**#1 SLEEP EXPERT: Your Brain Is Being Damaged Every Night (Simple Fix!) — Transcript & Summary | SozAI**
Source: https://sozai.app/transcript/sleep-expert-brain-damage-simple-fix/

Sleep expert Matt Walker joins Jay Shetty to explain the QQRT framework (quantity, quality, regularity, timing) and why aligning sleep with your chronotype matters for health.

## Key Takeaways

- Aim for 7 to 9 hours of sleep and keep a consistent sleep schedule.
- Align your sleep timing with your natural chronotype where possible.
- Good sleep depends on quality and regularity as much as total hours.
- Lifestyle factors like caffeine, meal timing, screens, and alcohol strongly affect sleep.

## What the video covers

- Approximately 80% of people with sleep apnea are estimated to be undiagnosed.
- Adults generally need 7 to 9 hours of sleep; sleeping less than 7 hours is linked to measurable impairment in brain and body performance.
- Short sleep predicts all-cause mortality, with shorter sleep associated with shorter life.
- The QQRT framework stands for quantity, quality, regularity, and timing of sleep.
- Regularity may be as important as, or more important than, total quantity in predicting mortality, according to a comparative study.
- Chronotype (morning type, evening type, or neutral) is largely genetically determined, and sleeping out of sync with it worsens sleep quality.
- The Morningness-Eveningness Questionnaire (MEQ) can be used to assess chronotype online.
- Good sleep quality includes minimal awakenings and sufficient deep and REM sleep, not just time in bed.
- Practical tips include limiting caffeine, avoiding large meals and heavy or simple sugars close to bedtime, getting darkness, and keeping phones out of the bedroom.
- Sleeping pills and melatonin usage raise questions about long-term risks and dependence, and sleep deprivation impairs gene expression, immunity, emotional regulation, and prosocial behavior.

## Chapters

1. 00:00 Undiagnosed Sleep Apnea and Introduction
2. 04:00 Chronotype and Sleep Timing
3. 09:00 Sleep Duration and Mortality
4. 18:30 Quantity, Quality, Regularity, Timing Framework
5. 30:00 Caffeine, Diet, and Sleep Hygiene
6. 45:00 Sleeping Pills, Melatonin, and Risks
7. 60:00 Phones, Sleep Restriction, and Behavior
8. 78:00 Sleep Deprivation Effects on Body and Brain

Answers

## Questions about this video

How much sleep do adults need according to this video?

Matt Walker says the range for the average adult is 7 to 9 hours. He notes that getting less than 7 hours is associated with measurable impairment in brain performance and body metrics.

What is the QQRT framework?

QQRT stands for quantity, quality, regularity, and timing of sleep. Walker presents it as a four-part way to assess whether someone's sleep is good.

Can you change your chronotype?

Walker says chronotype is largely genetically determined, so night owls are not to blame. Instead of forcing a shift, people can try to align their schedules more closely with their natural biological rhythm, which improves sleep.

## Full Transcript — Download SRT & Markdown

00:00

Speaker A

Right now, we estimate that approximately 80% of people who have sleep apnea are undiagnosed. That's crazy.

00:09

Speaker A

Please welcome Matt Walker. What is good sleep? And should we just use the metric of quantity? The range is somewhere between 7 to 9 hours. Once you start to get less, the shorter your sleep, the shorter your life. When sleep is

00:24

Speaker A

Please welcome Matt Walker.

00:40

Speaker A

one domino that then naturally helps all of the others. If you are not sleeping in harmony with your natural biological sort of rhythm, then your sleep quantity and quality is worse. Regularity may be as if not more important than quantity.

00:56

Speaker A

What is good sleep? And should we just use the metric of quantity?

01:04

Speaker A

The number one health and wellness podcast, J Shetty. J Shetty, the one, the only J Shetty.

01:12

Speaker A

The range is somewhere between 7 to 9 hours.

01:25

Speaker A

was, you know, necessary and get anything less and there's doom and gloom. The range is somewhere between 7 to 9 hours for the average adult. And what we certainly know is that once you start to get less than 7 hours of sleep,

01:39

Speaker A

Once you start to get less, the shorter your sleep, the shorter your life.

01:55

Speaker A

should because using that sweet spot of 7 to 9 hours. It looks as though the shorter your sleep the shorter your life. Short sleep predicts all cause mortality. So duration total amount is necessary. But if you actually look at

02:09

Speaker A

When sleep is abundant, all of a sudden your appetite hormones are rebalanced.

02:24

Speaker A

it by the acronym QQRT and it stands for quantity, quality, regularity and timing. So quantity, you're absolutely right.

02:34

Speaker A

So you naturally stop eating as much as you wanted to.

02:46

Speaker A

That's not good quality of sleep. So, you could be in bed for 9 and 1/2 hours and still get 7 hours of sleep, but you're spending 2 and 1/2 hours of time awake. That's not good quality of sleep.

03:00

Speaker A

The weight starts to come off you, and you're simply sleeping the weight off yourself.

03:07

Speaker A

Well, do I really have to worry about regularity? There's a great study and they looked at regularity and quantity.

03:14

Speaker A

It sounds like you're saying that sleep is that number one domino that then naturally helps all of the others.

03:27

Speaker A

in the same statistical analysis and did the sort of Coke Pepsi challenge between the two. What they found is that regularity beat out quantity in terms of predicting your mortality. Meaning regularity may be as if not more important than quantity. Now you've got

03:44

Speaker A

If you are not sleeping in harmony with your natural biological sort of rhythm, then your sleep quantity and quality is worse.

03:55

Speaker A

Timing is about your chronotype. Are you a morning type, evening type, or a neutral? And it turns out, by the way, that if you're a night owl, it's not your fault. It is genetically or largely genetically determined. There are at

04:08

Speaker A

Regularity may be as if not more important than quantity.

04:18

Speaker A

And what we find is that if you are not sleeping in harmony with your natural biological sort of rhythm, then your sleep quantity and quality is worse. So let's just say we take someone who goes to bed at 10 p.m. and wakes up at 6:00

04:33

Speaker A

And I would say to anyone listening, if you're going to do anything with this podcast, just do this one thing.

04:48

Speaker A

getting. But if the night owl 2:00 a.m. to 10 a.m. is forced to sleep from 10:00 p.m. to 6:00 a.m., still 8 hours, the quality of their sleep that they get will nowhere be as um sufficient as the

05:02

Speaker A

The number one health and wellness podcast, J Shetty.

05:14

Speaker A

chronotype assessment which is morning type evening type. And by the way people can do this online very quickly right now. You can just type into Google MQ test. MEQ. It stands for morningness eveningness questionnaire. And it fits very well with your genetics. takes

05:32

Speaker A

J Shetty, the one, the only J Shetty.

05:47

Speaker A

your natural biological prediliction, your sleep is not going to be as good as it could be if you moved yourself closer to your natural innate biological tendency. Does that make s some sense? So those to me would be

06:02

Speaker A

How much sleep do we actually need?

06:16

Speaker A

better for my partner. It would be better for my lifestyle. It would be better for my kids. Whatever it is, can you shift your type?" It's a really good question. I get asked that a lot because in some ways what I'm talking about is

06:28

Speaker A

Yeah, it's an interesting question, and there is definitely a range.

06:41

Speaker A

a group in Australia and they took, I think it was about 11 different things that you had to do as a night owl to see if they could drag you back so you felt more capable of going to sleep earlier.

06:53

Speaker A

You know, I think there is, and perhaps even populated by idiots like me, that there was this magical eight-hour number that was necessary, and get anything less and there's doom and gloom.

07:08

Speaker A

get as much darkness as you can, meaning put shades on if you're going to go outside in the evening. Make sure that you eat at least 3 hours before you expect to go to bed. and then try to

07:20

Speaker A

The range is somewhere between 7 to 9 hours for the average adult.

07:34

Speaker A

great. But the problem is these were extreme night owls who would prefer to go to sleep at maybe let's say 1:30 a.m.

07:41

Speaker A

And what we certainly know is that once you start to get less than 7 hours of sleep, we can measure impairment in both your brain performance as well as your body metrics.

07:59

Speaker A

some wiggle room it seems that you can sort of manipulate. But in truth, I think what we have to try and do as best we can is to say, how can I align myself better with my biology? When you fight

08:13

Speaker A

So there is a range, but in some ways it's also a question of what is good sleep, and should we just use the metric of quantity?

08:28

Speaker A

I mean hack isn't the right word, but there are ways that you can try to help yourself. So think about what you do in the morning that takes time. So is it that you sort of, you know, make the

08:38

Speaker A

And we absolutely should, because using that sweet spot of 7 to 9 hours, it looks as though the shorter your sleep, the shorter your life.

08:53

Speaker A

next morning and say allow yourself to sleep a little bit later so you're at least getting closer to your natural tendency. then go to the front end of sleep and say, "What is it that I do in the last 15 minutes before I go to bed?"

09:05

Speaker A

Short sleep predicts all-cause mortality.

09:20

Speaker A

then right before you go to bed, when that alarm goes off, the to bed alarm, all you do is get up and you go straight to bed. So you've saved yourself 15 minutes on the front end. So you can go

09:30

Speaker A

So duration, total amount, is necessary.

09:41

Speaker A

So you can try to short sort of thin slice some of that a little bit. Yeah, absolutely. If you're someone who's waking up tired regularly, like right now someone's listening and they're just like, Jay and Matt, I wake up every day

09:53

Speaker A

But if you actually look at the science, what is good sleep can be really answered by a four-part equation.

10:05

Speaker A

Are you getting a consistent 7 to N hours of time at least in bed? Next, are you trying to um assess your sleep and say, "Am I waking up a lot throughout the night?" I would say that's one of

10:18

Speaker A

In my mind, there are really sort of four macros of good sleep.

10:29

Speaker A

quantity. But if you're being good and you're spending sufficient time in bed but still feeling unrefreshed and restored, we have to ask, are you waking up a lot throughout the night? If you are, let's figure out why. Is it that

10:42

Speaker A

Three macros are food: fat, protein, carbohydrate, for sleep, four macros.

10:57

Speaker A

download it. It records your breathing. You place the phone next to you on your bed. Then in the morning, it shows you a RTOR shock sort of scale throughout the night. And it quantifies your snoring into quiet, moderate, loud, and epic.

11:12

Speaker A

And you can remember it by the acronym QQRT, and it stands for quantity, quality, regularity, and timing.

11:24

Speaker A

would say is it a case that you're maybe over consuming on caffeine during the day. Some people will feel completely comfortable having an espresso with dinner and they say I fall asleep and I stay asleep. So, I'm one of those and it

11:38

Speaker A

So quantity, you're absolutely right.

11:53

Speaker A

movement sleep. That's where you get a lot of restoration sensation from. So, maybe we need to ask how much caffeine are you taking? The dose and the timing make the poison. Try to cut yourself off after about three cups and try to stay

12:07

Speaker A

Somewhere between 7 to 9, is that fit?

12:11

Speaker A

The final thing I would probably say is are you also using anything in the evening to help you fall asleep? And the principle thing I'm talking about here is alcohol. It's probably the most misunderstood sleep aid that there is

12:24

Speaker A

Quality is about the continuity of your sleep.

12:37

Speaker A

are you doing in terms of your bedtime timing? Are you spending a lot of time awake and also the things that you're taking into your body? Alcohol, caffeine, etc. The final thing I would say is stress and anxiety. If there is

12:51

Speaker A

Is your sleep fragmented and littered with all of these awakenings, and you're awake for a lot of the night?

13:08

Speaker A

rarely do we do reflection and the only time now in the modern world when we do reflection is when our head hits the pillow. And that's the last time that we need to do reflection because at that point the rolodex of anxiety starts

13:23

Speaker A

That's not good quality of sleep.

13:37

Speaker A

next 2 hours. So the final thing I would say is let's speak about your mental state. So does that give you a sense of sort of the pinwheel diagnostics that we would go through? I absolutely love it.

13:45

Speaker A

So you could be in bed for 9 and a half hours and still get 7 hours of sleep, but you're spending 2 and a half hours of time awake.

13:59

Speaker A

very well and and generally always have. But whenever I have had disturbances in my sleep, I can easily pinpoint it to something you've said and that shows me how great the model is because as someone who is lucky and fortunate

14:15

Speaker A

That's not good quality of sleep.

14:28

Speaker A

dive into each of those. Let's start with sleep apnea because I think that's something a lot of us don't actually know enough about and so I love the fact that people can use the app Snore Lab as you mentioned. How many people are

14:39

Speaker A

Then we can speak about regularity: going to bed at the same time, waking up at the same time.

14:58

Speaker A

look at the numbers is going to be a non-trivial proportion of the population. And the reason it's so dangerous is because when you have sleep apnnea essentially what's happening is that your airway is either partially becoming obstructed or like a straw it's

15:14

Speaker A

It sounds very benign.

15:29

Speaker A

a partial what we call occlusion of the airway. And that's what you hear when you hear the sound. That's the sort of the flapping of the partial occlusion.

15:39

Speaker A

Well, do I really have to worry about regularity?

15:55

Speaker A

because at that point you are slowly esphyxiating and it sends a wakeup trigger up to your cortex and then all of a sudden you hear and you gasp and you're awake. So imagine now we have a way that we measure these sort of

16:11

Speaker A

There's a great study, and they looked at regularity and quantity.

16:27

Speaker A

you were to have very mild sleep apnnea, you may be having 5 10 15 of these events. That's considered mild. Some people could have 80 of them per hour.

16:35

Speaker A

Both of them predicted all-cause mortality.

16:49

Speaker A

your bedroom, Jay, and every hour I'm going to throttle you, strangle you to the point where you actually stop breathing, and I'm going to do that 10 times every hour for every one of the eight hours. So I'm going to do that 80

17:02

Speaker A

So if you're very regular and you get that 7 to 9 hours of sleep, you have the lowest mortality risk.

17:13

Speaker A

we're facing even with the mildest version of undiagnosed sleep apnnea. That's why sleep apnnea untreated is associated with a very significant increase in all cause mortality as well as increases in mortality related to diabetes to cardiovascular disease as

17:31

Speaker A

But then, because they had these two measures in the same individuals, they put them in the same statistical analysis and did the sort of Coke-Pepsi challenge between the two.

17:44

Speaker A

That's what most of us are worried about. Not really our lifespan, it's our health span. None of us want to live with disease or sickness. I certainly don't want to. And I remember there was a patient that we work with um with

17:55

Speaker A

What they found is that regularity beat out quantity in terms of predicting your mortality.

18:08

Speaker A

the way I felt. And when you treated me with sleep apnnea, it was almost as though someone cognitively had wiped a fogged glass clear and finally I could see again. And so that's why I think so many people can benefit by way of just

18:26

Speaker A

Meaning regularity may be as if not more important than quantity.

18:43

Speaker A

questionnaire probably about 2 minutes and it will evaluate your risk likelihood of having sleep apnnea. One of those two. If you fear that you have sleep apnnea or if you know that your partner has sleep apnnea, please go and

18:57

Speaker A

Now you've got to get both.

19:11

Speaker A

anything but a funny story when it comes to undiagnosed sleep apnnea. Yeah. Thank you so much for giving such practical tips as to how we can check as well. And I hope everyone who's listening and watching, please go do that because the

19:22

Speaker A

So QQR, quantity, quality, regularity, timing.

19:34

Speaker A

That's huge. And so many downstream consequences happen when they get treated that they are typically overweight. They usually have high levels of of blood sugar, of blood glucose. They typically have hypertension, high blood pressure. And what's nice is that when you were to

19:50

Speaker A

Timing sounds like regularity, and you think, well, what's the difference?

20:03

Speaker A

overweight, hypertensive, high glycemic, they just find it so hard to change. But if you treat them with sleep apnnea, when sleep is is abundant in good quantity and quality, which it will be when you treat them, all of a sudden

20:18

Speaker A

Timing is about your chronotype.

20:34

Speaker A

sugary sort of high sugar sort of immediate hit foods. So your blood sugar comes back into control and you're more motivated to be physically active, meaning that your cardiovascular health.

20:46

Speaker A

Are you a morning type, evening type, or neutral?

20:59

Speaker A

far left that if you move it, all of those other dials just kind of move up.

21:03

Speaker A

And it turns out, by the way, that if you're a night owl, it's not your fault.

21:17

Speaker A

even have to do anything. You just have to start sleeping better. Caffeine has a halfife for the average adult of 5 to 6 hours, which means that after about 5 to 6 hours, 50% of the caffeine is still

21:29

Speaker A

It is genetically, or largely genetically, determined.

21:42

Speaker A

in your brain at midnight. So many of us see sleep as a cost to our lives. Yes.

21:48

Speaker A

There are at least 22 different genes that dictate whether you want to be a morning person or an evening person.

22:03

Speaker A

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22:18

Speaker A

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Speaker A

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Speaker A

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Speaker A

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23:20

Speaker A

And what we find is that if you are not sleeping in harmony with your natural biological sort of rhythm, then your sleep quantity and quality is worse.

23:30

Speaker A

I for the past 6 weeks I've been in LA which is rare in terms of I haven't traveled, I haven't jumped on a plane.

23:37

Speaker A

So let's just say we take someone who goes to bed at 10 p.m. and wakes up at 6:00 a.m.

23:49

Speaker A

you maybe whatever right you you eat something that wasn't great you're in a hotel room whatever it may be. I've been here for six weeks so I've not been on a phenomenal schedule. Last week I I was only gone for like 4 hours away. I took

24:02

Speaker A

Well, if you're a slight morning type, that's actually quite ideal for you.

24:10

Speaker A

which is rare for me. I don't do that. I usually sleep by 9:30 p.m. I'm a morning person for sure. And I got back at 4 am.

24:17

Speaker A

But if you're an evening type who likes to go to bed at 2:00 a.m. and maybe wake up at 10:00 a.m., then it's the same 8-hour window that they're getting.

24:27

Speaker A

more tired than I've felt for a long time. And I actually felt weaker. So I've been feeling really strong across the last 6 weeks, but I felt weaker. I was like, I don't think I can lift that much today. I'm not feeling up to it. On

24:39

Speaker A

But if the night owl, 2:00 a.m. to 10 a.m., is forced to sleep from 10:00 p.m. to 6:00 a.m., still 8 hours, the quality of their sleep will nowhere be as sufficient as the morning type.

24:51

Speaker A

for like weeks on end now." But this one day, all I'm craving is fats and sugars, and that's that's all I'm after. And I did give in and I was okay about it. But but but it's so interesting to feel it

25:03

Speaker A

So some people will come to our sleep center and say, "I have terrible sleep-onset insomnia.

25:11

Speaker A

All of it makes a difference. And in some ways we what's great now is the science is compelling in terms of the mechanism such that firstly there are two appetite regulating hormones they're called leptin and ghrein. Now leptin is

25:25

Speaker A

I get into bed and I'm awake for the first 2 hours, and then I fall asleep."

25:41

Speaker A

start to sort of thin slice people's sleep, and it doesn't take very much, you can sort of get maybe 6 hours of sleep for five nights or 5 hours of sleep for four nights. All of a sudden, the hormone leptin, which says you're

25:55

Speaker A

And we do a chronotype assessment, which is morning type, evening type.

26:09

Speaker A

appetite behavior changes as a consequence. So, it doesn't take very much. And then if that wasn't bad enough, ghrein, the hormone that says, "Oh, no, no, no, you're still hungry.

26:20

Speaker A

And by the way, people can do this online very quickly right now.

26:29

Speaker A

Once by switching off the signal of I'm full, I don't need to eat and once again by I'm hungry and I need to eat more.

26:37

Speaker A

You can just type into Google "MEQ test."

26:51

Speaker A

cannabis. But we have naturally occurring canabonoids in our system called endockinabonoids. Now many people will um let's say know someone of course I'm not going to judge anyone will know someone who said when I you know when I

27:05

Speaker A

MEQ stands for Morningness-Eveningness Questionnaire.

27:18

Speaker A

naturally occurring canabonoids these endockinabonoids they also increase and that drives you to eat even more in addition to the changes in leptin and ghrein. And then finally, we did a study with brain imaging where we scanned people's brains with and without good

27:34

Speaker A

It fits very well with your genetics.

27:52

Speaker A

pleasurable foods, they started to become much more reactive. And it set you on this path of almost obesogenic eating where you crave those sort of you know the sugars, the chocolates, the stodgy carbohydrates and you don't go towards the leafy greens and the healthy

28:09

Speaker A

It takes about 3 minutes.

28:21

Speaker A

were just describing as a sort of a phenomenon. And that's why I think this you've always got to be careful with epidemiological studies where you say okay shorter sleep equals higher body mass index higher chances of obesity.

28:33

Speaker A

When we do this type of assessment with them, what we realize is that they don't have insomnia.

28:49

Speaker A

ideal meal type three hours before we go to bed? A so that we don't get hungry just before we go to bed and B because I also understand that the digestive process can actually make sleeping much harder and so what should we be trying

29:04

Speaker A

They're a night owl, but they're trying to sleep like a morning type.

29:09

Speaker A

Yeah, it's a really good question and and so there the sort of the 3 hours what we were trying to do is take those night owls and try to drag them back in time. But if you're not a night owl

29:19

Speaker A

And so when you sleep against your natural biological predilection, your sleep is not going to be as good as it could be if you moved yourself closer to your natural innate biological tendency.

29:32

Speaker A

this strong sentiment out there on social media that you need to stop eating maybe 3 or 4 hours before bed. If you look at the data and I did this sort of analysis of all the literature, if you eat as close as 60 minutes before

29:45

Speaker A

Does that make some sense?

29:56

Speaker A

Nevertheless, that's a very different question than saying what would be beneficial to my sleep. I'm I'm phrasing the question as at what point does it become harmful for your sleep? And the answer is you can eat up to an hour

30:10

Speaker A

So those, to me, would be...

30:23

Speaker A

that it's very idiosyncratic that you need to test drive it and you will know which kind of quote unquote type you are. Some people, mostly night owls, have a preference to eat late in the day or early in the evening and very little

30:38

Speaker A

Yeah.

30:46

Speaker A

I think it's dependent on your chronoype. That said though, the two ways that food can disrupt us. First, if we're eating high sugar content foods at night, it has a disruptive impact. And we know this in part because it could be

31:04

Speaker A

Yeah.

31:21

Speaker A

increase our core body temperature quite quickly. And it turns out temperature is key for sleep. We need to drop our brain and our body temperature by about 1° C or about 2 to 3° F to fall asleep and

31:34

Speaker A

Can you shift your sleep type?

31:47

Speaker A

uh simple sugars at night, it starts to just moderately, just gently increase your core body temperature, which can disrupt your sleep. So I would say content try to aim for if you're going to go after sort of carbohydrate make

32:02

Speaker A

If someone said, "Matt, that makes so much sense.

32:18

Speaker A

sugar unfortunately. So yogurt together with some kind of slowrelease carbohydrate is probably a fantastic approach to to food. The second way though that you can disrupt yourself above and beyond the the macros of food is that when you eat too late,

32:33

Speaker A

I've been a night owl my whole life, but I just feel like I should be trying to sleep early and wake up earlier.

32:48

Speaker A

caseinbased protein and then aim for if you're going to go after carbohydrate just make it a smaller portion and make it a complex carbohydrate. That's probably the best recommendation. Yeah.

32:58

Speaker A

It would be better for my partner.

33:13

Speaker A

my best? Yeah. And feeling at my best. And when you're already struggling with the quality of sleep, every minute kind of factor is going to make a difference.

33:22

Speaker A

It would be better for my lifestyle.

33:32

Speaker A

As I was hearing you speak, I was just thinking about just how hard it's become for people to regulate their lives and and manage this. I know in some cultures it's just so natural to eat really late before you go to bed. How much does

33:50

Speaker A

It would be better for my kids.

34:03

Speaker A

chronotype prediliction but you can almost violate that biology and override some of it by creating sort of certain conditions under which it will distort your natural rhythm. One way that this rhythm is played out is the release of

34:21

Speaker A

Whatever it is, can you shift your type?"

34:35

Speaker A

there are ways that you can artificially delay your mel your natural melatonin release. A good one would be being exposed to too much light in the evening. Too much artificial light. What I would think of as junk light. You

34:48

Speaker A

It's a really good question.

35:00

Speaker A

delay your natural biology. And if let's say that all food was taken away, all electric light was gone, all internet service was down, and you know the lights were out, you would naturally say to me, "Well, I'm someone who would

35:14

Speaker A

I get asked that a lot, because in some ways what I'm talking about is the ideal world.

35:29

Speaker A

sleepy." And it's because modernity through all of its changes, light, social media, you know, sort of entertainment that we're constantly exposed to. It's dislocated us from our natural sensation of biology telling us it's time to sleep. Most of us think

35:48

Speaker A

And drumroll, none of us live in the ideal world.

36:03

Speaker A

no you're much closer to a a 1020 to 6:30 a.m. kind of person but modern sort of industrial life has come in the way of that and it has modified our perception. So to uh to come back to

36:18

Speaker A

We live in this thing called the real world.

36:35

Speaker A

activating alertness sensation in the brain and the body and force you perhaps to go to bed or feel tired 2 hours later than you naturally would otherwise. So you have the way that we usually measure someone's natural sort of tendencies is

36:51

Speaker A

So, you know, stop your fancy sleep science and tell me, can that change?

36:59

Speaker A

And we just measure your natural biology. when we separate you from everything that is in the outside world and that way we can bring you back to your innate tendencies and usually there is quite the mismatch between when we

37:14

Speaker A

There was a study done by a group in Australia, and they took, I think, about 11 different things that you had to do as a night owl to see if they could drag you back so you felt more capable of going to sleep earlier.

37:26

Speaker A

was thinking about obviously the rise in melatonin gummies melatonin supplements I guess you could take before going to bed. And then you also have sleeping pills. Walk us through what's what's in sleeping pills versus melatonin gummies or or the sort. And what's your take on

37:42

Speaker A

And it was things like: as soon as you wake up, eat a large breakfast, go and get daylight first thing, exercise before midday, do not nap, take an earlier lunch, don't nap again in the afternoon.

37:58

Speaker A

world. And now here at least in America where it's not regulated by the FDA, you can go into a supermarket or a grocery store and down the sort of the health food section um there is this big sort

38:10

Speaker A

In the afternoon, start to get as much darkness as you can, meaning put shades on if you're going to be outside in the evening.

38:26

Speaker A

Kingdom, um, and I live just outside of San Francisco, it's 8 hours ahead. So I can use it to try to trick my brain into thinking, "Oh, it's nighttime on the first night I arrive in the UK." When in

38:39

Speaker A

Make sure that you eat at least 3 hours before you expect to go to bed, and then try to push your sort of alarm clock the next morning by about 1 to 2 hours.

38:53

Speaker A

the studies, melatonin will only increase the speed with which you fall asleep by about 2.2 minutes. And it will only increase the efficiency of your sleep by about 3.7%. Which isn't that much more above and beyond placebo. And the reason is

39:10

Speaker A

And they collected all of these different regimens, and sure enough, they were able to drag people back by a little bit over 1 hour, which sounds great.

39:24

Speaker A

participate in that sleep race. That's a whole different set of brain chemicals, which we'll come on to with sleeping pills. So, that's the reason that melatonin isn't a particularly effective sleep aid. It's the reason that you will never see people being prescribed

39:38

Speaker A

But the problem is these were extreme night owls who would prefer to go to sleep at, let's say, 1:30 a.m.

39:54

Speaker A

it may be a placebo effect. And by the way, the placebo effect is the most reliable effect in all of pharmarmacology. So maybe no harm, no foul. The only other caveats I would offer with melatonin first because it's

40:05

Speaker A

That means they're still having to go to bed biologically at 12:30 a.m.

40:19

Speaker A

based on what they said on the bottle versus what was actually in the pill. It ranged from about 80% less than what it said to 460% more than what it stated on the label. So it's a bit of a wild west.

40:33

Speaker A

It's not the 9:30 p.m. or the 10 p.m. that you would prefer.

40:46

Speaker A

phosphorolated about it. What's your take on the fact that when we're taking these, I guess, artificial supplements of melatonin that it depletes our body's ability to make it and regulate it at the right times that we actually need

41:00

Speaker A

And imagine trying to capitulate and adhere to that regimen for the rest of your life.

41:12

Speaker A

replacement therapy with exogenous testosterone, what we know is with certain forms of testosterone replacement therapy, after some period of time, the testes will stop producing their own testosterone. And even if you were to stop your exogenous injection of

41:30

Speaker A

So there is some wiggle room, it seems, that you can sort of manipulate.

41:47

Speaker A

and when they stop, melatonin production returns. So, it looks as though we don't have to worry. My worry though with those data when someone has sort of offered them to me is to say but most people in society they're not using

42:00

Speaker A

But in truth, I think what we have to try and do as best we can is to say, how can I align myself better with my biology?

42:16

Speaker A

meaning it's far higher than anything your body would naturally release so people are taking 5 millig 10 milligrams, maybe sometimes even 20 millig whereas what we would recommend in sleep medicine is somewhere around about one maybe maximum of 3 millig. So

42:33

Speaker A

When you fight biology, you normally lose.

42:49

Speaker A

probably 30 years ago looking at juvenile male rats meaning that they're going through that sort of adolescent phase and they were getting dosed with high amounts of melatonin and that high dosing of melatonin in the juvenile male rats actually stunted their sexual

43:05

Speaker A

And the way you know you've lost is disease and sickness.

43:20

Speaker A

would like you this evening to start dosing your children with a bioactive hormone." And it is a hormone that I would like you to dose your children with every night at maybe 5 to 10 times their natural release. And also, it's a

43:35

Speaker A

And that's what we see with night owls who are trying to sleep against their tendency.

43:50

Speaker A

there is that concern or not. I'm simply saying that if we don't know, my sort of suspicion, at least personally, would be I'd probably air on the side of caution, at least at this stage, particularly because the FDA recently released data

44:04

Speaker A

That said, though, is there a way that you can... I mean, "hack" isn't the right word, but there are ways that you can try to help yourself.

44:20

Speaker A

Again though, it's largely an inert compound. So I don't mean to be scaremongering here. Your second part of the question was sleeping pills and it it's a really interesting evolution. I think we're now at the stage of sleeping

44:33

Speaker A

So think about what you do in the morning that takes t

44:50

Speaker A

in the brain called GABA, which stands for gamma aminobuteric acid. Don't worry about the name. It's simply the red light stop sign for brain activity.

44:59

Speaker A

these things like Valium, they would go after the this GABA system in the brain and they would activate it and essentially just knock out your cortex.

45:09

Speaker A

And then the second generation of sleeping pills came along, the ambient lanesta sonatas of this world, they also go after that GABA inhibitory neurotransmitter system in the brain, but they just sort of tickle the receptor in the brain a little bit

45:24

Speaker A

differently. But for the most part, they are doing the same thing. And that's why we call them the seditive hypnotics because they are sedating your cortex. Now, if you take an ambient at full dose, I'm not going to argue that

45:38

Speaker A

you're awake. You're clearly not awake. But to argue that you're in naturalistic sleep, in some ways is an equal fallacy.

45:46

Speaker A

Because if I show you the electrical signature of your sleep with and without ambient, they're not the same. And in some ways, ambient will come in and it will take a bite out of the deepest of the deep slow brain waves of deep nonREM

46:02

Speaker A

sleep. Sort of this big dent that you see that happens. And so again, it's not necessarily to say that there isn't a time and a place for the use of those medications. Sleep medicine right now does recognize them as being useful

46:17

Speaker A

potentially in the short term to start to begin treatment for insomnia, but they are no longer the first line recommended treatment. And one of the reasons that in a book that I wrote where I was sort of I probably wasn't

46:32

Speaker A

overly enthusiastic about those web 2.0 sleeping pills, the ambience lenus and it was for several reasons. first because sedation is not sleep and when you take those medications you mistake the former for the latter but it's not natural sleep. We also know that those

46:50

Speaker A

sleeping pills have been associated with higher risks of mortality in certain forms of cancer. Now those associations we don't know necessarily that that's causal. But then there was another very interesting study where they looked at how sleep helps your learning and your

47:05

Speaker A

memory. And one of the incredible things about sleep is that it will take recently learned memories and that memory circuit in the brain sleep will strengthen the sinapses so that you come back the next day and that memory is

47:19

Speaker A

almost it's like hitting the save button on those memories. You cement it into the architecture of the brain. And they did a study where they dosed um animals after learning um a maze or different types of learning and they could measure

47:33

Speaker A

the strength of the memory circuit. And then they gave them natural sleep and sure enough the next day sleep had almost doubled the strength of the memory. Then they did a version where they dosed the animals with a body

47:44

Speaker A

appropriate amount of ambient and those animals slept longer. And you would think well if sleep is helping the memories and strengthening that memory circuit sleeping longer should lead to an even greater strengthening of the memory. Unfortunately ambient had

47:59

Speaker A

unwired the memory and it had actually reduced the strength of the memory by 50% 50. So to me that's just a demonstration that perhaps the the the quality of sleep is not a naturalistic quality of sleep and it may not

48:14

Speaker A

therefore be transacting the natural functions that sleep typically provides like learning in memory. There is a newer class of medications though out on the market and I think the the evidence right now is still early but so far I

48:30

Speaker A

actually think that they look really quite effective and again I think people had taken my stance to be I'm very anti-farmarmacology in general. I'm not I'm I'm very pro-farmarmacology if the pharmarmacology is good and not necessarily causing you harm. And these

48:48

Speaker A

new uh class of medications, they are called the Dora's drugs and it's D O R A small s and it's a class of drugs and there are currently three FDA approved.

49:00

Speaker A

Um probably the first one was called Bell Sombra. It's a play on sort of beautiful sleep and the actual chemical name is suvorex. These medications do something really much more elegant. the ambience and the lines as I said that's just a

49:15

Speaker A

seditive hit to the cortex. These new class of medications the doras they go after a wakeromoting chemical called ereexin. You can think of a rexin like the the wakefulness volume button. And when it's turned up, we're wide awake.

49:30

Speaker A

And these medications, they come in and they act like an additional set of chemical fingers and they just go after the volume button of wakefulness of a Rexin and they just dial it down and then they step back and they allow the

49:43

Speaker A

antithesis of wakefulness to come in its place, which is this thing called naturalistic sleep. And so I I think right now I'm probably more bullish on those medications. Again, a lot of water to pass under the bridge before we

49:57

Speaker A

understand them, but so far I think that they're a much more elegant and nuanced way of manipulating sleep. The other thing I would be remissed to mention is there is an alternative to these medications in general and it's called

50:09

Speaker A

cognitive behavioral therapy for insomnia or CBTI for short. It is just as effective as sleeping pills in the short term. But what's nice is that when you stop working with your therapist after maybe six or eight sessions, not

50:23

Speaker A

only do you with with a sleeping pill like ambient when you stop, you typically go back to the bad sleep that you were having or you actually have rebound insomnia where your sleep is even worse. But with a therapist,

50:36

Speaker A

they're giving you the tools and techniques. It's sort of the difference between, let's say, you know, giving a woman or a man a fish versus teaching them how to fish. This way you actually understand how to manipulate your sleep.

50:48

Speaker A

They give you the tools and then you can continue to sleep better for years later even after you've stopped utilizing the therapy unlike medications. So I would just say that that's a little bit about both melatonin the sort of the emergence

51:01

Speaker A

of these new flavors of sleep medications and then an alternative should people wish for that. Yeah, it's it's so worrying because I think we've got so used to treating our brain and our mind like technology and this desire

51:16

Speaker A

to just switch it on and off, power up, power down, power on, power off. It's almost like you don't ever really stop to think what's happening in order for that to happen. And I know I didn't for a long time where I grew up and you just

51:31

Speaker A

pop a well paracetamol from where we're from but Advil from you know in the US and you got a headache just take this it's gone you know you you can't sleep take this you fall asleep and you're not

51:41

Speaker A

really recognizing what's happening at a chemical level and how many consequences there are and what's what's actually happening beneath the scenes and I think it's so easy to forget because it's giving you the instant thing that you want in that moment but the kind of

51:57

Speaker A

circuit that it's kicking off or or closing down has far more long-term consequences that like you said we're not even aware of. It's sad and hard and difficult that wanting to get these natural things to happen that we are naturally wired to

52:15

Speaker A

do, right? These chemicals are being naturally produced and there are natural things we can do to boost those chemicals within ourselves that will hopefully get us to go to sleep as you talked about like seeing light first thing in the morning like you know be

52:28

Speaker A

being outdoor more reducing blue light in the evening reducing exposure to junk light as you called it in the evening.

52:35

Speaker A

I've definitely seen that one make a big difference. I'm someone who generally loves light. I really like being in bright places and my wife's the opposite. She knows she's very much like wants to follow the sun and so when it's

52:47

Speaker A

dark she'll be like all the lights have to be off in the house. And recently when we've been watching our shows we've been watching our shows in total darkness apart from the screen obviously and it's so natural for both of us to

52:59

Speaker A

just feel tired earlier and we'll be like all right time to go to bed. and we don't have our screen in our bedroom and so we'll finish watching whatever we're watching and we've sometimes we'll both even like you can tell we're just

53:11

Speaker A

falling asleep while watching we figure it out turn it off and go to our bed and and we're out to sleep and and just simply completely making it dark in the evening has had a huge huge impact on

53:23

Speaker A

honestly I I love that you bring this up and I would say to anyone listening if you're going to do anything with this podcast in terms of an actionable you event, just do this one thing for the next week. If you get the opportunity,

53:38

Speaker A

just do me this favor. Set a to bed alarm 1 hour before you would normally go to bed. And when that alarm goes off, shut down 50% if not 75% of all of the lights in your home. And then see how

53:53

Speaker A

sooperrific that will make you feel, how sleepy that you will make you feel. It It's really quite striking. And then don't just stop there. Do what I would call the off on off version of the experiment. So baseline, you're coming

54:08

Speaker A

in. You're normally leaving the lights on blazing. Now we go into the on version of the experiment, the intervention, which is darkness 1 hour before bed. And then after that one week, go back to doing what you used to

54:21

Speaker A

do. Keep all of the lights blazing for right up until you go to bed. And don't just ask the question, did my sleep get any better when I did the manipulation of 1 hour before bed, switch the lights

54:34

Speaker A

off? Ask the question, did my sleep go back to being actually worse when I returned to keeping the lights on. And so you show birectionality. And when you show birectionality, it's usually a much more powerful version of the experiment.

54:49

Speaker A

And if honestly you can say to me, it made no difference to my sensation of feeling drowsy and sleepy or the quality of my sleep, then no problem at all.

55:00

Speaker A

Keep doing what you're doing and it it just didn't work for you. That's fine, too. I I love what the advice you gave for people who are struggling with insomnia. For someone who's waking up, they they go to sleep for 3 hours, but

55:11

Speaker A

then they're up. they finally put themselves back to sleep after an hour and a half and they sleep for maybe another three hours and then they're back up again. Yeah. For that person, what's the most helpful way for them to

55:21

Speaker A

be able to fall back asleep in that moment? So, we've talked about the roots of the issues and and the core from the acronym, but what about that person who's just like, I just want to know how to get back to sleep for another 3, four

55:34

Speaker A

hours if I could. What's the quickest way I can do that? I would say there are three things to keep in mind here. When I often hear that description, people will say, "I always wake up at it's about 3:15 in the morning or it's 4:10

55:46

Speaker A

and it just happens so reliably." My first question to them is, "How do you know it's 4:00 in the morning?" That's your problem. You're looking at the clock and knowing that it's 3:15 or 4:00 a.m. in the morning does you no favors

56:01

Speaker A

at all. It's not going to change the outcome. So, the first recommendation is remove all clock faces from the bedroom.

56:08

Speaker A

It's okay to, if you really must do, keep your phone next to your bed, but keep it out of sight. Even though I would strongly recommend that you keep your phone in the kitchen or even better still, uh, a friend of mine recommended

56:20

Speaker A

recently, um, just put it in the garage. Put it in your car in the garage and that way it the amount of motivation, effort to go and get your phone within the first 10 minutes of the morning is

56:30

Speaker A

very, very high. Meaning, you're probably not going to do it. So, let's baby steps. Let's just say crawl, walk, run. First thing to do, just make sure you can't see any clock faces. And if you wake up, resist the urge because as

56:42

Speaker A

soon as you start doing that night after night, you're actually training your brain, reinforcing it to wake up at 3:15 in the morning. So, we've started that.

56:52

Speaker A

The next question is, well, what should you do about it? You know, don't tell me the fancy remove the clo at that point at night, either if you've woken up or you just can't fall asleep. It works for both of these. The

57:06

Speaker A

problem here is that you have to get your mind off itself because at that moment when you're awake, you start thinking, okay, I'm awake. This is now going to just obliterate my day tomorrow. It I've got that important meeting. I'm now going to

57:22

Speaker A

be underslept. At that point, the anxiety starts to begin. Then you start thinking, "Oh gosh, I remember now. I didn't do that one thing that I should have done for tomorrow morning and then I've got to do that thing for next week

57:33

Speaker A

and I also didn't do that thing last week for and again at that point that's going to keep you awake for the next 1 or 2 hours. So your job to try to get back asleep is to disengage the mind.

57:46

Speaker A

How do you do that? I would say there probably four or five different tools that you can use. The first is meditation.

57:54

Speaker A

It may be or may not be for you. But if you look at the data, meditation for sleep immensely powerful. If meditation is not your thing, just do something simple like breath work and you can just Google box breathing and anything like

58:08

Speaker A

that is great. You could also just do a simple body scan. Start at the top of the head, move down just and again Google body scan and you can start to train yourself to do that. The next thing you could do is listen to a sleep

58:20

Speaker A

story or just listen to a podcast. Make sure it's on a timed sort of shut off.

58:25

Speaker A

But again, all of these things common across all of them is you're getting your mind off itself. If I'm meditating, I'm not thinking about my worries. If I'm breathing, I'm focusing on the breath. If I'm doing some kind of a

58:40

Speaker A

relaxation, a body scan, again, I'm just moving through my body. It's very hard for me to think about my anxieties. If I'm listening to a sleep story, I'm engaging in the sort of the externality of the story, not my own internal

58:52

Speaker A

worries. And then the final thing that was done is great study done at UC Berkeley, not by my group. They found that taking yourself on a mental walk in hyperdetail was wonderful. So, let's say it's a walk that I take with my dog. And

59:07

Speaker A

you've got to remember it in high detail. So, I think, okay, I open the drawer. Which colored leash am I going to take? I'll take the blue one. clip it in with my right hand. With my left hand, I open the door, take a left down

59:17

Speaker A

the stairs, go. It's at that level of detail. And all of these things are taking your mind off itself because at that time of night, sleep is a little bit like trying to remember someone's name. Sleep is not something that you

59:31

Speaker A

make happen. Sleep is something that happens to you. And like trying to remember someone's name, the harder you try, the further you push it away. And it's only when you stop trying does it return to you. Absolutely. And that's

59:46

Speaker A

the same way with sleep. And normally if you engage in some of these methods and tools, the next thing that you remember is your alarm going off in the morning.

59:55

Speaker A

Why? Because you tuck your mind off itself. Totally. If that doesn't work and you are consistently waking up and spending long amounts of time in bed awake, then we may have to implement one of the methods in cognitive behavioral

60:10

Speaker A

therapy for insomnia, which is something called bedtime restructuring. It used to be called sleep restriction therapy. And for reasons obviously you can think it's not the best name where you come to me and say, "Look, I'm having real problems

60:24

Speaker A

getting enough sleep." Might say, "Great. We're going to do sleep restriction therapy." and you say, "No, no, wait, wait a second. You didn't hear me. I can't get enough sleep." And you're saying you're going to restrict my sleep. It's actually not sleep

60:34

Speaker A

restriction. It's time in bed restriction. So, you tell me, "Okay, I am in bed for 8 hours and I'm awake for 2 hours across the night. So, I'm only getting 6 hours of sleep, but I'm in bed for 8 hours." To me as a sleep

60:50

Speaker A

scientist, I then know we've got to constrain the time with which you are giving your brain the opportunity to sleep because your brain has become inefficient. It's like saying I go to the gym and I take an hour to work out.

61:04

Speaker A

But if you were to actually observe me, I'm actually only working out for about 25 minutes because, you know, at the end I finish my, you know, my last rep, then I do the 11th rep, which is I pick up my

61:14

Speaker A

phone and I start checking social media and then I'm talking to people and utterly inefficient. But then at some point someone says to me, "Look, today you've only got a maximum of 30 minutes in the gym and as soon as your 30

61:25

Speaker A

minutes is up, we kick you out." The first couple of days I'm still doing what I normally do and I get through maybe 15% of my workout because I'm not doing it efficiently. After a week of doing that, I now realize as soon as I

61:38

Speaker A

go into the gym, I put my phone down and I just go at it real hard and I still get my 25 minutes of workout in the 30 minutes. It's the same with sleep restriction. You tell me, okay, I'm in

61:49

Speaker A

bed for 8 hours and I only get about sort of 6 hours of sleep. Well, now I'm going to say I'm going to limit you and I'm going to take 1 hour of sleep away from you. You wake up at the same time,

62:02

Speaker A

but I want you to go to bed consistently 1 hour later, maybe even 1 and 1/2 hours later. You tell me I go to bed normally at 10 p.m. I say, "You are now not allowed to get into bed until 11:30 p.m.

62:15

Speaker A

Push through. I don't care." And then you've got to wake up at the same time.

62:19

Speaker A

And after about 3 or 4 days of this, your brain starts to build up. Now, the first couple of nights, you're still going to be sleeping bad. But then after a couple of nights, your brain starts to build up this starvation, this hunger

62:31

Speaker A

for sleep. It creates a sleep debt. And then after a while, it's like resetting the Wi-Fi button on your router. The brain thinks, gosh, I don't have the luxury of 8 and 1/2 hours of time in bed. I'm only allowed 6 and 1/2 now or

62:46

Speaker A

7. And now all of a sudden, it becomes incredibly efficient. You stop waking up in the middle of the night. If you do wake up, you fall back asleep very quickly and you end up getting maybe 6 and 3/4 hours of sleep within 7, whereas

63:00

Speaker A

you used to get 6 and 1/2 hours of sleep with 8 and 1/2 hours of time in bed. So, it's a quite convoluted method, but I would say I would use that as the last approach. Firstly, try to get your mind

63:12

Speaker A

off itself. If it's still not working, think about sleep restriction therapy. You can just Google it. It's pretty simple. Great advice. Thank you so much.

63:20

Speaker A

I love how tactical and practical you are. It's so helpful. Like I if there's anyone who's listening to this episode right now and you have a friend or a family member who's struggling with sleep, please pass this episode on

63:32

Speaker A

because I've never heard someone make it that granular as you are. Honestly, it's it's so brilliant and it's so helpful because it's so easy to get philosophical about these ideas and we all understand how important sleep is and how much we need it and and you

63:49

Speaker A

know, I can hear everyone going, "Yeah, but what do I do?" And and and you're really you've created a map for people.

63:53

Speaker A

So, thank you so much for Well, I think I was I was very guilty of doing this, you know, when I first came out a couple of years ago, speaking about sleep. I was speaking all about the science of

64:03

Speaker A

sleep and the bad things that happen about sleep. I think someone even said my TED talk which I think it was called they they name it sleep is your superpower or something should have really been called sleep or else dot dot

64:12

Speaker A

dot you know and it did people with insomnia no favors I I understand that now but I think what I've tried to do is people have said okay I get it sleep is important but how how do I get it and I

64:26

Speaker A

completely suffered what we call in neurology is hemi neglect one half of what I needed to do as a sort of a public intellect ual regarding sleep was missing, which is I was telling everyone how critical it was and the bad things

64:40

Speaker A

that happen when you don't get it, but I wasn't being very helpful cuz I wasn't telling anyone how it works and how, you know, where is the user manual for sleep? And that's what I'm now trying to do. So, thank you for saying that. I'm

64:52

Speaker A

trying to do a little bit better. Trying to do less bad. Let's just say that. No, it's coming across. Great. I want to move on to talk about caffeine and coffee. You spoke earlier. You said we should be having our last cup of coffee

65:05

Speaker A

or caffeine at 10 to 12 hours before we go to bed. Yeah. And when I was listening to that, I was like, I think a lot of people are not doing that. Like from what at least from the

65:16

Speaker A

conversations I'm having, I think people are having it much closer to bed or they're having so much that it's affecting their bed. If you had to tell people just a couple of things about caffeine or coffee and sleep, what what

65:29

Speaker A

would you want them to know? I think I would say that firstly caffeine has a halflife for the average adult of 5 to 6 hours which means that after about 5 to 6 hours 50% of the caffeine is still

65:41

Speaker A

circulating in your brain. That means that caffeine has a quarter life of 10 to 12 hours. So if you have a cup of coffee at noon uh 25% of that a quarter of that cup of coffee is still in your

65:54

Speaker A

brain at midnight. So, I don't think many of us would get into bed and sort of pour a quarter of a cup of coffee and then swig it and then, you know, put your head on the pillow. We understand

66:05

Speaker A

that that probably doesn't lead to good sleep, but in some ways that's not dissimilar to what you're doing if you have a cup of coffee at noon. Keep in mind, however, there is variability that some people have a faster capability to

66:18

Speaker A

metabolize or at least clear caffeine from the system. And you can do these genetic tests and um there's an enzyme called the CYP1 A2 gene and that will dictate the speed with it. It's sort of a liver enzyme, a cytochrome enzyme that will

66:34

Speaker A

speed or slow down and you will know if you're caffeine sensitive or not. So firstly, the timing of caffeine can be important. Also the dose. And that's why we've looked at people even if you just have one weekly sort of drip brewed cup

66:51

Speaker A

of coffee in the evening, let's say it's just 100 millig of caffeine, it will not necessarily prevent you from falling asleep as efficiently, but it will increase the chances with which you wake up. And if you wake up, it will increase

67:07

Speaker A

the duration with which it takes you to fall back asleep. And if it doesn't do that, it can also reduce down the depth of your deep sleep. And we know for example that it's during that deep sleep when your brain has a cleansing system

67:20

Speaker A

that washes away things like the Alzheimer's proteins, amaloid and ta protein. So you really would prefer not to try to degrade the quality of your deep sleep considering all that it does for your brain and your body. But in

67:35

Speaker A

some ways that's what many of us are inadvertently doing if we have caffeine too late in the day. I would say though that I've probably changed my tune a little bit on coffee. I would say drink coffee but the dose and the timing make

67:50

Speaker A

the poison. Try to as I said cut yourself off after about three cups of coffee and try to you know cut yourself off at least 10 hours you know as a rule of thumb before bed. The reason I

68:02

Speaker A

reverted back in some ways to say coffee is not necessarily a bad thing to drink.

68:08

Speaker A

If you look at the relationship between drinking coffee and the health benefits, they are non-negotiably astronomically impressive. Drinking coffee seems to be a very good thing. Now again, it's dose dependent. Once you get past about four cups of coffee, then it goes in the

68:26

Speaker A

opposite direction. It's not a good thing. And if you look at that list, and it is quite a list of health benefits and disease derisking that drinking coffee provides, and you compare that to all of the health benefits that sleep

68:40

Speaker A

provides, it's a remarkable overlap. So people were saying to me, how do you square that circle? Because that doesn't make any sense. Well, if you look at the data, the reason that drinking coffee is so beneficial is because the coffee bean

68:54

Speaker A

itself contains a whopping dose of antioxidants. And because in the western world, we're so deficient in our dietary intake of antioxidants, this one thing, the coffee bean, has been asked to carry the herculean weight of all of our

69:12

Speaker A

antioxidant needs. And therefore that's why drinking coffee has such a health predictive signal in the literature.

69:19

Speaker A

Case in point if you look at decaffeinated coffee has almost the same health benefits. So it's not the caffeine it's the antioxidants in the coffee bean itself. So again with all of these things with alcohol and caffeine I

69:35

Speaker A

am just a scientist. I have no right to tell anyone how to live their life and I don't want to be the healthiest person in the graveyard either. Life is to be lived for good, you know, dev for

69:47

Speaker A

goodness sake, live a little bit. All I simply want to do is empower you with the scientific evidence and then you can make an informed choice as to how you want to live your life. But does that help a little bit in terms of navigating

70:00

Speaker A

caffeine and Yeah, absolutely. Huge. And the other thing you mentioned at this point of the uh the acronym is alcohol and and you were talking about how just the negative effects of alcohol in terms of that disruption of our sleep. If

70:15

Speaker A

there were a couple of things you wanted people to know about alcohol and sleep, what would they what would they be?

70:19

Speaker A

Yeah, there I think I probably haven't changed my tune and I I don't see any upside in terms of alcohol for health or certainly for sleep. Alcohol is probably the most misunderstood sleep aid that there is out there. Unfortunately, it's

70:35

Speaker A

not an aid at all. Alcohol will hurt your sleep in at least one of three different ways. The first thing is that alcohol is also in the class of drugs that we call the sedatives. And again, when you have a couple of sort of night

70:50

Speaker A

caps in the evening, you say it helps me fall asleep. Alcohol is simply helping you lose consciousness more quickly.

70:58

Speaker A

it's not really putting you into natural sleep. The second thing is that alcohol will fragment your sleep in the first half of the night. And the reason that it does that is that alcohol will activate the fightor-flight branch of

71:13

Speaker A

the nervous system. Now, in the first half of the night, that's when we get most of our deep sleep. And when we go into deep sleep, we shift from the fightorflight branch of the nervous system over to what we call the

71:24

Speaker A

parasympathetic nervous system, which is this quiescent nervous branch. Now, alcohol will crank you back over to the fightor-flight sympathetic nervous system, which then makes your sleep, the depth of your sleep far more shallow, so you don't get as much deep sleep. You

71:41

Speaker A

wake up more frequently, but those awakenings are so brief that you never commit them to memory. M so you never think alcohol is harming my sleep by fragmenting it and sort of littering it with all of these awakenings. So your

71:54

Speaker A

deep sleep suffers, your sleep is fragmented. Then finally, alcohol is very potent at blocking your dream sleep or your rapid eye movement sleep. And dream sleep is critical for things like emotional and mental health. It's essential for creativity. It's also

72:10

Speaker A

important for hormonal health. It's during REM sleep when we release our peak levels of testosterone in both men and women. And alcohol will sort of shortch change you of that REM sleep. So on all of those counts, you know, I just

72:25

Speaker A

can't say in good conscience even a glass of wine with dinner, you know, is that okay? We can see the blast radius.

72:33

Speaker A

It is in some ways both a dose and also time dependent process such that if you have let's say a glass of wine with lunch versus a glass of wine with dinner, the glass of wine with lunch will have less of a damaging impact on

72:47

Speaker A

your sleep at night. So the completely politically incorrect thing that I would never say on a podcast would be go to the pub in the morning and that way the alcohol is out your system in the evening and no harm, no foul. But no, of

73:00

Speaker A

course I would never suggest something like that. But um yeah, what are you doing tomorrow morning now? I'm kidding.

73:06

Speaker A

Like you said, I think it's so easy for human just ideas that become prevalent in human society that we just take as being normal or habits and practices that become normalized over a certain period of time and we just start

73:23

Speaker A

operating like it's normal, it's okay, it's accepted and not really realizing what's going on. And and I'm also of the spirit of we should enjoy life and appreciate life and and everything else.

73:35

Speaker A

But I think to really appreciate life, it means to know what works for you and what doesn't and what helps you and what doesn't and and to really recognize the value of the impact of that. Because I think it's really easy to be like, "Oh

73:47

Speaker A

yeah, well, you know, let's just see how things go." And then all of a sudden you hear about a family member or a friend who gets a diagnosis and then that's when it kind of really hits you. And and

73:57

Speaker A

I've had that far too often where I've had friends and family members at young ages diagnosed with things and it's consistent with a habit. And by the way, sometimes someone gets something and it's got nothing to do with their habits

74:09

Speaker A

and it's bad luck and it's, you know, everything else. And both of those are positions to be compassionate and empathetic.

74:17

Speaker A

But I think when it comes to ourselves, I look at it and go, I would like it to not be my own fault. If it happens from something beyond me, great. But if I can avoid it by taking responsibility and

74:29

Speaker A

accountability for my health, then that's probably a good play and a good way to live. Yeah. I I like the way that you're thinking there in the sense that so many of us see sleep as a cost to our

74:41

Speaker A

lives. Yes. And instead, I think what we have to realize is think of sleep like an investment in tomorrow, not a cost of what I get for today. And you're right when you look at, you know, some of the

74:53

Speaker A

mentality of, you know, I'll sleep when I'm dead. I mean, firstly, what we know from the data is that if we adopt that mentality, you will be both dead sooner and the quality of your life will be significantly worse as a consequence.

75:07

Speaker A

But also if you look at the data between short sleep and cardiovascular disease, if you look at short sleep and certain forms of cancer, not all forms of cancer, short sleep and dementia um risk, imagine if you were to say in 20

75:22

Speaker A

years time when you're at the hospital and you've just lost a third of your heart function because you've had a massive coronary blockage. If I were to at that point say I could wave a magic wand right now in the hospital at your

75:39

Speaker A

bedside and if only you could go back 20 years and start investing in your sleep instead of maybe adopting what some not all people but some have this sort of almost this it's almost like a sleep machismo attitude. I think in certain

75:53

Speaker A

sectors of the workplace, we've got this competitive undersleeping, you know, mentality, the sleep braggadocio notion.

76:01

Speaker A

But I know no one who 20 years later in a hospital wouldn't say, "If I could go back and remove all of this cardiovascular consequence that you've just had by way of this heart attack, if only you'd gone back and started just to

76:16

Speaker A

try to invest even just five or six days a week in consistent good sleep, would you do it?" Most people at that point would say, "Absolutely. I wish I could take it back." But it's so hard for us

76:29

Speaker A

to prospect into the future and do backcasting. Many of us just can't do forecasting at all very well in terms of our health. So what do we do? We burn the candle at both ends. Also, I think it's not anyone's fault regarding this

76:45

Speaker A

global sleep loss ep epidemic and this it isn't consistent sort of sleep neglect because firstly I think society is conspiring against us to get sufficient sleep because sleep has this image problem. We think of people who get sufficient sleep as slothful, as

77:01

Speaker A

lazy. That sleep, whoever the PR agent for sleep has been, we probably should have fired them long ago because you're the new agent, but I'm going to try and push back at least. But also from a perspective of someone who doesn't know

77:14

Speaker A

anything about sleep, I would just think, well, my body is at rest, my mind is dormant, like how much danger is there really in losing one hour of of sleep or even two hours of sleep? Surely there's not much danger. It can even

77:29

Speaker A

actually change your very nucleic alphabet. So I'll tell you about a fascinating study that impressed upon me the importance. They took perfectly healthy individuals and they limited them to 6 hours of sleep a night for one week. By the way, 6 hours of sleep a

77:44

Speaker A

night for one week is actually what many people are getting in society. At least a third of the population seems to be getting 6 hours or less during the week.

77:53

Speaker A

So it was a very sort of ecologically relevant experiment. And then they measured the change in their gene activity profile relative to when those same individuals were getting a full 8-hour night of sleep. And there were two key findings. First, a sizable and

78:09

Speaker A

significant 711 genes were distorted in their activity caused by that 6 hours a night of sleep. If that wasn't impressive enough, the second was that about half of those genes were increased in their activity. The other half were decreased.

78:26

Speaker A

Now, the genes that were increased in their activity were genes that were associated with biological stress and cardiovascular disease, genes that were associated with the promotion of tumors, and genes that were associated with long-term chronic inflammation within the body. Whereas those genes that were

78:45

Speaker A

actually switched off or turned down were genes associated with your immune system. And so to me, what that demonstrated was that there's no aspect of our wellness that can retreat at the sign of sleep deprivation and get away

79:01

Speaker A

unscathed. That it's almost like a broken water pipe in your home. that sleep loss will leak down into every nook and cranny of your physiology and even tamper with the very DNA alphabet that spells out your daily health

79:16

Speaker A

narrative. And so why if you didn't know that evidence, why would you think that sleep is so necessarily important if I just as a lay public person would be thinking, well, my mind's dormant, my body gets a bit of a rest. Well, I can

79:31

Speaker A

rest when I'm watching Netflix. body gets plenty enough rest there, so I don't need my sleep. But if you think about it, sleep is the most idiotic of all evolutionary creations. You know, finding a mate, you're not reproducing,

79:44

Speaker A

you're not caring for your young, you're not foraging for food, and worse, you're vulnerable to predation. Sleep should have been strongly selected against during the course of evolution if it wasn't important. It is absolutely important. It serves a constellation of

79:59

Speaker A

different vital functions for brain and body. But if I didn't know about them, of course, I'd neglect my sleep. So, I'm simply saying that to both impress the importance of sleep, but also try to be compassionately sensitive to why I

80:13

Speaker A

understand people neglect it, not because they're trying to show how brave and tefloncoated they are. It's just because no one understands sleep. So, that's why I've tried to sort of make it in part a mission for life is sleep has

80:27

Speaker A

been the the neglected stepsister in the health conversation of today. We speak a lot about diet and exercise and that's great. And because of people like you, I think we're speaking so much more about emotional and mental health, which to me

80:39

Speaker A

is the fourth pillar of life and health. Sleep is one of those pillars, too, though. So, hopefully this helps a little bit. No, it's brilliant. Matt, I think you are the best PR agent that sleep could ever ask for. I think your

80:52

Speaker A

method of communication, the empathy and compassion that comes with it, the lack of judgment and and at the same time waking us up to the reality which I think is an important part of the narrative comes across extremely clearly

81:06

Speaker A

uh and I'm so grateful and I hope you'll come back on many many times to deepen this discussion to extend it. There's so much we didn't even get to today, but we end every OnPurpose episode with a final

81:18

Speaker A

five. And these have to be answered in one word or one sentence maximum. But I know I'm going to break that rule with you already. Uh so the first question is, what is the best sleep advice you've ever heard, received, or given?

81:32

Speaker A

Regularity digital detox. Going to bed at the same time, waking up at the same time. Do that. So many other things like quantity and quality will fall into place. And then the second is as much as you can in the last hour before bed try

81:49

Speaker A

to stay off your phone and in the morning give yourself 10 minutes. Why? Because what we do is we train oursel.

81:57

Speaker A

What's the first thing that most people do when they wake up? They open their phone. Yeah. And there's this way the tsunami of anxiety comes flooding in every day. You are training yourself when you go to bed at night to expect

82:10

Speaker A

that huge wave of anxiety when you wake up. It's what we call anticipatory anxiety. And most people will have had this. You have an early morning flight and you know you've got to wake up for it. It's essential. And you also know

82:24

Speaker A

that your sleep that night will be so shallow and so sort of dimminionative early. Well, this is a diet version of that, but every single day by way of swiping open on your phone next to you, just give yourself 10 minutes in the

82:39

Speaker A

morning. I promise your sleep will be better. So, regularity digital detox. I love it. Uh, question number two. What's the worst sleep advice you've ever heard, received, or given? That you can make up sleep at the weekend. You can't

82:52

Speaker A

accumulate a debt and then hope to fully pay it off at the weekend. And there's some great evidence looking at all sorts of brain and body metrics that for the most part, some of them you can kind of

83:04

Speaker A

sleep back at the weekend, but for the most part, when you look at your cardiovascular system, your metabolic system, your immune system, your hormonal system, if you look at your brain processes, your cognition, your emotional um stability or instability,

83:18

Speaker A

all of these things do not fully recover by weight of weekend sleep. So, you can't do this binge purge process. So I would say that the myth of makeup sleep is unfortunately just that that it's not like the bank. Yeah. So you just have to

83:35

Speaker A

get into a good rhythm and a good pattern and invest in it. It's just it's never if if it was like that trust me you know mother nature would have figured out a way to have us short sleeping all the time because it's sleep

83:46

Speaker A

is so deletarious to any organism. And if there was a way to short change, we would have been shortch changing long ago and it would be baked into our sort of sleep DNA biology. The fact that it's not that human beings are the only

84:01

Speaker A

species that will deliberately deprive themselves of sleep for no apparent good reason is testament to the fact that you just can't make it up like that. The system doesn't work like that. Question number three, how does what does bad

84:13

Speaker A

sleep do to your mental health? Firstly, you become much more emotionally erratic. You become pendulum like you.

84:21

Speaker A

Why? Why is that? Yeah. Part of the reason is because there is a part of your prefrontal cortex right down in the middle. So my prefrontal cortex sits right above my eyes. It's the most evolved part of our sort of homminid

84:33

Speaker A

brain. It's what makes us human beings. That middle part of the brain acts like almost a brake pedal on our emotional accelerator regions deep in the brain.

84:44

Speaker A

And when we are underslept that part of the brain gets shut down. So now we become all emotional gas pedal and too little regulatory control break as it were and that's why we become so reactive. We become you know it's that

85:01

Speaker A

um I just snapped dot dot dot fill in the blank when I am underslept. So firstly our regulation of our emotions becomes impaired as a consequence.

85:12

Speaker A

Secondly, the anxiety centers of the brain can become 30 to 40% more reactive when we're not getting sufficient sleep.

85:21

Speaker A

You can flip that narrative then and say, well, if that's the bad that happens when I take sleep away, what is it about sleep when I do get it that is beneficial? And what we've discovered is that it's REM sleep or dream sleep that

85:35

Speaker A

provides a form of almost overnight therapy. Dream sleep is emotional first aid. And it's during dream sleep that your brain takes those painful, difficult experiences and acts almost like a nocturnal soothing balm and it just takes the sharp edges off those

85:53

Speaker A

painful difficult experiences so that we come back the next day and we feel better about them. It's that idea of it's not time that heals all wounds.

86:04

Speaker A

It's time during sleep and specifically dream sleep that provides emotional convolescence. And there's a wonderful gosh I wish I'd come up with this quote by an American entrepreneur e Joseph Kosman and he once said that the best bridge between despair and hope is a

86:22

Speaker A

good night of sleep. That's exactly what dream sleep provides. Yeah. If you love your family, the best thing you can do is get a good night's sleep. When you have had a good night of sleep, I think we all sense this. You wake up and you

86:36

Speaker A

are dressed in a different set of psychological clothes. Absolutely. It's almost as though sleep provides this sort of emotional windscreen wiper benefit and we can see clearly. And I to me that's I think one of the most powerful aspects. Sleep gives me back

86:54

Speaker A

the rose in the tint of my world view glasses every single morning. I I mean I I experience that all the time. I know what I can be like if I haven't had a good night's sleep. Yeah. You know, I'll

87:05

Speaker A

sometimes say that to my much better half. You know, when I wake up, I'll say to her, "Look, you know, darling, I am I am so sorry. I didn't sleep well last night. I am not the best version of

87:15

Speaker A

myself for whatever I do today, whatever idiocy that I, you know, enunciate or behave in." Yeah. Please forgive me and I will make sure that I will do all the dishes for the next two months. Yeah.

87:28

Speaker A

Sleep affects our our emotional relationships, our intimacy, everything. Uh, question number four. I I have something in my mind. I was going to ask you, what have you seen as being a surprising connection that's connected to sleep? Something that sleep impacts

87:44

Speaker A

that surprised you, something a bit that we might not have heard of. We've done some studies looking at what I would think of as more complex pro-social behavior. And what we found is that a lack of sleep will immediately make

88:00

Speaker A

someone become more asocial, meaning that they withdraw socially. They do not wish to have the contact with other people that they typically do. They become therefore more isolated. They feel more lonely as a consequence. And we know that there is this epidemic of

88:18

Speaker A

loneliness happening. We didn't realize how much a lack of sleep was contributing to that. Worse still, when you interact with someone who is sleepd deprived and you are well-rested, having had that interaction with the sleep-d deprived person, when we ask that

88:35

Speaker A

person, do you feel any more or less lonely in this moment? They rate themselves as now feeling more lonely themselves having interacted with a sleepd deprived individual. In other words, the loneliness that a lack of sleep creates is contagious and it is

88:52

Speaker A

transmitted from one person to the next. The second thing that we looked at was perhaps one of the most fundamental components of us homo sapiens, which is that we help each other. It's what we call pro-social behavior. And I cannot

89:10

Speaker A

imagine any modern civilization that has emerged without pro-social helping between individuals. It's a fundamental ingredient. We help each other. And what we found is that when you are underslept, you withdraw your natural tendency to help other human beings. We

89:31

Speaker A

observed it at the level of me helping other people. We observed it at the level of entire groups helping each other and we also found it across entire nations. And you think how do you figure that one out? There is a global

89:48

Speaker A

experiment that's performed on 1.6 billion people across 70 countries twice a year and it's called daylight savings time. And what we did, we looked at the national donation database across the United States, which is in some ways a

90:02

Speaker A

measure of selfless giving. I give to charity. I give to other people. And what we found is that in the days after the spring daylight savings time, when we lose 1 hour of sleep, there was this huge dent in proactive giving by way of

90:21

Speaker A

donations to charities. We become more stingy. we become more self-centered. So I would say that it's this new wave of sleep science that goes beyond the DNA nucleus that we spoke about. It goes beyond cells. It goes beyond

90:35

Speaker A

physiological systems. It goes beyond entire brain networks. It goes beyond the organism themselves. It now translates to a lack of sleep impacting our inter relationships and impacting the very fabric of society itself. That to me has been stunning and quite the

90:54

Speaker A

surprise. That Yeah, that is a surprise. I was not expecting that. Yeah. Uh, fifth and final question. We ask this to every guest who's ever been on the show.

91:02

Speaker A

Matt, if you could create one law that everyone in the world had to follow, what would it be? Self forgiveness. Why?

91:10

Speaker A

Because I think that there is so much ill grace that is enacted by ourselves on others because we are not good with ourselves that it makes me sad at sometimes. And I think so much of what we react to others is really about a

91:31

Speaker A

mirror being held up to ourselves and the pain of that that if we just let go and gave ourselves self-compassion and self forgiveness, society would be, I think, demonstrabably, which is to say demonstrabably better as a result. In

91:49

Speaker A

truth though, that's probably me just holding a mirror up to myself to your question. Beautiful. Uh, Matt, thank you so much for your incredible work, uh, incredible sharing of insights today and I really hope you'll come back for

92:03

Speaker A

another episode because I have another million questions to ask you. Uh, thank you so much. I'm so grateful for your time and energy. I hope everyone who's been listening and watching back at home, at work, whether you're on a hike,

92:14

Speaker A

whether you're with your dog, whether you're on driving right now, wherever you are, I hope that you will find it possible to try some just one. And even if you just try one of Matt's suggestions today, I really truly

92:28

Speaker A

believe your life will change. And as Matt said, it will impact all other areas of our lives. Please prioritize your sleep and uh watch how your life changes. Uh thank you so much, Matt.

92:39

Speaker A

Thank you. And can I just say thank you to you for what you do for society. You have dedicated yourself to the wellness and the health of the rest of humanity.

92:50

Speaker A

But what I see as a big differentiator is that you have a very genuine passion for doing this. You mean it when you say it. Thank you. And I think that's why in part you've had just this incredible

93:04

Speaker A

impact on society. Authenticity is a very rare thing. And as human beings, we're actually very good at identifying it and also identifying its absence. And one of the reasons that I just have such admiration for what you do is not just

93:19

Speaker A

that what you're doing is an incredible service, but the authentic way that you're doing it because you genuinely mean it is something that I think is a remarkable beauty to behold. So for all that you do for society, thank you so

93:34

Speaker A

much. Well, thank you, man. That's extremely gracious and kind. Genuinely, that touched my heart. Thank you so much. Thank you. If you love this episode, you'll enjoy my interview with Dr. Daniel Aemon on how to change your life by changing your brain. If we want

93:49

Speaker A

a healthy mind, it actually starts with a healthy brain. You know, I've had the blessing or the curse to scan over a thousand convicted felons and over a hundred murderers, and their brains are very damaged.

Topics: sleep sleep health Matt Walker Jay Shetty chronotype sleep quality circadian rhythm sleep apnea sleep deprivation QQRT

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