 micro

34:09

calling you out. So 500 micrograms or 1 to 2 millig but

34:14

not much more. And lastly, taken before bedtime in advance. It's not right before bedtime, but it's kind of when

34:21

sun is setting in your new environment is when you should be taking melatonin a couple hours before you want to be falling asleep. I didn't realize it was

34:28

a few hours before. What you're saying is you don't take melatonin right before you, okay, I'm going to pop my melatonin

34:35

and go to sleep. You want to plan in advance and facilitate that internal secretion

34:40

of melatonin and adjustment to your new time zone. I am only aware of one thing that suppresses melatonin and that would

34:47

be light. Is there something else? Does cortisol suppress melatonin? Are there other do we know? The two things that

34:53

have the biggest impact on our circadian rhythm are number one blue light, blue daylight spectrum light and that is the

35:01

strongest what we call lifegiver giver or zitgabber to our circadian system. So light comes in through the eyeballs and

35:07

it travels along the optic cayazm to a tiny region of the brain called the super kaismatic nucleus and that's the

35:13

circadian rhythm home in the brain and then that kind of fires the secretion of

35:18

melatonin. If the eyes detect absence of blue daylight spectrum light. But if

35:23

bedtime approaches and you open up a computer screen that has full brightness, you're going to be giving

35:29

yourself a physiological cue to become alert and awake because the eyeballs will receive blue daylight spectrum

35:36

light from that screen and think it's time to become alert and awake. And so we're virtually shooting ourselves in

35:42

the foot when we use blue light emmitting devices before bedtime. There's a free software called Flux F.

35:48

UX um and it's free, widely available. I I'm not affiliated with them, but I personally use the technology. You do

35:55

amazing. And what that will do is it will take away the blue from a computer screen. So, if you must be working

36:01

before bedtime, do consider Flux. And what's nice is you can set it up so that it just goes on automatically. And as

36:07

the sun sets in your time on your laptop or your tablet, then the screen will become warmer. So, blue daylight

36:14

spectrum light is the strongest input to our circadian system. and exposure to blue light at inappropriate times will

36:20

disrupt the flow of melatonin. The second is meal timing. A meal consumed

36:26

too late will disrupt the circadian system and could make it difficult to fall asleep that night and experience

36:32

consolidated restorative sleep. That would make a lot of sense. And we do see a lot of disregulated eating in

36:39

general. Mhm. Um I think not only do we have a ton of extra light exposure?

36:45

I don't know. Is fluorescent also blue? I mean there's light pollution everywhere. Everywhere. Mhm. And it takes a lot of

36:52

effort and there I think there's also a lot of confusion because there are a lot of devices that say there are circadian lights or they're you know sleepromoting

36:59

lights um which you know also are quite bright and then maybe someone's using that before bedtime. So, the best thing

37:05

for your bedroom is to go to a a department store or a drugstore and uh buy a sleep friendly light bulb and put

37:12

that into your your red light almost a red on your nightstand. Yes, it's a red spectrum. Red um colors are measured in

37:20

temperature. So, it's a warm light. It's reds. It's maybe oranges. Those are kind of sleep inducing colors. And use that

37:27

in your bedroom if you're reading before bedtime. And then if when you wake up in the morning, do you need one of these

37:33

circadian lights? I don't know. But I think that, you know, generally is if you have one and love it, amazing. Um,

37:38

but getting outside into the natural blue daylight spectrum light kind of as soon as as possible is great for helping

37:44

our helping align our internal circadian rhythms. I do that with the kids uh every day. I

37:51

don't know if you think about Do you do that too with your kids? I love that. Right. As much as I can. Okay. All right guys, let's go out.

37:57

Also, just having them out of the house is sometimes the best. Bye. agree with you there.

38:03

Do we know the impact of exercise and the types of exercise on sleep quality?

38:09

This is a great question. For so long in sleep, we would discourage exercise at night. Now, I think the the research is

38:15

still emerging, but what we've found is that generally if you're getting exercise, that's the most important

38:21

predictor of good sleep quality. We we really care less when you get it. There have been a couple studies, one in

38:27

vigorous activity, for instance, doing a very vigorous um, you know, high-intensity workout before bedtime is

38:34

ill advised. Um, that does, you know, have some negative impact on sleep. But by and large, just making time for

38:40

exercise, I'm really not worried about when you do it as long as you get it in. And this question is related to our

38:45

circadian rhythm preference, our chronoype. Because if you're a true morning person, one of the other

38:50

questions I like to ask that's a great predictor of where you are on the spectrum from morningness to eveningness

38:56

is when you do your best work and when you want to work out. A true morning person will say h you know the morning

39:02

or an evening person will say I love to get a workout in after work. I don't think I've ever I handful of

39:08

times. Have you ever worked out after work? Oh my god. I It's very hard. I need a lot of motivation. I already know it's not going to happen.

39:13

I'm exhausted. Mhm. I'd rather get up at 4 to train than I would rather train at

39:19

5:00 p.m. I also think, you know, our poor evening people in our society, I feel like I I want to advocate for even true evening

39:24

types because there's so many things in society that privilege a morning person. Even, you know, our figures of speech,

39:30

the early bird gets the worm. Um, and there's so many people, the true evening types, the idea of a 900 a.m. wake up is

39:39

very stressful. And then think about a commute to get to a nine-to-five office job. For a young professional who's a

39:46

true evening type, it's really hard. I I dream of a workplace where the quality of our work will be the biggest

39:52

predictor of schedules. You know, if you're doing enough, I don't really care where you are or, you know, when you're

39:58

doing it as long as you're able to get the sleep that you need. And that's the be the biggest most important question

40:04

employers should be asking. How can we set our employees up for success? I think there's such a focus on you know

40:09

being at the office but you know the hours aren't ideal for many many millions of Americans.

40:15

Do you think that the environment matters in the way that if we are exposed all the time to blue

40:22

light under fluorescent light do we wear we use flux in the evening? Do we wear red light glasses, blue light

40:30

blocking glasses? Should we be spending four hours or more of our time outside

40:36

to to combat this light? This is a great question. I think sometimes we can get too in our head

40:42

about things. And I think the bottom line is more fresh air the better and natural fresh air. What comes with that

40:49

often during the daytime at least is exposure to blue daylight spectrum light. Getting more fresh air, more

40:55

sunlight exposure over the course of the day, the better. So think about ways to build that into your daily routine so

41:01

you can kind of it behavioral economics can you know fall into place and you can just reap the benefits if that means you

41:07

know if you're like look I work in an office building I don't have a lot of opportunity to get outside one simple

41:13

way to get a little bit more fresh air is to if you live in a city walk one extra subway stop or park your car far

41:20

away from the entrance and walk for 5 minutes take a call that you can off video and go outside so I'm really the

41:26

more the better and in the morning is terri But sunlight exposure in the afternoon is also great. So many people

41:31

are reaching for a coffee or, you know, a sugary sweetened beverage in the afternoon. And I get it. We all

41:37

experience a little bit of dip in alertness. But if we combed that with either a power nap if you're really

41:43

tired or um simply going outside and walking around the block and getting exposure to sunlight can have the

41:49

energizing benefits of caffeine without the jitters or the adverse implications

41:55

for your sleep that night. Hydration isn't just about drinking Coke

42:00

Zero or other sugar-free sweetened beverages like Red Bull. No, I'm saying this for a friend. Or it's not even

42:05

about drinking more water. It's about keeping the right balance of electrolytes and fluids. During life's

42:11

most demanding season, like, I don't know, parenting, maybe pregnancy or postpartum. Your body is going through

42:18

massive changes. Blood volume increases, hormones shift, breastfeeding demands, you know, all those things. All of these

42:24

life transitions, you probably need more and better hydration, and you need electrolytes like sodium, magnesium, and

42:31

potassium. Element is formulated to replenish what you actually lose without

42:37

sugar, fillers, and junk that you don't need. It's a clean, effective way to stay hydrated. And for men, again, it's

42:44

not just about hydration. It's also about performance, recovery, mental clarity, and yes, even energy. Whether

42:51

you're hitting the gym, chasing kids, or grinding through your workday, maybe even your teeth, dehydration can quietly

42:58

sabotage your focus and endurance, Element helps you stay sharp, strong, and ready. We use Element because it

43:04

works, tastes amazing, and it's no nonsense, just sciencebacked hydration that actually makes a difference. And

43:10

right now, Element is offering a free sample pack with any purchase. That's eight flavors to try on the house. Go to

43:18

drinklmnt.com/dlion to claim yours. That's

43:23

drinklmnt.com/dion. Stay hydrated, stay strong, and as

43:31

Gogggins would say, stay hard. The power nap is interesting. Does it have to be 20 minutes? If you're tired enough,

43:38

could you fall asleep for 10? Mhm. What's so interesting about naps is maybe even less is is is beneficial and

43:44

in a little bit of a different way. Uh research from MIT just revealed that brief naps, I'm talking seconds, moments

43:52

of sleep over the course of the day allow you a tiny bit of what we call hypnogogia sleep. It's that weigh

43:57

station from sleep to wakefulness or the other way. It's that weigh station between wakefulness and sleep. And we're

44:05

finding the research is showing that moments, seconds in hypnogoga sleep is associated with bursts in creativity in

44:13

the ability to come up with solutions to complex problems. And what I love about that research is it really lowers the

44:20

stakes. So many people say, "H, I can't nap. I see the research. I wish I could, but I can't." And what that says is

44:27

don't worry. If you can get a couple minutes, you are in great shape to, you know, crush the rest of your day. And it

44:34

doesn't matter. It doesn't matter when you do it. The ideal time for a nap is in the dip in our circadian rhythm in the

44:40

afternoon, which we all experience. Whether you're a true evening person or a true morning person, we all simply

44:46

experience a dip in our alertness in the afternoon. Why? Because we've been up for, you know, so many hours so far in

44:53

the day. We've consumed a lot of information. There's a small drop in our core body temperature in the afternoon.

44:58

So, it's kind of the perfect storm for a nap. And that's also a really good litmus test for whether you're getting

45:04

enough sleep. How do you feel in the afternoon? Are you exhausted? Are you like, "Listen, I need something to get

45:11

me through." That's a really good barometer for whether you're getting enough sleep at night. 20 minutes is considered a power nap.

45:18

So moments are have been shown to be beneficial. And then what we call a power nap is gen.

45:25

All right, guys. Just give me a second. And my husband would do it. He he could fall asleep right here for 2 minutes. I

45:31

love it. I love it. But he he needs a lot more sleep. He will get it once he's done with his residency.

45:36

Yes. And he's doing such an amazing job. And remember, these periods of life are fortunately fortunately shortlived for

45:43

many of us. The reality is most of us are not getting enough sleep. And I don't want anyone to feel bad as they're listening

45:49

to this going, "Gh, I wish I get more sleep." Is there a way to recover? And I

45:55

don't just mean in the short term, the brain function, the executive

46:01

function, um, you know, from years of lack of sleep of doing all of the things, I

46:06

don't know, from being in high school. All of the research is showing that sleep, the quantity and quality of our

46:11

sleep at night is a significant predictor of our health, our well-being today, tomorrow, and well into the

46:18

future. But importantly, sleep is not going to be perfect every night. And that's because sleep is part of the

46:24

fabric of the human condition. And stress is all around us, I think, now more than ever. And if you've been

46:30

experiencing stress, you're you could have done everything else right, but you go into your bedroom and you slip into

46:37

in between the sheets and you toss and turn. And it could be because of something a co-orker said, um, or maybe

46:43

stress that you weren't managing over the course of the day or some a negative experience as you approach bedtime, you know, a scary Netflix show. The list

46:49

goes on. But all of those don't watch those. Sometimes there are things that are out of our control.

46:54

Do you have tips or tricks? I mean, I want to share mine because I I have a handful that I think will solve

47:01

everybody's sleep problems. It doesn't include alcohol. Number one, sheets. I know that sounds ridiculous,

47:08

but the sheets have to be cool and they have to be really silky. Mhm. Again, maybe it's a personal preference.

47:15

It just makes if you are physically so comfortable, that's incredible. I couldn't agree more. And you want your

47:21

bedroom to be the place that you look forward to. I can tell that you love your sheets. And what a beautiful hack.

47:26

Like that's one thing that's easy to change. Sometimes it's hard for all of us to go out and get a new mattress. But

47:32

by the way, we should be sleeping on a mattress for maybe seven, maybe eight, maybe 9 years, but not much longer than

47:38

that. Uh, but we did some research recently and we found that one in three Americans have had their mattress for

47:44

far too long. But a mattress is expensive. And I think some of the other elements of your bedroom environment, your pillows, your sheets, you can

47:52

upgrade. And they're they don't have to be expensive, but I do encourage go to whatever store, find sheets that you

47:58

love just like you love yours. And you want to look at your bed and want so badly to get it and look forward to

48:04

sleep. Does it matter the kind of mattress? Does it matter if it's firm or not firm? Is there any data that would

48:11

support people sleep better with X or at a 5% incline on a pillow?

48:20

We are actually doing some of these studies right now to look at the best sleep surfaces and the components of an

48:26

ideal mattress, springs, you know, what is the topper? Those types of questions. So stay tuned. But bottom line, there is

48:32

a lot of individual preference. However, if you're talking about a really plush surface versus a, you know, a really firm surface, there is a lot of

48:39

individual difference and some people, you know, really look forward to a plush, you know, would love a plush

48:45

experience, meaning something very soft. Um, others much prefer a firm surface. And I do think that your your sleep

48:51

position matters. So, if you're a side sleeper, imagine your body on its side

48:56

on the mattress. Are you a side sleeper? I am a stomach sleeper. Are you amazing? You're part of the the

49:03

minority. There aren't a lot of stomach sleepers. I don't even know how that is possible. No, I think it's cool. I think it's fascinating that we all have these

49:08

preferences that we just move into. I'm a side sleeper and specifically I kind of curl into the fetal position

49:16

covered by pillows. My husband gives me such a hard time for it. He sleeps with one and I have like 16 on my side. Wait, what about the kids? So then what

49:23

position is this? That is It's so funny. There's actually scientific research on this. Um, one of

49:28

my favorite studies looked at different sleeper positions and had all these cute names for all the different types. And that is called the starfish pose.

49:34

My kids are 100% starfish pose. Is Shane also? No. No. My husband doesn't move. He is a

49:41

back sleeper. Okay. Interest. And you both You have two starfish. That's so interesting. And this research was it was interesting.

49:46

They um did they delivered the big five personality assessment and then asked questions about your sleeper position.

49:52

They found that extroverts were associate the starfish pose was um you're more likely to be an extrovert if

49:58

you slept as a starfish. So there you go. You have two extroverts maybe on your hands. And then what about the rest?

50:03

Yeah, I have to go back to the paper for all the other I think you're more introverted if you're if you sleep like I do actually, which is which is true. I

50:09

think I'm an extroverted introvert, I'd say. But um the fetal position, you're a little bit more introverted. No, I'm face down. Nobody touch me. I'm

50:18

just in my silky sheets with an eye mask. So I wear an eye mask and

50:24

earplugs. I love that. Only wax earplugs when Shane is home. I love that so much because that is your

50:29

routine. And what you've actually done is you've classically conditioned yourself to put in your earplugs, put on

50:36

your eye mask, slip into your sheets, assume your position, and go to sleep. And these little things make such a

50:43

difference. And what I also love about that routine is you can take it with you on the road. I do. It's already packed.

50:49

There we go. It stays packed. It's beautiful. And then you can have some protection cuz you never can guarantee a quiet bedroom when you're

50:56

traveling. the light environment. So many even really nice hotels often have that sliver of light. What about air

51:01

quality? We do see a strong association between the quality of our environment and our

51:06

sleep. So if there's poor air quality, if it's stuffy, if there are allergens, we do see that that does interrupt our

51:13

sleep. So buying an air purifier that can promote good air air flow and air quality can be useful.

51:20

Do you usually use air filter? I do. I do like and that's part of my sleep routine. I also ear do earplugs

51:26

and an eye mask every night and I have brands that I love and I know, you know, that I can um they're my go-to things

51:32

and I take those with me when I travel. I also do like a little bit of background noise. And so that is one

51:37

nice thing that an air purifier provides is a little bit of background noise to attenuate any interruptions. You know, a

51:44

siren even a town over you can sometimes hear, you know, in the country or if you're in an urban environment, there

51:49

are definitely going to be noises. Is there any data that would support it enhances sleep or does something to the

51:54

brain while the brain is going through its cognitive processes or some research

52:00

to show that pink noise which are generally kind of natural sounds can be associated with memory consolidation or

52:06

not. Mhm. What's the difference between pink and white noise? Basically different frequency of sound.

52:11

White noise tends to be a little bit more of a static or mechanic noise whereas pink noise is typically a

52:18

natural sound. It does make sense cuz white noise is a little jarring. Yes. So, one of the biggest differences

52:23

is that pink noise has more power at lower frequencies. It's typically natural sounds, rain or a babbling

52:29

brook. And research has shown associations between the use of pink noise and memory consolidation. Believe

52:35

it or not, you have talked a lot in the past about cognitive health, Alzheimer's, sleep, mortality. Are there

52:43

sleep biomarkers that we would be able to look for? Sleep

52:49

is a really rich process and I think we often kind of hyperfocus on duration. Getting enough duration is a really

52:55

important part of the equation. For the vast majority of adults, that's between 7 and 9 hours and finding where you are

53:01

on that spectrum and ideally meeting it as many nights of the week as possible. Realizing not every night is going to be

53:08

perfect, but doing your best. Now, in addition to getting enough sleep is consistent sleep. That is another

53:14

vitally important thumbrint of what constitutes good sleep health. Consistent sleep meaning falling asleep

53:20

at the same time and waking up at the same time as many nights of the week as possible and keeping those times as

53:27

close together as possible. Varying by maybe 15 minutes here, 30 minutes there,

53:33

an hour, but really no no longer than that. Now, in addition, I want you to wake up and I want you to feel good from

53:38

sleep. I want you to tell me that you feel restorative. Now, in addition to duration, to the consistency of our

53:44

sleep, to being satisfied with our sleep, consolidated sleep is also vitally important. Sleeping as much as

53:51

possible in one consolidated period of sleep that's not interrupted by multiple

53:56

prolonged awakenings. Waking up from time to time is not a problem. As long as you keep the lights low, it's

54:02

typically to use the bathroom and come back to bed as soon as you can. Those are the four markers of what we call a

54:09

good night's sleep. And doing your best to meet those as many nights of the week as possible. But I think one of the

54:16

things that we do is we kind of will hyperfocus on duration. And we'll talk about all of the the dangerous and scary

54:21

things that happen if you don't meet those things. But the truth is sleep is not going to be perfect every night. But

54:28

the key is getting back on track as quickly as possible towards those four components. Now, those are kind of the

54:35

manifestations of a good night's sleep. But the interesting thing about sleep is a health behavior is it's also

54:41

intimately related to a constellation of other things. I mean, I like to say that good sleep really starts when you wake

54:47

up and getting plenty of blue light, natural sunlight exposure over the course of the day. The timing of your

54:53

meals, this is your work, the composition of your meals, um managing your stress over the course of the day.

54:59

I think one of the most powerful tools that is really not widely understood is meditation and mindfulness and those

55:06

tools allow you to find peace in a moment. Um, do you meditate before sleep?

55:11

I do. I very regimented. What's your pre-sleep routine? Meditation. Well, after the kids are

55:18

asleep, I do the whole You wash my face. I use this essential oil. Um, yes, I do.

55:23

I love that name. Your skin looks amazing. Um, and sometimes I use the wax ear plugs,

55:28

sometimes I don't. I only use it when my husband is home. Does he snore? Is that why we love him? No, he actually has sleep apnnea.

55:35

Really? Yes. Okay. Yes. Oh, that's a whole other It is a whole I mean he has I don't know. His neck is like 18 in.

55:42

But does he have a CPAP? We Yes, he does. Amazing. Every which way. It's very romantic.

55:47

Always hasn't. He's got like the sleeves, my mask is um

55:53

But I love that. That's great news. Yeah. The other aspect is I'll put on a

55:58

meditation before I go to sleep. I love that. 15 20 minutes. The same one. Do you use? No, I just I'll switch it up or that or

56:06

some kind of noise. Not white noise, but some kind of What's so beautiful about that is that it's your routine and you've classically

56:13

conditioned yourself to wash your face, to start your meditation, to put on your

56:18

eye mask, and then your brain starts to understand that what follows is sleep. And I think sometimes we're I mean look,

56:25

we have busy days now more than ever filled with information and all of this stuff and then our day comes to a

56:31

screeching halt at night. And I think that whole uh bedtime procrastination trend emerged because especially younger

56:37

generations who are, you know, being told to do things all day long and then they finally have some agency at night

56:43

and they kind of kind of push back on the idea of needing to sleep or needing to keep a bedtime. But a good night's

56:50

rest is the strongest predictor of so many aspects of our waking success.

56:55

Better productivity, better mental health, better mood, better exercise. When you exercise, you're going to get more out of your sleep if you're well

57:02

rested. So many positive things when you can put sleep first. But our days are busy and then they come to a screeching

57:08

halt. And I think that the time between, you know, you send the last email and for us as moms putting our kids to bed,

57:15

it's so easy to think, you know, I'd love to have a, you know, watch a show or, you know, but then unfortunately

57:21

what can happen is a lot of times that the next show will start and suddenly there's not a lot of awareness about

57:26

your bedtime for many people and watch shows for that reason. It's so dangerous. It's a risky game,

57:32

right? Because then you want to know what happens next. Nope, I do not. If it's a show, I'm out. Nope.

57:37

I love that. and finding ways to relax and kind of fuel your soul and prepare

57:42

you for sleep so that you can get the the rest that your body needs. If an individual is

57:50

sleeping, um, is there a way to see if there's an improvement in brain

57:56

function? Would that be on an EEG? Again, that's probably uh outside of what would happen at sleep, but I'm

58:03

assuming that you can see the health of the brain while it's sleeping. Is that this is a

58:08

great question. Now, of course, we need to be measuring brain activity to really know without a shadow of a doubt where

58:13

you are in terms of light sleep, deep sleep, rapid eye movement sleep. Now, as it relates to brain health and function

58:20

and structure, what um I think the response I'd make is kind of twofold. First, if you take someone who has maybe

58:26

what we call yo-yo sleep schedules, which are, you know, keeping one bedtime one night, you know, falling asleep at

58:33

the next night, waking up at: 10:00

58:38

next morning. So, all over the map, which is quite common. So, an irregular sleep schedule or maybe not getting

58:44

enough sleep. So if you take someone who is maintaining a schedule like that kind

58:49

of sleep and wake times all over the map, sleep duration all over the map and you move them into a regimented sleep

58:55

schedule. During sleep, what's going to change is the structure is going to improve. So that we're going to see a

59:01

healthy cycling in and out of all the stages at the times that we would expect to see those stages. Again, deep sleep

59:07

predominating in the first half of the night and rapid eye movement sleep in the second half of the night. So the

59:12

structure of your brain activity over the course of the night will become more regulated and you'll you're going to get

59:19

more out of your sleep. Also, if you move someone from even someone getting enough sleep but keeping that what we

59:25

call yo-yo sleep schedule, falling asleep at different times all over the week, waking up at different times all

59:30

over the week. We take someone like that who's getting enough sleep, but we look at their this the structure of their

59:36

sleep, it's going to be all over the map. And if we move that person even to a slightly shorter sleep schedule, but a

59:41

consistent one, so many things improve and their brain starts to understand, oh, this is when I'm going to fall

59:46

asleep. And then it can align itself within that period in a much more efficient way. So that sleeper is going

59:53

to move, even if they're getting a little less sleep, into a schedule that's more consistent and more

59:58

regulated and wake up and probably have more energy than the person who is maybe even getting more sleep, but sleeping

:: 00:04

all over the map. Is there any data and this might be very hard to study but the that glimpmphatic system cleage the

:: 00:12

cellular turnover do we know if it's more effective that mirrors that regular consistent

:: 00:19

sleep? What we do know is in lab studies and these have been done in rodents because

:: 00:24

we can inject the brains of rodents and we do that to humans. No, not quite. No. Yeah. But what those and what's so

:: 00:29

interesting is these findings were developed by a neuroscientist who wasn't necessarily a sleep scientist but had this amazing finding and in rodents they

:: 00:37

found that the brains of of these rodents in their studies that were sleepd deprived compared to well-rested

:: 00:43

there was an accelerated clearance of toxic particles which are observed of course in greater deposition in humans

:: 00:50

with Alzheimer's disease and related dementia as compared to healthy controls. So there is this increased

:: 00:57

clearance of these neural toxins in the rodents that were allowed to sleep to the tune of 60% greater clearance in the

:: 01:04

well-rested rodents as compared to the sleepd deprived. Isn't that fascinating? And mechanistically what's happening

:: 01:10

there is there's this fluid I like to think of it as like Drano. It's washing through the networks of our brain and

:: 01:16

the gal cells expand when we're sleeping allowing for accelerated clearance of those toxic particles. And that

:: 01:23

accelerated removal then results in better brain health over time. And we've looked at this in humans and we found

:: 01:28

that in cohorts of older adults. Um we've published several papers on this where individuals enter the cohort at

:: 01:35

age 65 and we we monitor them over time and those individuals that are maintaining poor sleep schedules.

:: 01:40

They're struggling to get good sleep, maintaining inconsistent sleep schedules, they're at a market increased risk for dementia as compared to the

:: 01:47

individuals who are getting consistent and regular healthy sleep. I'd like to acknowledge one of the sponsors and

:: 01:52

that's our place. I'd also like to acknowledge my mom jokes that are coming in hot about my old pan. It was so toxic

:: 02:00

even my veggies wanted to detox after dinner. That's bad. Seriously, non-stick

:: 02:06

cookware is still used. Very convenient, but it comes at a cost. Non-stick contains harmful chemicals like Teflon

:: 02:12

and other PAS which can leech into your food. In our home, we use our place, which is toxin-free, high performance

:: 02:19

cookware and appliances designed for safer, simpler use. The hidden dangers of traditional non-stick cookware is

:: 02:26

loaded with forever chemicals. Dump them. It is not worth it. If you want to start somewhere, start with the

:: 02:32

fourpiece cookware set. It is your best way to overhaul that kitchen. Stop

:: 02:38

cooking with toxic cookware. Stop spending time with toxic people. Upgrade

:: 02:43

your place today. Visit from ourplace.com/drlion

:: 02:49

and use the code drlion for 10% off sitewide. That's 10% off sitewide with a

:: 02:56

100day risk-free trial. Free shipping, free returns. You will experience a

:: 03:03

gamechanging cookware. Do you have a position on sleep medications? Things

:: 03:10

like ambient lunasta. I understand that certain people tradone. I know that

:: 03:15

people need them, but as a sleep scientist, do you have concerns about their utility?

:: 03:20

This is a great question and there are many millions of Americans who are using sleep medications and there is a time

:: 03:26

and a place for medication and for some patients it is a lifeline if someone is

:: 03:31

really struggling with sleep and has been for many years. So the first answer is talk to your healthcare provider and

:: 03:37

create a plan that works for you. Some of the research shows that in the longer term it is advantageous to move onto a

:: 03:43

behavioral change regime. But what is interesting in individuals who have the option and think they might be open to

:: 03:50

behavioral intervention or medication. The research that pits those two treatments head-to-head pharmacological

:: 03:56

intervention and behavior change specifically cognitive behavioral change

:: 04:01

for better sleep, we refer to this as cognitive behavioral therapy for insomnia or CBTI. When we take that

:: 04:07

treatment and we compare it to pharmarmacological intervention, those two patients sufferers of insomnia and

:: 04:13

we compare them over time, the behavioral treatment wins out in the short and especially in the longer term.

:: 04:20

The unfortunate thing is we have a der of sleep providers that can provide this treatment. So it's one of the

:: 04:26

interesting and exciting applications of artificial intelligence for the future to think about providing some of these

:: 04:32

behavioral treatments. I was going to ask you what is you're very involved in sleep sleep nationally sleep globally

:: 04:40

where do you think that the future is going in terms of tracking improving outcomes testing what is on the

:: 04:47

forefront of sleep I am really excited about the intersection of some of the

:: 04:52

new technologies we're seeing and sleep and specifically in my work which is behavioral interventions I one of my

:: 04:59

areas of expertise is designing interventions to nudge and navigate patients and populations towards better

:: 05:04

sleep. And I am so excited at the idea of developing an avatar that could

:: 05:09

deliver tailored personalized recommendations. It could help you, you know, make sense and act on your

:: 05:15

information from your wearable device. I mean, how exciting to take, you know, this the problem which is a der of sleep

:: 05:22

providers and think about sleep interventions at scale. Uh I also think

:: 05:27

the trend towards sleep tracking is incredibly exciting. These devices are increasingly relied upon by many

:: 05:33

millions of Americans. We published data in 2019 to show that one in three Americans were tracking their sleep with

:: 05:39

some sort of wearable technology. And I think that that number has only increased since that time. And so um

:: 05:46

ensuring that these devices are increasingly accurate, increasingly small and increasingly scalable and soon

:: 05:53

I hope also able to detect signs and signals for sleep disorders that people might not even be aware they have and

:: 05:59

might be limiting their sleep quality. What would be one of those disorders? There are more than 80 differentially

:: 06:05

diagnosible sleep disorders, but a couple of the big ones are insomnia. Number one, it impacts anywhere between

:: 06:12

30 and 40% of the population depending on how we're measuring it and studying it and in what population. But it's a

:: 06:18

condition that is debilitating for many. It is characterized by uh a chronic experience of difficulty falling asleep.

:: 06:25

So taking longer than 30 45 minutes night in and night out. Uh difficulty

:: 06:30

maintaining sleep. So uh maybe being able to fall asleep but then waking up and fighting struggling to get back to

:: 06:36

sleep. waking up too early in the morning and not being able to fall back asleep. And those are typically also

:: 06:41

accompanied with feelings of exhaustion during the day. Individuals who suffer from insomnia will tell us that they are

:: 06:48

absolutely exhausted. And the frontline treatment for sleep for insomnia is

:: 06:54

cognitive behavioral therapy for insomnia when available or pharmacological intervention and then

:: 06:59

kind of titrating to get onto a behavioral regime. Often with insomnia, we're trying to do away with maladaptive

:: 07:06

cognitions about sleep. Someone with insomnia will walk into their bedroom and their cortisol will spike, which we

:: 07:12

know interrupts your ability to relax and prepare for sleep.

:: 07:18

Um, the second most concerning sleep disorder is obstructive sleep apnea and that is, you know, is a condition marked

:: 07:25

by often loud snoring, loud rockus snoring, but also interruptions or pauses in breath. Some

:: 07:31

very scary. Yes. Yes. As a spouse. Mhm. And so if those symptoms sound familiar

:: 07:37

to anyone listening, there are treatments. It's imminently treatable, which is the good news. And there are a

:: 07:43

range of options. But do find a sleep professional to coach you on the available options for your personal

:: 07:50

needs. And treatment is a significant predictor of better quality of life, better sleep of course, uh better heart

:: 07:57

health. Often in patients with untreated sleep apnea, uh, blood pressure can become uncontrolled. Um, many issues

:: 08:04

start to snowball when you're not getting proper treatment for obstructive sleep apnnea. That's absolutely true. Blood pressure,

:: 08:11

hemoglobin, hematocrit, people, they just don't feel well. Um, low testosterone.

:: 08:17

Do you guys use the Upworth sleep score or No, we do. That, you know, the good news is there are a lot of, you know, very easy

:: 08:22

to deliver questionnaires that are very sensitive for your risk for these things. So you don't often even have to

:: 08:27

go into a sleep lab just to get a sense of if you're at risk for some for some of these conditions. The Epworth

:: 08:34

sleepiness um scale, the insomnia severity index. Uh for any providers or

:: 08:39

clinicians listening, um the Berlin questionnaire, uh the stop bang questionnaire are all widely used

:: 08:45

validated questionnaires that can give you um you know, for instance, if you're a primary care provider could give you a really good sense of whether a patient

:: 08:51

you're seeing uh is at risk for any of these disorders. I want to close out this podcast with some common sleep

:: 08:58

myths. What is your top three myths that you hear? Number one is this belief that

:: 09:06

there's some people out there somewhere somehow that do well on less than 7 hours. And there might be they're very

:: 09:12

poorly studied if they are out there. People who truly truly need less than seven hours and they have a kind of

:: 09:19

appropriate health profile. Um but we do find there are several notable figures. Um Thomas Edison was one and there have

:: 09:26

been others in across uh across history that people who brag about not getting enough sleep. But Thomas Edison, yes, he

:: 09:32

probably slept around 4 hours at night, but he had a cut in his office and he was known for taking protracted naps. So

:: 09:40

it is not in fact true that he was only sleeping for 4 hours a day. He simply wore that on his shoulder as a valor of

:: 09:47

honor somehow despite all of the health concerns. but uh was in fact likely sleeping closer to 7. So um really

:: 09:54

duration we can't there's no cure there's no silver bullet. We do need to

:: 09:59

spend the time sleeping but the secret is if you can combine a healthy duration of sleep with consistent sleep. You

:: 10:06

start to maybe need a little bit less sleep overall because your sleep will become so consolidated and so efficient

:: 10:12

within the time that we're provided. the idea of bedtime routines and the time before sleep. We don't often factor that

:: 10:19

in, but it is a vitally important part of a sleep routine. We're really not made to fall asleep immediately,

:: 10:26

quickly, right away, but we need to set ourselves up for success. And just knowing that can be helpful. And then

:: 10:31

creating a relaxing bedtime ritual, whether that's doing a couple breathing exercises, reading a couple pages in a

:: 10:37

book. One simple thing that I love to talk about is just one good thing from your day. I think sometimes at night

:: 10:44

time all the bad stuff can snowball. But if you close your eyes and breathe and focus on one person that touched you in

:: 10:51

some way, you know, touched your heart, was kind to you, was thoughtful, one nice thing that you did can also sometimes make us feel good ourselves.

:: 10:58

That can just put you in the right headsp space to drift off to sleep. And then number two, I'd say is this myth

:: 11:03

that falling asleep quickly is a sign of good sleep. So often people say, "Oh, you know, I'm such a bad sleeper. It

:: 11:09

takes me 15, 20 minutes." I'm like, yo, it takes a healthy sleeper 15 to 20

:: 11:15

minutes to fall asleep. But I think that that some people think of that is, you know, what's wrong with me? So falling

:: 11:20

asleep quickly just as if you were underfed and you were presented with a buffet and you helped yourself to a ton,

:: 11:28

you know, ate, you know, ton of food right away and you're you're you're starved for food. So similarly, if

:: 11:33

you're falling asleep right away, you're probably starved for sleep. And the third myth is snoozing. So many people

:: 11:41

at dinner parties or, you know, wherever will open their phone and show me a dozen snooze alarms and they're like,

:: 11:46

"Look at me. I get all this extra sleep." And that is another myth that hitting the snooze alarm will give you

:: 11:52

more sleep. What the vast majority of us are doing if we're using the snooze alarm is is you're looking at your schedule. Say you have to get up at 7:00

:: 11:59

for work and that's a non-negotiable to commute, to get ready, to all do all of

:: 12:04

your things. So, what people are typically doing is setting their first alarm for 6:30 and then for 6:40 and

:: 12:10

then 6:45. And I'm like, "Guys, let's just set it for 7 and find the latest

:: 12:16

possible time. Set your alarm and then it's going to be tough. You've got to get your butt out of bed." Um, but just

:: 12:23

commit. Say, you know, I'm going to maximize my sleep and maybe put my phone on the other side of the room so I'm not

:: 12:30

this news. Again, it's genius. We're all inspired to sleep more and you know what? You don't make it sound painful.

:: 12:35

Oh, thank you. That means so much to me. It's just important. You're really on this mission to improve cognition

:: 12:42

through sleep and just better life. And if we can get ahead of it, then we can

:: 12:47

get ahead of it for our children. Absolutely. And set them up for a more resilient life. Absolutely. If we can do that, it's the biggest gift

:: 12:53

as parents, giving them a good sleep. Think about it. When they are disregulated, it's often times when

:: 12:59

they're tired. 100%. Dr. Rebecca Robbins, you're just a joy

:: 13:05

and um likewise it's so fun to be able to sit down with my friends and people that I just respect and admire the work

:: 13:12

that they're doing in the world. So to this I would say good day, but I'm going to say good night. Good night. And can we add sweet dreams?