Speaker 1: Hi, Hi, It's twenty twenty two. Me up top, letting
Speaker 1: you know that this is an encore of a pair
Speaker 1: of episodes. Everyone needs and I really needed some time
Speaker 1: to be with my family after my dad's brain surgery.
Speaker 1: I'm back up north and I'm recording this at my
Speaker 1: sister's dining room table with Jarrett nearby. And there is
Speaker 1: a fresh update on how we are doing at the
Speaker 1: end of the episode for anyone who's been following along
Speaker 1: with our word family stuff. So thank you so much
Speaker 1: for all the love and sport. Thank you for just
Speaker 1: keeping us in your big brains in your hearts. Okay, Sleep,
Speaker 1: Oh hey, it's your little step brother who tries to
Speaker 1: trade you their calcified banana flavor now and later is
Speaker 1: for your Mini Reese's peanut butter cups. And you're like,
Speaker 1: little dude, step all the way off. That's not how
Speaker 1: life works. Ali, board back for another episode of Ologies.
Speaker 1: So this is coming out in October. So let's get
Speaker 1: deep into something that happens usually in the dead of night.
Speaker 1: If you're lucky, Sleep, you do it every day or
Speaker 1: night probably, and it should be an exercise in comfort
Speaker 1: and restoration and flirting with Death's hotter friendlier twin. But
Speaker 1: just looking at the word sleep probably made your bewels
Speaker 1: drop with dread because you know you're screwing it up
Speaker 1: a little bit. We kind of all are so in
Speaker 1: the next two episodes. That's right, Part two with your
Speaker 1: Questions comes out next week. We are gonna go head
Speaker 1: to head with the Sandman, but first let's get ready
Speaker 1: for bed. A little business. First things first, Happy happy
Speaker 1: birthday to my amazing mom Nancy Ward, who's so funny
Speaker 1: and so smart and inspiring and accepts me even though
Speaker 1: I swear like filth on this podcast. She also gave
Speaker 1: me the best care for insomnia. It has never failed me.
Speaker 1: We don't talk about it in part one of this
Speaker 1: Sleep episode, so you're gonna have to wait until part
Speaker 1: two next week. But it is an actual life saver.
Speaker 1: I can't wait to tell you Happy birthday.
Speaker 2: Mom.
Speaker 1: Me and my sisters and pop love you you a bunch.
Speaker 1: So thank you also to the patrons at patreon dot
Speaker 1: com for donating as little as one shiny American quarter
Speaker 1: an episode to help fund the show. And thank you
Speaker 1: to all who are sporting ologies weares from ologiesmerch dot com.
Speaker 1: And thanks to the people who post on Instagram and
Speaker 1: tweet about it. You can tell a friend, you can
Speaker 1: tell a foe I don't care. You can scream into
Speaker 1: the night about it and rate and subscribe and review.
Speaker 1: That all helps get the show in others' ears. And
Speaker 1: very often you make my day with your nice words
Speaker 1: in the reviews. So like a sucubus, I pluck one
Speaker 1: every week to read from the bunch, And this week
Speaker 1: Teapath says ten out of ten would look like a
Speaker 1: complete nutjob scream crying and laughter about sharks in my
Speaker 1: car again, So thank you, please continue Tepath to do that.
Speaker 1: And thanks to everyone who left reviews that I savored
Speaker 1: individually over a cup of herbal tea this week. I
Speaker 1: just appreciate them so much. Okay, somnology very much a thing.
Speaker 1: It's the study of how we sleep. And I looked
Speaker 1: up the etymology of it just after I wrote that
Speaker 1: intro and Holly smokes you guys. Somness is the Roman
Speaker 1: god of sleep and yes, the brother of death. I
Speaker 1: had no idea when I wrote that a few minutes ago,
Speaker 1: so there you go. Also, Somnos probably a remake of
Speaker 1: the Greek myth of Hypnos, who was the Greek god
Speaker 1: of sleep, also the half brother of Thanatos death. So
Speaker 1: Hypnos lived in a dark grotto in the underworld. What
Speaker 1: a bachelor, but was kind of a helper of humans.
Speaker 1: He was a good dude. His dad was Darkness and
Speaker 1: his mother was nix or night, and even Zeus was
Speaker 1: afraid of her. Zeus was like, damn, lady, you're kind
Speaker 1: of a bitch. But I respect that. And so somnology
Speaker 1: is the study of the god that comes in darkness
Speaker 1: to incapacitate and recharge us, and it seems to vex
Speaker 1: us more and more. So, Yes, we have cars and antibiotics,
Speaker 1: but when it comes to sleep, we're kind of boning ourselves. Fam.
Speaker 1: So in this two parter episode, I'm determined to help
Speaker 1: fix your sleep, And by your I mean are I
Speaker 1: appall my own friends physicians, I appall my own fitbit
Speaker 1: with my poor sleep habits, and as a result, I
Speaker 1: sometimes forget which month it is, and I have eaten
Speaker 1: more stickers on produce than you need to know about.
Speaker 1: So you're gonna learn the difference between deep sleep, light sleep,
Speaker 1: rem sleep. What aspects of sleep hygiene are important, The
Speaker 1: root of insomnia how much sleep you really need, if
Speaker 1: you should go somewhere to get wires taped to your
Speaker 1: head while a stranger watches you, and how to help
Speaker 1: the molecular janitors that live in your skull. This guest
Speaker 1: has been called the sleep Whisperer and works with professional
Speaker 1: athletes and normies alike to perform better and to remedy
Speaker 1: their sleep issues. He has literally written the book on sleep.
Speaker 1: It's called The Sleep Solution. Why Your Sleep Is Broken
Speaker 1: and How to Fix It. He's based in Virginia. He's
Speaker 1: the owner of the Charlottesville Neurology and Sleep Medicine Clinic.
Speaker 1: So we scheduled this interview months in advance for a
Speaker 1: time he was going to be in southern California to
Speaker 1: give a talk. We met up at a hotel and
Speaker 1: I barraged him with so many questions that he was
Speaker 1: held physically captive answering them for me for close to
Speaker 1: two hours, and I was like, yes, double episode, So
Speaker 1: get cozy, zip up your onesies, and get ready for
Speaker 1: part one with the gently southern voiced dulcimer wisdom of
Speaker 1: neurologist and somnologist doctor William Chris Winter. You are a neurologist.
Speaker 1: But you're also a somnologist, correct because you study sleep?
Speaker 2: Correct?
Speaker 1: Why sleep for you? Because I read your book, which
Speaker 1: is great. Your book is, by the way, so funny.
Speaker 1: I was like, oh my god, this is keeping me
Speaker 1: up because it's so funny. Why and you mentioned the
Speaker 1: book that you like sleep when you're a good sleeper.
Speaker 1: So what drew you to this field if you have
Speaker 1: no problems in it?
Speaker 2: So what drew me to the field is just because
Speaker 2: I have a problem with it, doesn't I don't love it?
Speaker 2: Number one? Okay, number two. I came into the field
Speaker 2: completely accidentally. I decided around third grade that I would
Speaker 2: become a doctor. And I'm pretty certain that there was
Speaker 2: a phenomenon going on. My parents were both the first
Speaker 2: people and their families I believe to go to college
Speaker 2: on both sides.
Speaker 1: So doctor Winter says that he didn't grow up in
Speaker 1: a family of academics, but that his appellation me Ma
Speaker 1: and Papa supported big dreams for little Whooper Snappers.
Speaker 2: We go out and visit Roommamo on Grandpa and the
Speaker 2: remote reaches of West virgin If you told them that
Speaker 2: you would be a doctor, they would give you, you know,
Speaker 2: a quarter and some candy. So I think very from
Speaker 2: a very young age, I realized if I tell Papol
Speaker 2: that I'm going to be a doctor, he gets really excited.
Speaker 2: He calls Mamma in I get some candy and some money,
Speaker 2: and this is awesome. So I think that that probably
Speaker 2: had a big role in shape. So I want to
Speaker 2: be a doctor. I didn't really want to be a
Speaker 2: sleep doctor or neurologist, but I started doing research in
Speaker 2: sleep just to get beer money and biology credit hours
Speaker 2: as an undergraduate.
Speaker 1: So quick question, how much does this pay? According to
Speaker 1: one USA Today article I read, about one hundred and
Speaker 1: fifty bucks a day is the going rate for research studies,
Speaker 1: but there are accounts of folks making over three grand
Speaker 1: for a nine day sleep study. But based on the
Speaker 1: fact that the article was titled quote how to get
Speaker 1: paid to sleep, I'm guessing that the job competition might
Speaker 1: be stiff, like grueling, farting, and unconscious but stiff.
Speaker 2: Yeah, guy said here, they'll pay you to do some
Speaker 2: research and you can get some cool thing for your
Speaker 2: med school resume. So it was just completely accidental. But
Speaker 2: the field is fun, the people within it are inviting.
Speaker 2: It was a new field so anything you sort of
Speaker 2: dreamt up had never really been looked at before.
Speaker 1: At what point did you get to start doing research
Speaker 1: on humans? And what was your end goal? Did you
Speaker 1: want people to sleep better and thus be happier? Like
Speaker 1: what did you want to do as a neurologist?
Speaker 2: Sure, so that was my undergraduate experience. From there, I
Speaker 2: went to medical school down at Emory and was introduced
Speaker 2: to Don Blywise and David Raye, who were sort of
Speaker 2: they run the sleep center down there. Now, when I
Speaker 2: was an undergraduate, I was working at a sleep that
Speaker 2: was mainly pulmonary, looked at breathing. These gentlemen were more
Speaker 2: neurology oriented. So that was my first taste of neurology.
Speaker 2: I really thought that, you know, the brain was really cool.
Speaker 2: So I would go to medical school during the day
Speaker 2: and then at night I would run these studies. One
Speaker 2: of them was and so this is when I first
Speaker 2: started interacting with real human subjects. One was the idea
Speaker 2: of if you pull all night, or and stay up
Speaker 2: all night, or if you have a night where your
Speaker 2: sleep is fragmented, like being on call or something of
Speaker 2: that nature. How was that? No, No, No, it's d no, Yeah,
Speaker 2: I'm sure it is. I've heard all about you. You've
Speaker 2: got a lot going on. Worried about you, Ali. So
Speaker 2: so the question was, how is that affecting our brain's
Speaker 2: blood flow in the morning. So we would bring my
Speaker 2: A lot of these were my friends. There were medical
Speaker 2: students who were looking for a little bit of money,
Speaker 2: and I would say, hey, you should come do the
Speaker 2: sleep study. So the sleep study consisted of three nights.
Speaker 2: The first night you would sleep normally. The second night
Speaker 2: you would not sleep at all. The third night we
Speaker 2: would fragment your sleep. And the way we did that
Speaker 2: was we had these little C three po alarms that
Speaker 2: made this unbelievably grating sound that right away.
Speaker 1: Oh my god, that is the worst. I'm so glad
Speaker 1: I looked this up and.
Speaker 2: We had them bolted underneath the subject's bed. And so
Speaker 2: my job was on the fragment On the sleep deprivation night,
Speaker 2: I just had to make sure they were doing whatever
Speaker 2: they wanted to do. They couldn't sleep on the fragmented night.
Speaker 2: I had to watch them and every time they would
Speaker 2: fall asleep, I would give them five you know, five minutes,
Speaker 2: and then we would start sounding the alarms so they
Speaker 2: would get little five minute chunks of sleep throughout the
Speaker 2: entire night. And the funny thing was, all my friends
Speaker 2: would make these big arrangements for the sleep deprivation night,
Speaker 2: but for the fragmented night. They're like, so I get
Speaker 2: to sleep, right, I'm like, yes, you do. But as
Speaker 2: soon as you fall asleep, you'll sleep for a little while.
Speaker 2: Then we're gonna wake you up, but you can go
Speaker 2: right back to sleep. After that. They would make arrangements
Speaker 2: for that. They were a mess after those studies. One
Speaker 2: guy actually woke up and walked out of the sleep
Speaker 2: center with all the wires hooked to him and it
Speaker 2: was trying to get into his car. He had no
Speaker 2: idea what he was doing. Another person actually got up
Speaker 2: and went to the bathroom hooked up with everything. It.
Speaker 2: It was just they were absolutely hysterical. And what we
Speaker 2: found was it was much more dangerous from a blood
Speaker 2: flow perspective to have fragmented sleep than it was to
Speaker 2: actually to stay up. In fact, when you stood, when
Speaker 2: you stayed up all night and never slept for the
Speaker 2: first few hours of the morning, your brain blood flow
Speaker 2: was really happening. It was really so I think that's
Speaker 2: that sort of the background and you pull an a lighter
Speaker 2: for a test. The next day, you feel kind of
Speaker 2: euphoric for a while, and then you.
Speaker 1: Crash so real quick, as if being a walking skeleton
Speaker 1: covered in raw hamburger isn't chilling enough. Just please take
Speaker 1: a moment to remember that the thought sponge nested in
Speaker 1: your skull is soaked in blood. So during some stages
Speaker 1: of sleep the blood volume goes down, but in rem
Speaker 1: it can be engorged with more blood than when you're awake. So, yes,
Speaker 1: you're snoozing and your brain has a dream boner unless
Speaker 1: some factor screws it up like a creep in a
Speaker 1: lab coat with a C three po alarm clock.
Speaker 2: But that fragmented night, and when you think about that
Speaker 2: in relation to people who are on call or a
Speaker 2: new mother with the baby that's crying out throughout the night,
Speaker 2: it's a real risk factor potentially for things like stroke.
Speaker 2: So just not a healthy situation to be in. Oof.
Speaker 1: Do you have kids?
Speaker 2: I have three? Yes? How did you.
Speaker 1: Did this affect you? Because it's not just new mothers?
Speaker 1: I imagine think you got to get like Papa's got
Speaker 1: to get up too, right.
Speaker 2: Papa does, and Papa was this papa. I was always
Speaker 2: I always felt so not helpful and somewhat inadequate during
Speaker 2: the whole situation that I would always get up. Even
Speaker 2: when our first child, my daughter, was born, when I
Speaker 2: was a third year medical student, I would get up
Speaker 2: and just sit with my wife while she nursed, because
Speaker 2: I felt like, Okay, well, you go take care of
Speaker 2: this creation I put inside of you, and I'll be
Speaker 2: getting some sleep over here. So I felt really guilty
Speaker 2: by that, even though I would often kind of, you know,
Speaker 2: nod off as we were talking. And the guilt really
Speaker 2: started from the birth of my daughter. At one point,
Speaker 2: I fell asleep during life and my wife said, did
Speaker 2: you just fall asleep? I said, And this is what
Speaker 2: I said. I was so sleep deprived from being a
Speaker 2: medical student. I said something like, I just didn't know
Speaker 2: it was going to take this long. Oh sorry, those
Speaker 2: are those words that leave your mouth and you're trying
Speaker 2: to grab them as they leave to shove back in
Speaker 2: your face. And so I think that part of the
Speaker 2: guilt stem from that comment.
Speaker 1: So oh, and I imagine also as a med student,
Speaker 1: I feel like there's no one who is more sleep
Speaker 1: deprived than a medical student, like you have these insane
Speaker 1: long shifts and hours and then it's like, Okay, you
Speaker 1: haven't slept in thirty six hours. Fix this person so
Speaker 1: they don't die.
Speaker 2: Correct. So, yes, we were very sleep deprived. It's not
Speaker 2: an accident that a lot of mistakes are making made
Speaker 2: because of sleep deporation in hospitals. At one point, I
Speaker 2: was at a computer entering in medications for a patient
Speaker 2: and I got a call at on the phone right
Speaker 2: next to me, and I picked it up and this
Speaker 2: woman said, who is this? I said, this is doctor Winner.
Speaker 2: Who's this?
Speaker 1: She?
Speaker 2: This is phill Us in the cafeteria. Why are you
Speaker 2: sending us medications through the cafeteria pathway? So I had somehow,
Speaker 2: in my sleep deprived haze, gotten into the completely wrong
Speaker 2: system on the computer and instead of sending dietary orders
Speaker 2: to the cafeterias, putting all their medications through there, which
Speaker 2: is fortunately didn't hurt anybody. But I had no idea
Speaker 2: what I was doing. Just like.
Speaker 1: Gone with in its like exactly, poppy seed klonopin.
Speaker 2: That's right, that's good for you. These are great, It's
Speaker 2: really I'm sure this would sell really well. Actually, I think.
Speaker 1: Now, tell me a little bit about what is sleep.
Speaker 1: I mean, that's like the golden question, because it does
Speaker 1: seem crazy that for eight hours of the day we
Speaker 1: just kind of semi die. It seems we're so vulnerable
Speaker 1: to predation, we just clock out. Like what what is
Speaker 1: sleep exactly?
Speaker 2: Yeah, I don't think people really know. I mean, there's
Speaker 2: all kinds of theories in terms of sleep being something
Speaker 2: important for energy balance. There's a metabolic sort of pathway
Speaker 2: that sleeps very important for you know. We get some
Speaker 2: insight into the answer that question if we look at
Speaker 2: sleep deprivation models where you take something. You know, they
Speaker 2: used to put these little mice on these rotating platforms
Speaker 2: over water, and if they fall asleep, the platform would
Speaker 2: rotate and push them into the water, which he really
Speaker 2: didn't like. And so you found that after a very
Speaker 2: short period of time, there's a lot of brain dysregulation
Speaker 2: that starts to happen, particularly with the brain. It's regulation
Speaker 2: of our cardiovascular system. Our body temperature gets really screwed up,
Speaker 2: we have difficulty fighting infection, and generally organisms die fairly
Speaker 2: quickly with sleep deprivation. So I don't know that we
Speaker 2: necessarily know exactly what it is, but it's a very
Speaker 2: important thing. For sort of re establishing balance within our
Speaker 2: body throughout organ systems, and you know, every organism does it,
Speaker 2: they do it differently. You know some fish that have
Speaker 2: to continue to always swim, they'll sleep one half their
Speaker 2: brain and then the other at other times, and really
Speaker 2: fascinating things like that. But it's this very preserved process
Speaker 2: that you know, kind of allows us to sort of
Speaker 2: reset and go word about our day. But to answer
Speaker 2: that definitively, I don't think anybody really can, which is shocking,
Speaker 2: is something, like you said, so basic that we don't
Speaker 2: really know why we do it.
Speaker 1: We don't know is this true? I fact checked it,
Speaker 1: and yes, pretty much all legit scientific papers start with
Speaker 1: even though how and why we sleep is a fucking
Speaker 1: mystery for real, but we do know that there are
Speaker 1: different stages of sleep. So what happens in the different
Speaker 1: sleep stages? I just got a fit bit, yeah, track
Speaker 1: my sleep because I'm very Yeah, it's like you've made
Speaker 1: two hundred steps this week. But I so the different
Speaker 1: stages of sleep were kind of elusive to me. Can
Speaker 1: you go through the different stages of sleep really quick?
Speaker 1: And when they happen to in absolutely or the day?
Speaker 2: So it's easy to think about sleep and sort of
Speaker 2: in terms of three stages. There's lights sleep, deep sleep,
Speaker 2: and dream sleep. And so a lot of people think
Speaker 2: dream sleep and deep sleep are kind of the same thing.
Speaker 2: They're not so very distinct. So we spent about half
Speaker 2: of our night in light sleep.
Speaker 1: Half in light sleep is normal that just blew me away.
Speaker 1: Light sleep is like the shoe that you wear most days,
Speaker 1: like versatile essential. Not the fanciest, but you need it.
Speaker 2: And that's sort of the sleep that sort of moves
Speaker 2: us through all the different stages. So we're awake and
Speaker 2: we fall into light sleep, and from there we might dream,
Speaker 2: and then we'll go back to light sleep, and then
Speaker 2: we might have deep sleep, back to light sleep, maybe
Speaker 2: wake up and go to the bathroom. So light sleep
Speaker 2: is not only the sort of the foundation of our sleep,
Speaker 2: but it's also the portal through which we move to
Speaker 2: the different stages. About ninety minutes after we fall asleep,
Speaker 2: if we're on a schedule and relatively well rested, we'll
Speaker 2: have dream or rem sleep. So rem sleep, rapid eye
Speaker 2: movement sleep, and dream sleep are the same thing. So
Speaker 2: generally at nine minutes after you fall asleep, I have
Speaker 2: your first dream. It's a very short dream, typically very fragile.
Speaker 2: So if you're in an uncomfortable situation and a lot
Speaker 2: of anxiet in your life, you're sleeping in a bad hotel,
Speaker 2: you may drop that first cycle quite a bit, and
Speaker 2: then every hour to hour and a half we'll have
Speaker 2: another cycle of dreaming, usually last somewhere between twenty five
Speaker 2: to forty five minutes, and those get longer and longer
Speaker 2: the night goes on.
Speaker 1: So light sleep starts as a stage called N one
Speaker 1: as you're starting to drift off, and you might have
Speaker 1: like a quick, funky dream that kind of like, oh shit, yay,
Speaker 1: I'm falling asleep, nothing is real feeling, and then your
Speaker 1: brain waves slow down and then a little deeper light
Speaker 1: sleep is called END two, when your breath and your
Speaker 1: heart rates slow down. Almost half of your night is
Speaker 1: spent in end two, but it's not terribly restorative. Now
Speaker 1: what is with this N one? End Two's what are
Speaker 1: the ends? They're short for non rem sleep, So all
Speaker 1: stages of sleep that aren't rem are called non rem
Speaker 1: which is like if you had four kids and you
Speaker 1: just named the best, most interesting one, Jeremy, and then
Speaker 1: all the rest were just like non Jeremy one, non
Speaker 1: Jeremy two, that one's non Jeremy three. Like sure, they
Speaker 1: all have their place in this family. Your life wouldn't
Speaker 1: be the same without them, you know. But they're not
Speaker 1: as interesting as Jeremy. So think of light sleep as
Speaker 1: your day to day shoe. Nothing fancy, but it works.
Speaker 1: Now another kind of shoe in your sleep closet. Let's say,
Speaker 1: the ug of the shoes is deep sleep now also
Speaker 1: called slow waves sleep or delta sleep or if for
Speaker 1: being an asshole M three not rem three. This stage
Speaker 1: of deep sleep happens more at the beginning of the night,
Speaker 1: and during this deep sleep stage, our bodies repair and
Speaker 1: they heal themselves. We release human growth hormone, which is
Speaker 1: dope for free, no shady prescription necessary. And the more
Speaker 1: of this deep sleep we get those first few hours
Speaker 1: in bed, usually around twenty five percent of the night,
Speaker 1: the more chipper and refreshed and not sleepy or groggy
Speaker 1: or crawling toward a triple espresso we feel.
Speaker 2: In the first three hours of our night is dominantly
Speaker 2: when we have deep sleep. So if you sort of
Speaker 2: track somebody through a typical night hop into bed should
Speaker 2: take you about ten to fifty minutes to fall asleep,
Speaker 2: you go into sort of transitional or light sleep, into
Speaker 2: deep sleep. About nine minutes later, you'll have your first
Speaker 2: little cycle of dreaming, back to light sleep, some more
Speaker 2: deep sleep, maybe a little bit less this time, a
Speaker 2: bit longer cycle of dreaming. So as the night goes on,
Speaker 2: we're having bigger, bigger cycles of dreaming, smaller cycles of
Speaker 2: deep sleep. So if you cut the night in half,
Speaker 2: and I often ask this question to patience, if you're
Speaker 2: having difficulty with your sleep, do you feel like the
Speaker 2: first half your night's better or the second half, And
Speaker 2: depending on their answer, the first half is predominantly deep sleep,
Speaker 2: the second half is predominantly rem sleep. So you can
Speaker 2: get a little bit of a sense of what might
Speaker 2: be going on with somebody's sleep, and in terms of
Speaker 2: the function of it, deep sleep is what makes us
Speaker 2: feel rested. So if somebody's nodding off listening to your podcast,
Speaker 2: or fall asleep at a stop light or in church
Speaker 2: or wherever you like to fall asleep, you can you
Speaker 2: know very quickly that person did not get enough deep sleep,
Speaker 2: either because they didn't get enough sleep or there's something
Speaker 2: inhibiting their deep sleep. And then remsleep has a lot
Speaker 2: more to do with focus, concentration, mood, even pain perception.
Speaker 2: So it's a little bit more of a finesse sort
Speaker 2: of situation, which is probably why it's second in the night.
Speaker 2: Your brain really needs the deep sleep to make the
Speaker 2: motor go to find the food to get through your day.
Speaker 2: The second half the night it's a little bit more
Speaker 2: detail oriented.
Speaker 1: So if light sleep is like an everyday sneaker and
Speaker 1: deep sleep is a comfortable ug, rem sleep is like
Speaker 1: the shimmering dress shoe, just full of dreams, increased breathing
Speaker 1: and heart rates, more blood in your brain, and our
Speaker 1: eyes are just like darting around like kittens under our eyelids. Now,
Speaker 1: rem sleep was discovered by a scientist only in the
Speaker 1: nineteen fifties, pretty recently. He was just watching children sleep,
Speaker 1: so that's a job. Just go to the office to
Speaker 1: watch baby's dream and he's like, hey, look at that.
Speaker 1: Maybe there's like a rapid eye movement stage of sleep.
Speaker 1: And they're like, well, boy, howdy hot dang, there is.
Speaker 1: So in this state our brain is as active as
Speaker 1: when we're awake. And REM sleep, they think is supposed
Speaker 1: to help with memory and concentration and also mood. Now,
Speaker 1: if you're like, what's up with Rim the band? If
Speaker 1: that's confused you, you're not alone because up until about
Speaker 1: five minutes ago, I wasn't sure if it was called
Speaker 1: REM or Rim sleep. I had no idea, and I
Speaker 1: would just never say it out loud. Michael Stipe just
Speaker 1: flipped to the dictionary, added periods between the letters and
Speaker 1: confused us all for decades. So the band is Rim,
Speaker 1: the sleep is rem. This would not have happened if
Speaker 1: Rim had stuck to their original name, which was Jars
Speaker 1: of Piss. That's a true story. So the dress shoes
Speaker 1: takes care of memory and mood, and it happens for
Speaker 1: about twenty five percent of the night. Now, the cushy,
Speaker 1: comfy ug deep sleep or N three also twenty five
Speaker 1: percent of the night, repairs your bod and keeps you
Speaker 1: from feeling sleepy. So yes, that light sleep is the
Speaker 1: majority of the night in fifty percent, But like, what
Speaker 1: does it do? And then what is happening during light sleep?
Speaker 2: So light sleep is important again, like I said, was
Speaker 2: it's sort of the foundation of sleep. There are a
Speaker 2: lot of processes going on, not you know, it's I
Speaker 2: don't want to use the word filler, but it's a
Speaker 2: lot of sort of just the general rest of our body,
Speaker 2: our bodies being inactive for a period of time. And
Speaker 2: interesting about light sleep is for a lot of individuals
Speaker 2: who struggle with their sleep, they will misperceived light sleep
Speaker 2: as being wakefulness. And we all do that. I mean,
Speaker 2: my wife would sit down on the couch and put
Speaker 2: on Property Brothers. Got that show. It's the same episode
Speaker 2: every time. It's there's no shocker here. You know, they're
Speaker 2: gonna get thousands of dollars worth of renovation for like
Speaker 2: six hundred bucks. And I don't know what places they
Speaker 2: are living in, Okiddy, I love, Probably good for you guys.
Speaker 2: I mean, this is just jealousy talking. Come out here,
Speaker 2: have a look at your pool. She sits down to watch,
Speaker 2: you know, Property Brothers. Shall fall asleep. I'll grab the remote,
Speaker 2: flip it over to the Dodgers game, and after twenty
Speaker 2: minutes you'll wake up and say, why'd you do that?
Speaker 2: I was watching that show. I'm like, no, you weren't.
Speaker 2: You were sound asleep because I was not asleep. I
Speaker 2: know everything that's going on. Then she'll flip it back
Speaker 2: over to the properties. Now it's new property, brothers, new couple,
Speaker 2: and she's so proud. She will not admit the fact
Speaker 2: that that is not the couple you were looking at before.
Speaker 2: It's at the little rancher that they're renovating. We're all
Speaker 2: like the coastal, you know whatever. So yeah, so we
Speaker 2: all have that perceptive. But some people, particularly they have
Speaker 2: a lot of anxiety, can really misperceive that fifty percent
Speaker 2: of our night is being wakefulness. So these are the
Speaker 2: people who often tell you, oh, gosh, you know, for
Speaker 2: the last six weeks, I've not been able to sleep,
Speaker 2: and you can sleep an hour or two. But when
Speaker 2: you look at them, they don't look particularly impaired. And
Speaker 2: that's a problem we often refer to as paradoxical insomnia.
Speaker 2: It's just not the problem that often they think they have.
Speaker 1: So with paradoxical insomnia, you're like, yo, I am up
Speaker 1: all night thinking about my props, doc, But it turns
Speaker 1: out you're actually asleep. You're just in light sleep that
Speaker 1: you think is way fulness. So it's a small percentage
Speaker 1: of insomnia patients, but it does happen. And insomnia itself
Speaker 1: is something that plagues a lot of people. Most of
Speaker 1: whom don't fully understand it, and I know that you
Speaker 1: care about insomnia. We all do, and there's going to
Speaker 1: be more after the break. But each episode we donate
Speaker 1: to a cause, and this week is going to miloma
Speaker 1: dot org. The International Maloma Foundation is dedicated to improving
Speaker 1: the quality of life of myloma patients while working toward
Speaker 1: prevention and a cure. And my dad was diagnosed with
Speaker 1: multiple maloma in twenty thirteen. My uncle passed away from
Speaker 1: it as well, and the IMF has been just a lighthouse,
Speaker 1: beacon of hope and research and info and support. So
Speaker 1: if someone you know has maloma, which is a blood cancer,
Speaker 1: you can listen to the hematology episode with doctor Brian Durry.
Speaker 1: And there's also an uncut version on my website that
Speaker 1: has more patient specific info. So thank you sponsors for
Speaker 1: making that donation possible, and thanks to everyone at the
Speaker 1: IMF for everything they do.
Speaker 2: Mom, Why did I call it Scottish cheese?
Speaker 3: This cottage cheese, honey?
Speaker 1: And I'm not sure.
Speaker 2: Did dogs in other countries speak different languages? Yeah?
Speaker 3: I think so.
Speaker 1: When when we get there, well, we've got to fix
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Speaker 2: Us is it the man from Geneva.
Speaker 1: Not Geneva, He's from Aviva. Oh there's a van though.
Speaker 3: For car insurance with breakdown rescue, it takes a Viva
Speaker 3: visit a Viva data eat to say fifteen percent acceptance criteria,
Speaker 3: terms and conditions apply. Minimum premium of three hundred and
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Speaker 3: bought online. See Aviva Dota ev details. Car insurance is
Speaker 3: underwritten by Aviva Insurance Ireland dak A. Viva Direct Arland
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Speaker 1: Okay, insomnia, let's tackle it. And so when people will
Speaker 1: come to you, are they usually having trouble sleeping or
Speaker 1: is it mostly insomnia that you have to deal with, Like,
Speaker 1: what's the big thing that brings people to you?
Speaker 2: So I think you're about to say it, it's it's
Speaker 2: really fifty to fifty people who walk through our door.
Speaker 2: It's one of two things. Insomnia or I can't an't
Speaker 2: sleep is a huge problem. And then the flip side
Speaker 2: is the individual who sleeps too much. They're nodding off
Speaker 2: at work and getting in trouble. They can't stay awake
Speaker 2: during their college classes. They knotted off during an Aerosmith concert.
Speaker 2: I mean name the situation as I promise we've heard it.
Speaker 2: And I just told you I fell asleep during coldbirth
Speaker 2: and my first my first daughter, you know, intercourse, during
Speaker 2: your own wedding. Like, there's really some interesting things that
Speaker 2: people fall asleep doing.
Speaker 1: There are entire Reddit threads devoted to this topic. If
Speaker 1: you need some tales about drowsy pilots or people waking
Speaker 1: up in Halloween coffins and bathtubs. Now your all, Uncle
Speaker 1: Ali has fallen asleep inner car in the driveway after
Speaker 1: pulling in on multiple occasions. I've fallen asleep on the
Speaker 1: bathroom floor with a toothbrush in my hand somehow. I've
Speaker 1: fallen asleep face first in the laundry pile more than once.
Speaker 1: I once snoozed at a gothic industrial club while Skinny
Speaker 1: Puppy was blasting all Well sober now patron Saint of
Speaker 1: Podcasts Ologies, editor Stephen Ray Morris texted me while I
Speaker 1: was writing this to tell me that he fell asleep
Speaker 1: standing up once at Disneyland as an employee, which is
Speaker 1: the most Stephen Ray Morris story I have ever heard.
Speaker 1: Now it's all cute and fun until you get the bill.
Speaker 1: Sleep deprivation bumps up the risk of us screwing up,
Speaker 1: and it has an economic wallop. You ready for this,
Speaker 1: fifty billion dollars yearly in the United States just from
Speaker 1: like sleepy, sleepy Oopsie daisies now is for car accidents.
Speaker 1: It's estimated that six thousand people could die annually just
Speaker 1: because of drowsy driving. So staying on your couch when
Speaker 1: you're not up to party is literally saving lives because
Speaker 1: trust me, even a skinny puppy soundtrack might not be
Speaker 1: enough to keep you alert.
Speaker 2: All good people are a sleeping draining. So those are
Speaker 2: sort of the too much sleep or the perception of
Speaker 2: not enough sleep, or the two main things that people
Speaker 2: are coming to see us about.
Speaker 1: And when did our sleep start really getting screwed up?
Speaker 1: Like has it been in the last century, since we've
Speaker 1: had lights, since we've had jobs and factories, Like when
Speaker 1: when did things start getting dysregulated? Because everyone always hears
Speaker 1: that study of like farmers used to wake up in
Speaker 1: the middle of the night for three hours and then
Speaker 1: they piece out like what are we how are we
Speaker 1: supposed to be sleeping?
Speaker 2: So that's a great question I think our sleep has
Speaker 2: always been screwed up. I think the farmer that you're describing, yeah,
Speaker 2: I mean, he's got so much on his plate. He's
Speaker 2: tuberculosis everywhere, and crop, you know, light and you know,
Speaker 2: and money's bad and you know. So I think that
Speaker 2: that they just never really thought about their sleep. I
Speaker 2: think that as we've moved forward, two things have happened. One,
Speaker 2: we've put a lot of barriers in front of our sleep,
Speaker 2: including podcasts that they're like, gosh, I should stop now,
Speaker 2: but I'm going to listen to one more episode of
Speaker 2: this awesome podcast Alley's put together, and then I'll go
Speaker 2: to bed. You know, thanks, But y'all.
Speaker 1: Get that sleep. God Dad's orders.
Speaker 2: So that we have so much more technology at our fingertips.
Speaker 2: I mean, if I could have communicated with my girlfriend
Speaker 2: in middle school on a computer while we were both
Speaker 2: in bed, and I could have watched the movie Star
Speaker 2: Wars anytime I wanted to, I would not be talking
Speaker 2: to you today. There's no way I could have been.
Speaker 2: It just would be too much for me. So I
Speaker 2: think that people are trying to deal with a lot
Speaker 2: more distraction. And then also, so the twenty four hour
Speaker 2: culture really sort of gets in the way of us
Speaker 2: prioritizing our sleep. I think a lot of people want
Speaker 2: to do the right thing, they're just incapable of doing
Speaker 2: it because of all these barriers in front of us.
Speaker 1: So there was a study published just last year that
Speaker 1: had tracked the sleep of ninety four people in Bolivia
Speaker 1: and Tanzania who are living hunter gatherer lifestyles. They wanted
Speaker 1: to get a sense of pre industrialization sleep habits, and
Speaker 1: it turned out their average sleep was only six point
Speaker 1: four hours a night. But they were all in good health,
Speaker 1: so they went to sleep about three hours after sunset
Speaker 1: and then they got up before dawn and they slept
Speaker 1: pretty well for the night. And as for insomnia, incredibly rare,
Speaker 1: so much so that they didn't even have a word
Speaker 1: for it in any of their languages. So how can
Speaker 1: this change your life now? The researchers think that the
Speaker 1: sleep patterns have less to do with sunlight and more
Speaker 1: to do with temperature, which is tightly controlled in her houses.
Speaker 1: It does not match outdoor temperatures by design. One article
Speaker 1: I read recommended sleeping in a room that was sixty
Speaker 1: to seventy three degrees fahrenheit, which could help you get
Speaker 1: more restorative sleep, it's more natural. So this is, I guess,
Speaker 1: just another reason to bundle up, turn the heater down
Speaker 1: a scosh, maybe keep a window open. I mean, as
Speaker 1: a person who sleeps like shit and also turns hotel
Speaker 1: room thermostats up to eighty degrees, I feel personally called out.
Speaker 1: I feel attacked by myself, and I know this is
Speaker 1: still I feel like this is still such a basic question.
Speaker 1: But what is the big difference, like in brain waves
Speaker 1: or whatever, when we are awake and talking and functioning
Speaker 1: and like dodging things coming at our heads. But then
Speaker 1: the difference between that when we were stone cold out?
Speaker 2: Yeah?
Speaker 1: Why does that sometimes happen in the literally the blink
Speaker 1: of an eye?
Speaker 2: Sure, so you know it can happen in the blink
Speaker 2: of an eyd generally because you've developed a drive for sleep.
Speaker 2: So I always kind of compare sleep and hunger. If
Speaker 2: somebody says I'm hungry and I offer them, well, here,
Speaker 2: I've got a sandwich, I don't want you want it,
Speaker 2: and I don't want your sandwich, it'd be hard to
Speaker 2: sort of argue that they're that hungry. Yeah, if you're
Speaker 2: looking and notice somebody kind of looking at a trash
Speaker 2: can for something to eat, it must be very driven
Speaker 2: to eat. So sleep is kind of like that. We
Speaker 2: can really enhance our drive to sleep. And one of
Speaker 2: the things I always tell people is it sleep always wins.
Speaker 2: I mean, if you push yourself hard enough and get
Speaker 2: yourself sleepy enough. It's not something that you really have
Speaker 2: a lot of control over. And you're right. It can
Speaker 2: happen in the blink of an eye when you're driving
Speaker 2: down the road, which is why a lot of people
Speaker 2: come to our clinic after there's been some sort of
Speaker 2: car accident. I was driving back from the concert. I
Speaker 2: felt okay, and the next thing I know, I was
Speaker 2: in a median or I was in the oncoming lane
Speaker 2: of traffic. So sleep can sleep, Sleep happens. We're not
Speaker 2: in danger of not sleeping. I think that for a
Speaker 2: lot of when you look at sleep in terms of
Speaker 2: the wavelengs like you're talking about. What's interesting is when
Speaker 2: you look at somebody's brain activity when they're awake, it
Speaker 2: looks very different from somebody who's in deep sleep. Deep sleep,
Speaker 2: you can see this sort of the consciousness part of
Speaker 2: your brain taking a back seat to the more primitive
Speaker 2: parts of the brain we share like with an earthworm,
Speaker 2: so we have these big slow waves, which is why
Speaker 2: some people called deep sleep slow wave sleep. You know,
Speaker 2: consciousness is really suspended. You know, your brain is really
Speaker 2: taking care of much more primitive aspects of itself. But
Speaker 2: when you look at rem sleep, it's almost impossible to
Speaker 2: discern the brain activity video of somebody dreaming versus the
Speaker 2: brain activity of somebody who's awake. Really, yes, which is
Speaker 2: why it's really interesting. People say, you know, with rem
Speaker 2: sleep or deep sleep, they could not be more different.
Speaker 2: In fact, one of the only ways you can tell
Speaker 2: that somebody's dreaming if you're just looking at their brain
Speaker 2: is to look at their muscle tone. Because when we dream,
Speaker 2: we're paralyzed. So it's obvious from looking at a videotape. Oh,
Speaker 2: she's dreaming and she's awake. That's that's pretty obvious. But
Speaker 2: to purely look at the brain's activity, it's very difficult
Speaker 2: to discern, and not to mention there's eye movements, so
Speaker 2: these very unusual, bold eye movements that happen when we're
Speaker 2: dreaming that we don't see when we're awake. But really
Speaker 2: that muscle tone is the biggest way we differentiate somebody
Speaker 2: electrographically as to whether or not they're sleeping or they're awake,
Speaker 2: which is fascinating. So when you dream you're taking the
Speaker 2: test naked and it was a test you didn't know
Speaker 2: you were going to have, and your friends like, we're
Speaker 2: going to take our test and you're enrolled in the class,
Speaker 2: i'mic god, and even this is my recurring dream. You know,
Speaker 2: you're sitting there taking a test or whatever. You're being
Speaker 2: chased by wolves or whatever you like to dream about.
Speaker 2: You actually can't move when those things are happening, nor
Speaker 2: can we really regulate our body temperature, which is kind
Speaker 2: of interesting too.
Speaker 1: Why can't we move? And what is sleep paralysis?
Speaker 2: So sleep paralysis has to do with that. So technically
Speaker 2: all of us are experiencing a quote unquote sleep paralysis
Speaker 2: when we dream. So what's happening is as we dream,
Speaker 2: our brain is sending this signal down our spine that
Speaker 2: paralyzes voluntary muscles, which is really interesting. Yeah, so you
Speaker 2: were talking about creepy sleep studies a minute ago, and
Speaker 2: I love that. I use the word creepy all the time.
Speaker 2: Such a good word.
Speaker 1: So a bemused glance from your beloved fine, but as
Speaker 1: an extended occupation it's really only fitting for stocker, vampire
Speaker 1: heart throbs, or someone in a lab coat with a clipboard.
Speaker 2: I like watching you sleep.
Speaker 1: It's so.
Speaker 2: It's kind of fascinating to me. The studies they use
Speaker 2: to sort of discern dreaming in the past were that
Speaker 2: you come in fall asleep, and we will walk around
Speaker 2: while you sleep and look at you. And if we
Speaker 2: see your eyes moving quickly underneath your eyelids, and you
Speaker 2: can do, like find a friend, say close your eyes
Speaker 2: moveds eyeballs back and forth, you can see them moving
Speaker 2: under eyelids. At that point, they would wake somebody up
Speaker 2: and say what's going on, and the person would wake
Speaker 2: up and say, oh my god, I was taking the
Speaker 2: test naked, you know, or whatever their thing was. So
Speaker 2: that's how they determined that, oh, wow, looks like when
Speaker 2: these eyes are moving, your people are dreaming. But they
Speaker 2: realize very quickly that every other muscle pretty much was not,
Speaker 2: except for a tiny little muscle in the ear. There's
Speaker 2: a tiny little muscle in the voice box. Our diaphragms
Speaker 2: work so we can breathe, and then our sphincters work
Speaker 2: so we don't have so much clean up the next day,
Speaker 2: but outside of that, everything voluntary is completely shut down.
Speaker 2: So sleep PROAUSS is what you're referring to is when
Speaker 2: people experience this, they experience a recovery of consciousness before
Speaker 2: that paralysis has a chance to go away. Oh so
Speaker 2: what happen happens is you said you go to bed,
Speaker 2: and usually it's happening during stressful times in your life,
Speaker 2: and when you wake up, you hear the alarm clock
Speaker 2: going off, but you're powerless to move to turn it off.
Speaker 2: It can often feel like something's like on your chest,
Speaker 2: like sitting on you. It can be a terrifying experience.
Speaker 2: It usually only lasts about, you know, thirty seconds, a
Speaker 2: minute maybe, and then it passes. But for a lot
Speaker 2: of people who have those kind of fluctuating lifestyles and
Speaker 2: difficult schedules, they can feel it a lot. It is
Speaker 2: a classic sign of narcolepsies. If you get it a
Speaker 2: lot and you're excessively sleepy, it could be a sign
Speaker 2: to that. And interestingly, predominantly, like in the Southern African
Speaker 2: American community, they often talk about something called the witch
Speaker 2: riding you, which is awesome. It's invisible witch but I
Speaker 2: didn't even know that was So if you look at
Speaker 2: if you look at antiquity, and one of the cool
Speaker 2: things about sleep is this awesome intersection between science and mythology.
Speaker 2: If you look at sleep and there's this idea of
Speaker 2: the witch riding you say, they would think that a
Speaker 2: witch was literally sitting on your chest when you slept
Speaker 2: at night writing you.
Speaker 1: So I looked into this, and nearly every culture has
Speaker 1: a name for this nocturnal perpetrator of sleep paralysis. In
Speaker 1: Scandinavian culture it's a mare or a damned woman, and
Speaker 1: in Fiji it's a demon. In Thailand it's a ghost,
Speaker 1: In Britain it's an old hag, and in Eastern Asia
Speaker 1: it's a little breath stealing mouse. Spain blames it on
Speaker 1: a cat. But officially the Wikipedia for this is just
Speaker 1: titled casually night hag, which honestly sounds like the kind
Speaker 1: of down to earth, self aware lady who'd be fun
Speaker 1: to drink margs with and go to the disco. Just
Speaker 1: a side note, So this next acide was written and
Speaker 1: recorded in twenty eighteen, before I had read some great
Speaker 1: twenty twenty discourse on language and favoring the word black
Speaker 1: capitalized please instead of African American. And also before I
Speaker 1: learned that the term Caucasian is rooted in some deep racism,
Speaker 1: and now we just say white. So this next decide
Speaker 1: again from twenty eighteen, I was directly quoting stats from
Speaker 1: a two thousand and five study before these language updates.
Speaker 1: I'm leaving it in so that we can all learn this. Okay,
Speaker 1: carry on twenty eighteen episode. Now, as an Italian from
Speaker 1: northern California, I'd never heard of this very common Southern
Speaker 1: United States colloquialism about a witch writing your back. But
Speaker 1: I did do a little further research. Now, according to
Speaker 1: one two thousand and five study, recurrent sleep paralysis was
Speaker 1: reported by twenty three percent of African American volunteers in
Speaker 1: the study, but only six percent of Caucasian volunteers, and
Speaker 1: it can be linked to panic disorder. So what causes
Speaker 1: panic disorder? The study states that significantly more early life
Speaker 1: stressors were reported by African Americans than Caucasians, and it
Speaker 1: went on to say that higher levels of psychosocial stressors,
Speaker 1: including racism and a culturation, may contribute to the higher
Speaker 1: rates of sleep paralysis experienced by African Americans. So just
Speaker 1: another reminder that privilege is sneak, and scientists are wonderful
Speaker 1: for turning over rocks and looking at this stuff because
Speaker 1: the solutions might not be right under our literal noses.
Speaker 2: And a couple people have told me that the way
Speaker 2: you would keep the witch away is to keep a knife,
Speaker 2: a fork, and a spoon under your pillow, which is
Speaker 2: so cool. I love that kind of stuff. But even
Speaker 2: like you know, incubus and sucubists, when you read about
Speaker 2: these demons that would kind of visit people during during
Speaker 2: the night, there there are you know, feelings of paralysis
Speaker 2: or there's some really great Renaissance paintings of these demons
Speaker 2: sitting on top of people's chests. Is one called the nightmare,
Speaker 2: and that was the thought that this thing was sitting
Speaker 2: on you, which is why you felt the weight. But
Speaker 2: it was actually the paralysis all the muscles in between
Speaker 2: your ribs making your rib cage less easy to expand
Speaker 2: when you breathe, so it felt like weight on you.
Speaker 2: Which is really interesting.
Speaker 1: Is that what happened to you?
Speaker 2: I don't know. I don't think so. If it did,
Speaker 2: it never really inspired any kind of fear. Now I've
Speaker 2: certainly woken up and felt kind of incapacity. But I
Speaker 2: don't know that I've ever had sleep paralysis.
Speaker 1: Yeah, it happened to me once, and it was horrifying.
Speaker 1: It was like, Oh, I meant, when did it happened?
Speaker 1: When it happened, it happened oddly. I was on vacation,
Speaker 1: but I was on vacation with a boyfriend I broke
Speaker 1: up with shortly thereafter, So maybe it was stressed.
Speaker 2: But maybe he's on your chest in a weird way.
Speaker 2: He was.
Speaker 1: God, he was a ghost boyfriend. I will know I was,
Speaker 1: But I remember just being like, oh, this is the
Speaker 1: thing that people talk about. But it just is so
Speaker 1: crazy because you feel like you're dead but alive. You
Speaker 1: feel like a gud.
Speaker 2: Absolutely. So when we talk about sleep, one thing that's
Speaker 2: fun to think about is sleep is not a light switch,
Speaker 2: So we're not awake, and then the light switch goes
Speaker 2: off and when we're asleep, like it's a state on off.
Speaker 2: It's really sleep is a mechanism in our brain. But
Speaker 2: then vigilance or wakefulness is too, so it's really too switches.
Speaker 2: So when you're awake and we're sitting here talking, our
Speaker 2: wake switches turned on. Our sweet sleep switch is turned off,
Speaker 2: and when we sleep vice versa. Now sleep paralysis is
Speaker 2: the wake and the sleep switch being turned on at
Speaker 2: the same time.
Speaker 1: God is are these switches kind of like instead of
Speaker 1: binary switches, they are more like levers that go kind
Speaker 1: of absolute down.
Speaker 2: Like absolutely and they're affecting each other. So as the
Speaker 2: sleep switch gets turned on and we start to accumulate
Speaker 2: chemicals like a denizene that is feeding back to make
Speaker 2: to make the other, it's like the I don't know, I
Speaker 2: you've ever been like like a water park, like an
Speaker 2: indoor water park often has this massive bucket in the
Speaker 2: middle of it. It's constantly getting filled with water and
Speaker 2: every you know, seven minutes, it just dumps it on everybody.
Speaker 2: So that's kind of how sleep, you know, sleep and wakefulness.
Speaker 2: As we are awake and talking, we're a cumulating chemicals
Speaker 2: that are making that sleep bucket wanting to tip over
Speaker 2: more and more, which is why we are a lot
Speaker 2: sleepier at eleven PM than maybe eleven am.
Speaker 1: And so what happens in sleep that is kind of
Speaker 1: like a janitorial system. Like I've read something about how
Speaker 1: with all Zheimer's and other brain diseases that your brain
Speaker 1: kind of like rinses off plaques. Perhaps I don't know
Speaker 1: absolutely what kind of things are we cleaning. And I'm
Speaker 1: also asking you this as a way to get myself
Speaker 1: to sleep, more to scare myself, because i know I've
Speaker 1: got like a grimy ass brain, and I'm like, how
Speaker 1: can I clean this thing?
Speaker 2: It's great, so much to impact there. So yes, when
Speaker 2: I was in medical school back in the late nineties,
Speaker 2: I remember the lecture on the lymphatic system with an
Speaker 2: l lymphatic which is the cleaning janitorus, A great word,
Speaker 2: janitorial system of our body. It's getting rid of waste products,
Speaker 2: kind of flushing it out. And I remember our lectures saying,
Speaker 2: but interestingly, the brain doesn't have one, and then we
Speaker 2: went on to the next topic. And I remember sitting
Speaker 2: there thinking, wait a minute, the most important organ of
Speaker 2: our brain, our body does not have it, this dantor system.
Speaker 2: So it turns out that he and science was wrong.
Speaker 2: This fantastic researcher in Maryland, she discovered it. And I'm
Speaker 2: blanking on her name right now. Netterguard, I believe is
Speaker 2: her name.
Speaker 1: Danish neuroscientist doctor Mikannttergard. In twenty thirteen for anyone who
Speaker 1: just wants to get a tattoo of a new science hero.
Speaker 2: And she discovered it. She just said, it's hard to
Speaker 2: find because the way we would prepare cadavers, you wouldn't
Speaker 2: see it. So she not only discovered it, she named
Speaker 2: it the glimphatic system with a G and realized very
Speaker 2: quickly that not only is it pumping out waste products,
Speaker 2: but it's ten times more active when we sleep at
Speaker 2: night than when we're awake.
Speaker 1: My god.
Speaker 2: So we've always known scientist is really good about knowing stuff,
Speaker 2: we just don't know why. So we've always known that
Speaker 2: people who didn't sleep particularly well often lent themselves to
Speaker 2: developing things like dimensioned Alzheimer's disease. So now we've got
Speaker 2: this really interesting theory that if you are the shift worker,
Speaker 2: you're staying up late, playing video games at night, kind
Speaker 2: of abusing yourself. You're not allowing your body to engage
Speaker 2: this waste removal system effect. So the question becomes what
Speaker 2: waste product are we removing. We are removing a product
Speaker 2: called beta amyloid, which is exactly what you said, the
Speaker 2: constituent of plaque in Alzheimer's disease. So if you have
Speaker 2: a busy schedule, you don't value sleep. And it's interesting
Speaker 2: because I'm getting the sense from you, reading about you
Speaker 2: and learning more about you, is that you kind of
Speaker 2: look at people and two different on a scale of
Speaker 2: the horrible insomnia patient, can't sleep, tries like crazy, desperate
Speaker 2: for sleep, dread's going to bed at night, and then
Speaker 2: you've got sort of you the alley the neurosurgeon, which
Speaker 2: is the person who's like, you know, if I can
Speaker 2: get two hours of sleep, I'm pretty good. We want
Speaker 2: you to be in the middle. What we want you
Speaker 2: to find as you started getting into your thirties and forties,
Speaker 2: that middle ground of just because I can do it,
Speaker 2: probably doesn't mean I should.
Speaker 1: So one major thing you can do to ease insomnia.
Speaker 1: You're ready for this, stop being afraid of it. Doctor
Speaker 1: Winter says that the main cause of insomnia is anxiety
Speaker 1: and fear. You can see the Theorology episode with Mary
Speaker 1: Poff and Roth for a one two punch on dealing
Speaker 1: with that. She's incredible. I mean, also on the same token,
Speaker 1: if you think you can get away with four hours
Speaker 1: of sleep, go ahead and try getting more. Let your
Speaker 1: brain's clean up crew get to work. Now, what exactly
Speaker 1: what other things are we cleaning out other than the plaques?
Speaker 2: Like how does that affect our.
Speaker 1: Memory and our motor coordination, and like our ability to
Speaker 1: think quickly by having a brain.
Speaker 2: Yeah, so all those things you mentioned are true. So
Speaker 2: and you can look at science in one of two ways.
Speaker 2: You look at the science that either deprived or restricted sleep,
Speaker 2: or you can look at sort of newer science where
Speaker 2: you force people to sleep longer and even just rest longer.
Speaker 2: But even within sleep medicine, my specialty is sleep and performance.
Speaker 2: So I work with a lot of professional sports teams.
Speaker 2: Not that I really care that much about athletes. I
Speaker 2: care about them, I care about everybody. I'm not sort
Speaker 2: of a rabid athletic fan. But what I like about athletes,
Speaker 2: when you study it and you improve their sleep, we
Speaker 2: can immediately measure how well they're doing. So I've never
Speaker 2: seen the alley baseball card. You know how she doing, Oh,
Speaker 2: twenty fourteen was a good year for her. She you know,
Speaker 2: she batted this, she ran this, she scored this many runs,
Speaker 2: you know. So we're all doing things that require performance athletes,
Speaker 2: we just tend to measure it more. Right, So when
Speaker 2: you actually get an individual to restrict their sleep. So
Speaker 2: we don't do a lot of sleep deprivation experiments anymore
Speaker 2: because they're kind of difficult and inhumane and frankly somewhat dangerous.
Speaker 2: But even if you just restrict sleep, those things, to
Speaker 2: me are much more meaningful. I think most people believe
Speaker 2: that if you stay up all night, you don't work
Speaker 2: that well the next day. But what if you got
Speaker 2: four or five hours of sleep for several days in
Speaker 2: a row.
Speaker 1: So I use a fitbit, and this was actually me
Speaker 1: all last week, averaged four hours a night for an
Speaker 1: entire week. I was so foggy that I confused my itinerary.
Speaker 1: I missed my first flight in ten years, and then
Speaker 1: I cried in a airport bathroom out of frustration at myself,
Speaker 1: like a big, weepy, cranky baby. So does lack of
Speaker 1: sleep make me a weak person? Though? Well, physically yes.
Speaker 2: It's been shown that you binge press drops by thirty
Speaker 2: you know, twenty to thirty pounds, we make three times
Speaker 2: more attention, you know, attention errors. We have a much
Speaker 2: more impaired ability to read the emotions and cues of others.
Speaker 2: So to do these experiments where you would hear, you know,
Speaker 2: the person would say something like, that's a great idea,
Speaker 2: or that's a great idea.
Speaker 1: You know, Wow, this info is really helpful.
Speaker 2: Our ability to kind of read cues, to emotionally attach
Speaker 2: to other people becomes very impaired when we don't sleep. Now,
Speaker 2: the flip side is what if you do sleep, What
Speaker 2: if you do spend more time in bed? What if
Speaker 2: you're forced to spend ten hours in bed no matter
Speaker 2: what sleeping or resting. And it shows that people run faster,
Speaker 2: they swim faster, they react to things quicker, they're accurate,
Speaker 2: see in terms of aspects of their life improve they're happier,
Speaker 2: they have better ideas. It's just amazing. They even lose weight.
Speaker 2: I mean, so the idea that difficulties in sleep is
Speaker 2: not affecting some part of your body is probably not true.
Speaker 1: Do you think that depression or anxiety are related to
Speaker 1: a lack of sleep? Like, I know that depression anxieties
Speaker 1: are problems that a lot of people face. It seems
Speaker 1: like more and more so many people are on antidepressants
Speaker 1: anti anxiety medications. And also our sleep is kind of
Speaker 1: kind of crappy. Side note, asking for myself is there
Speaker 1: any correlation with that or is what does one cause
Speaker 1: the other?
Speaker 2: I think it works both ways. I think it's not
Speaker 2: and most people who are struggling with depression, mood disturbance,
Speaker 2: anxiety will tell you things like if I could just sleep,
Speaker 2: I would feel better. And now you set up this
Speaker 2: very vicious cycle of you know, you're depressed, you're anxious,
Speaker 2: you're not sleeping well, and that's going to feedback into
Speaker 2: making those depression anxieties worse and it makes you really
Speaker 2: not sleep well. So there is a downward spiral that
Speaker 2: can be set up there too. But I also think
Speaker 2: that the relationship works oppositely. I think that individuals who
Speaker 2: are depressed and who have difficulty with mood disturbance, their
Speaker 2: their disorder is creating a lot of sleep disturbances as
Speaker 2: well as the sleep disturbances helping to facilitate the disorder.
Speaker 2: I mean, it's very unusual to find somebody who has
Speaker 2: significant insomnia who doesn't have some degree of anxiety, and
Speaker 2: insomnia theory would tell you that step one in terms
Speaker 2: of developing insomnia is you have a predisposition to it.
Speaker 2: You're a type A, You've got a lot on your
Speaker 2: plate and you know, type A is a good thing.
Speaker 2: I mean, I want my surgeon, who's got to take
Speaker 2: the tomb around of my brain, to be very type A.
Speaker 2: I don't want the oh, well, you know, we'll get
Speaker 2: to it when we get to it. You know, I'm
Speaker 2: I'm gonna follow the dead this summer and you know,
Speaker 2: hockey sock flip flop, Doc Johnson. I don't want that
Speaker 2: person who sleep when we got the I want, you know,
Speaker 2: the really you know kind of you know, focused, hyper
Speaker 2: focused type A attention to detail person managing my finances
Speaker 2: and doing my surgeries whatnot. So that type A tendency
Speaker 2: makes the world around you successful. People have it. When
Speaker 2: they start to apply that that type A to the insomnia,
Speaker 2: it becomes a real problem. So I think that you know,
Speaker 2: individuals who are struggling with mood disturbance, I think it's
Speaker 2: important to understand and have an open mind to it
Speaker 2: working in both ways. Some people will resist, Oh, I
Speaker 2: don't have depression, doctor win or I'm not anxious. It's
Speaker 2: just my sleep is really messed up. And they may
Speaker 2: be right. But I think it's also okay to sort
Speaker 2: of open yourself up to the idea that maybe this
Speaker 2: is also playing a causet role in it too, so
Speaker 2: there's a huge connection between those two things.
Speaker 1: So lack of sleep can make you anxious and depressed.
Speaker 1: According to one study, just skimping on your sleep excites
Speaker 1: your amygdala in your insular cortex. Those are the parts
Speaker 1: of the brain that fire up your fight or flight response.
Speaker 1: But anxiety and depress can also cause insomnia. So the
Speaker 1: primary cause of just blinking awake in bed, according to
Speaker 1: doctor Winter, is anxiety. Now, there are secondary causes like
Speaker 1: pain that doesn't allow you to fall asleep, and those
Speaker 1: have to be addressed as a pain issue rather than
Speaker 1: a sleep issue. But primarily insomnia is an anxiety issue. Now,
Speaker 1: my personal issue with sleep, if we're gonna get confessional,
Speaker 1: is I learned this recently. It's called sleep avoidance or
Speaker 1: sleep procrastination. This is when you're tired and you need
Speaker 1: to sleep, but you just keep delaying it, either watching
Speaker 1: movies or scrolling or working or reading. Now, there are
Speaker 1: a few causes of this. One might be workaholism and
Speaker 1: not being able to admit that the day is done HEMP,
Speaker 1: or it could be loneliness and scrolling helps you feel
Speaker 1: connected to others. Also, I do that, or even a
Speaker 1: busy day tending to a lot of people can leave
Speaker 1: you needing alone time and staying up well passed. What
Speaker 1: is prudent is the only way for some people to
Speaker 1: get it, So hypnos is like, yo, this is why
Speaker 1: I hang out in a cave in hades. Nobody bucks me.
Speaker 1: So what are better sleep habits? The CDC has some
Speaker 1: hot tips. Centers for Disease Control, who apparently considers not
Speaker 1: sleeping enough kind of a disease, says, be consistent. Go
Speaker 1: to bed at the same time each night, including weekends,
Speaker 1: if you can make sure that your bedroom is quiet,
Speaker 1: dark and relaxing and at a comfortable temperature. We've learned
Speaker 1: colder is better. Who knew? Remove TVs, computers, smartphones from
Speaker 1: the bedroom. The CDC says to throw them into the
Speaker 1: simmering caldera of a volcano if you have one. Also,
Speaker 1: avoid big meals and caffeine and booze before bedtime. We
Speaker 1: all kind of know that we're supposed to do those things.
Speaker 1: I'm trying to shift the way I'm thinking about sleep
Speaker 1: to thinking of it as a free thing you can
Speaker 1: do to make your brain sharper and your skin glowier
Speaker 1: and your future sure less addled with disease. So if
Speaker 1: sleep hygiene were a thing you could buy and just
Speaker 1: not do, we would all be so pumped for it,
Speaker 1: we would Amazon prime this shit out of it. But
Speaker 1: really it's just a behavior, so we have to see
Speaker 1: value in the behavior. How much does sleep hygiene affect
Speaker 1: how much you actually sleep? Like, when you have to
Speaker 1: prescribe sleep hygiene, what do you tell people to do?
Speaker 2: Yeah, So, what I would say about sleep hygiene is this.
Speaker 2: The media focuses a lot of attention on sleep hygiene
Speaker 2: because it's sort of a digestible, little bite sized nugget. Hey,
Speaker 2: having trouble sleeping, make sure your room is this temperature,
Speaker 2: and here's a study that shows that. Great. Moving on
Speaker 2: to the next topic or you know whatever. So sleep
Speaker 2: hygen is great. I would say that in terms of
Speaker 2: its ability to solve a problem twenty percent. So I
Speaker 2: would say of the people out there who are struggling
Speaker 2: with their sleep, that twenty percent of people, if they
Speaker 2: did something related to sleep hygiene, could make their problem,
Speaker 2: you know, much better, or solve it. And what I
Speaker 2: mean by that too, is also the idea that it's
Speaker 2: sort of like knee pain. If you're a runner, you know,
Speaker 2: my knees starting to hurt. So what you're gonna do.
Speaker 2: You'll take some ibuprofen. Maybe you'll buy a brace at CVS,
Speaker 2: You'll ice it, You'll take a couple of days off
Speaker 2: you're running. Well, you know, if you're doing all those
Speaker 2: things and still hearing this clicking sound and having this
Speaker 2: excruciating pain in your knee, eventually you're going to say,
Speaker 2: I don't know that this is within my ability to solve.
Speaker 2: You go see a specialist, they do an MRI. You've
Speaker 2: got a big piece of carlt sticking into your joint.
Speaker 2: So to me, that's sort of the sleep hygiene is.
Speaker 2: We sort of have this message out there that every
Speaker 2: one of your sleep problems is solvable if you just
Speaker 2: get the right mattress and the right pajamas, and the
Speaker 2: right noise machine and the your ear plugs and those
Speaker 2: are all fine. I just think that for about the
Speaker 2: other eighty percent of people, it's very anxiety provoking that
Speaker 2: you've invested in the five thousand dollars mattress. You've got
Speaker 2: Tom Brady's you know, special pajamas that he wears, and
Speaker 2: my god, he's a quarterback married to a model. So
Speaker 2: it's got to work without the sleep where I don't
Speaker 2: really feel like I would be able to achieve the
Speaker 2: things that I have done it, you know, and you
Speaker 2: got all this stuff going on and it's not working.
Speaker 2: I think that creates a lot of anxiety, sort of
Speaker 2: like where I'm hopeless, like nothing work. I've read twenty
Speaker 2: different books, which is why I didn't put a lot
Speaker 2: of sleep hygiene in my book, just because I thought,
Speaker 2: I think we all know these things. Now it's kind
Speaker 2: of getting to the point of common knowledge.
Speaker 1: You know.
Speaker 2: Oh what not having the TV on really loud all
Speaker 2: night long? That's not good. Okay, you know if you
Speaker 2: if you're surprised by that, where have you been so anyway,
Speaker 2: So I think sleep hygiene is important. We want to
Speaker 2: set the stage for good sleep. We want to have
Speaker 2: positive thoughts about sleep, like sleep's great. I mean, we
Speaker 2: shouldn't be dreading it or fearing it. I think it's
Speaker 2: even strange to be kind of neutral about sleep. I mean,
Speaker 2: be neutral about brushing your teeth, but sleep, oh, it's
Speaker 2: the best thing in the world to get in bed,
Speaker 2: and you know whatnot And so I think that we
Speaker 2: need to cultivate that attitude, but understand that it has
Speaker 2: its limitations.
Speaker 1: And now, how dark and quiet should your room be?
Speaker 2: Though? You know again, I think that if you're struggling
Speaker 2: with your sleep, really dark and really quiet, you know,
Speaker 2: people ask about noise machines or things like that. I mean,
Speaker 2: we're always going to sleep better in a quiet environment.
Speaker 2: So and our brains pay attentions to sound. So if
Speaker 2: somebody says, well, I really like listening to a podcast
Speaker 2: when I go to bed at night, that's fine, but
Speaker 2: maybe you could set it so after fifteen minutes it
Speaker 2: turns itself off. Dark rooms are really important my parents,
Speaker 2: I think I talk about this in the book. My
Speaker 2: parents like redid their basement. When I was growing up,
Speaker 2: we had this like unfinished basement. They finished it themselves
Speaker 2: and kind of did it, you know, outside the you
Speaker 2: know the law. I think, you know. So one of
Speaker 2: the bedrooms, the bedroom down there, has no way to
Speaker 2: get out, so it's like surrounded by earth on two
Speaker 2: sides and there's a door, but there's zero window. It
Speaker 2: is incredibly dark, incredibly quiet, and incredibly cool. And I
Speaker 2: remember going there like well, I would come in for
Speaker 2: like college breaks and falling asleep in there and waking
Speaker 2: up at noon, you know, and being like, well, what
Speaker 2: time is it, Like where have you been? You know.
Speaker 2: So even the smallest little bit of light coming in
Speaker 2: through a door or underneath a blind can really impair
Speaker 2: our sleep.
Speaker 1: So side note, we're going to get all into blue
Speaker 1: light and how it affects sleep in next week's part two.
Speaker 1: Also stick around to this episode after the credits, and
Speaker 1: I'm going to tell you and only a little bit
Speaker 1: gross secret about my imask. Anyway, sleeping with the lights
Speaker 1: on very confusing to your brain.
Speaker 2: So if you're a shift worker, you know, especially and
Speaker 2: you're sleeping a lot during the day, you want that
Speaker 2: room to be so dark that you cannot see your
Speaker 2: hand from your.
Speaker 1: Face, and quiet, maybe with earplugs and quiet.
Speaker 2: And if you can't do that, then you know, like
Speaker 2: you said, earplugs or a mask over your eyes is
Speaker 2: probably just as good.
Speaker 1: And in your book you mentioned it's okay to not
Speaker 1: sleep in the same room as a spouse or a partner.
Speaker 2: It is, I mean, I always I'm a doctor who
Speaker 2: practices in Virginia, so I consider that the South. And
Speaker 2: you gotta be very careful about the way you speak
Speaker 2: to people, they always give you that look like you
Speaker 2: trying to steal my wife, Like you know this guy
Speaker 2: how you says look like no, and it's you know,
Speaker 2: so I have I think sleeping with somebody is fantastic.
Speaker 2: I do find it sort of strange that we have
Speaker 2: evolved to do that. Like I, you know, I don't
Speaker 2: necessarily feel the urge to do other things, like let's
Speaker 2: sit in the same chare, honey and eat this from
Speaker 2: the same plate. You know, it's okay to be like
Speaker 2: you sit over there and eat your thing. I'll eat
Speaker 2: over here. There's a lot of things we do separately.
Speaker 2: You do it over there, I'll do my thing over here.
Speaker 2: Even in our bathrooms have two different things sometimes, you know,
Speaker 2: you you know, so I do think it's funny that
Speaker 2: we've evolved to kind of create this thing that we
Speaker 2: need to sleep in the same bed. And maybe it
Speaker 2: was evolutionary that, you know, houses were small, you were
Speaker 2: conserving heat or things of that nature like that. But
Speaker 2: you know, I think that you can love somebody intensely
Speaker 2: and not be in the same bed with them, or
Speaker 2: you know, what I always tell people is some things
Speaker 2: that's a little bit more palatable for some couples is
Speaker 2: let's pick Thursday. Thursday will be the day we watch
Speaker 2: Handmaid's Tale, but then we sleep separately so we can
Speaker 2: consider what that means in terms of our society independent
Speaker 2: of one another, and over breakfast we'll talk about the
Speaker 2: episode and how we feel about it. I was asleep before.
Speaker 2: That's how we let it happen, yeah, or whatever, So
Speaker 2: so that way there's no guilt. It's like, oh, it's
Speaker 2: Thursday night, We're going to sleep separately, and it's kind
Speaker 2: of fun to get back together on Friday night, you know,
Speaker 2: kind of thing. So when I was on call as
Speaker 2: a doctor, I would always sleep in the basement in
Speaker 2: a guest bedroom that had a window by the way,
Speaker 2: and I know my wife was secretly thrilled when I
Speaker 2: would not be there. You know, you can stretch out
Speaker 2: and somebody's ether not moaning or pagers going off and whatnot.
Speaker 2: So I think it's okay. I mean, if somebody says, look,
Speaker 2: I really like sleeping with my partner, I don't want
Speaker 2: to sleep away from him or her, that's perfectly fine.
Speaker 2: But I think it's also it's you are we are
Speaker 2: capable of loving buddy and not be in the same mattress.
Speaker 1: I think you maybe just save some marriages right there.
Speaker 2: Yeah, we've got a sleep cation. I think my wife
Speaker 2: came with that word to it, called a sleepcation. It's
Speaker 2: kind of exotic, like when what they're up to tonight
Speaker 2: and you know, and I always tell people, you know,
Speaker 2: you can get in bed and read and maybe fool around,
Speaker 2: and then when it's time to sleep, you know, you
Speaker 2: kind of do the thing like, well, I'm going to
Speaker 2: leave now. And it doesn't mean you don't love them
Speaker 2: or want to be with them. And ohife hates me
Speaker 2: being anywhere near her at night and for some reason
Speaker 2: kind of gravitate over to her side of the bed
Speaker 2: and she's like, get away. You know, I just don't
Speaker 2: want that. And I don't mean I don't think. I
Speaker 2: don't think it means she doesn't love me. But you know,
Speaker 2: I think that people just need to sleep and do
Speaker 2: what's right for their sleep and not necessarily have some
Speaker 2: you know, guy breathing and hanging over top of you know,
Speaker 2: I think it's probably a good thing.
Speaker 1: And if you do this side note, you're not alone.
Speaker 1: I read one study that said almost fourteen percent of
Speaker 1: couples who live together sleep apart, mostly because of snoring.
Speaker 1: And I read this one tip that said sleeping on
Speaker 1: your back can cause snoring. And you can wear a
Speaker 1: T shirt with a pocket backwards and put a tennis
Speaker 1: ball in the pocket to train you not to sleep
Speaker 1: in hivas in a corpse post. Now, if it works,
Speaker 1: or if you have Wimbledon nightmares, please let me know.
Speaker 2: Now.
Speaker 1: What about naps good or bad?
Speaker 2: So my definition of so, I think a nap is
Speaker 2: good if you're an efficient sleeper. What I mean by
Speaker 2: that is if you're somebody who gets in bed, falls
Speaker 2: asleep in a time that's pleasing to you, you sleep
Speaker 2: relatively well, and then you still feel like you need sleep.
Speaker 2: On top of that, I think a nap is a
Speaker 2: great thing. You know, if you can build it into
Speaker 2: your day at a designated time and have a little
Speaker 2: place where you can do it, that's kind of special
Speaker 2: and I think that's great. I think it's a bad
Speaker 2: idea when somebody says I went to bed last night,
Speaker 2: I was really upset about a decision on the voice,
Speaker 2: and I can't believe they sent her home because she's
Speaker 2: so much better than that guy who's saying dock of
Speaker 2: the bay. For God's sakes, he got through seeing doc
Speaker 2: of the bed. I don't believe it, and she completely
Speaker 2: reworked that Christina or anyway digressing. So you're really upset
Speaker 2: about that thing, and you go to bed and it
Speaker 2: takes you three hours to fall asleep. You know, you
Speaker 2: were up all night because of that. You can't believe
Speaker 2: the decision. And then you take a nap the next
Speaker 2: day because you couldn't sleep last night. Now you had
Speaker 2: the opportunity to sleep, but for whatever reason, your brain
Speaker 2: decided he didn't want to. I think that's a dangerous
Speaker 2: path to go down. You see that a lot with
Speaker 2: retired people. There's no kids in the house anymore. I
Speaker 2: love old people. They can get up at three o'clock
Speaker 2: in the morning if they want to. They can go
Speaker 2: to bed at six o'clock after McNeil lair if they
Speaker 2: want to. They can do whatever the hell they want to.
Speaker 2: They've earned it, for God's sakes. But the problem is
Speaker 2: when they have no sort of constraints on their sleep.
Speaker 2: If they have a bad night, but they just sleep
Speaker 2: in or take a massive four hour nap, right, you know,
Speaker 2: at five o'clock in the afternoon, And now it's eleven o'clock,
Speaker 2: they want to go to bed, they can't, another frustrated,
Speaker 2: and so the cycle sort of begins. So I think
Speaker 2: napping is great. Try to keep it relatively short, twenty
Speaker 2: twenty five, thirty minutes closer to the beginning of the day,
Speaker 2: so we're adding on to last night, not subtracting from
Speaker 2: the upcoming night. And I think naps are great. I mean,
Speaker 2: it's such a such a wonderful thing to you know,
Speaker 2: kind of sleep at a time when you're not supposed to.
Speaker 2: And I think it's also interesting to pay attention to
Speaker 2: how you fall asleep when you nap. Meaning I've got
Speaker 2: a lot of people who it takes the four hours
Speaker 2: to fall asleep at night, and they feel completely dependent
Speaker 2: on sleeping pills. But they'll say things like, I was,
Speaker 2: you know, sitting there the other day and it's hard
Speaker 2: for me to you know, I come in from church,
Speaker 2: I'm so exhausted, I take a nap. And I always
Speaker 2: ask them, well, what what pill do you take to
Speaker 2: take your nap after church? And look at you like, oh,
Speaker 2: I don't take a pill, then well, why do you
Speaker 2: think if you're able to fall asleep after church? But
Speaker 2: you're not able to fall asleep eleven o'clock when you
Speaker 2: want to go to bed. And it's always interesting the
Speaker 2: answers they give you, you know, because we think of nap
Speaker 2: as being this sort of extra credit. You know, teacher
Speaker 2: gives you some problems, and the last two problems on
Speaker 2: the test to extra credit. Well, I've got some time.
Speaker 2: I'll do it, no pressure, and you to get those right,
Speaker 2: cause it's like if you get them, great, if you don't,
Speaker 2: it's not that big a deal. It's extra credit. Naps
Speaker 2: sort of like our sleep extra credit. You know, it's
Speaker 2: bonus sleep. But boy, you know, the final exam is
Speaker 2: our sleep at night. We got to sleep now, like
Speaker 2: we want to kind of get out of that place.
Speaker 2: So that's a good place.
Speaker 1: So the anxiety of sleeping doesn't let you sleep, doesn't
Speaker 1: let you.
Speaker 2: Sleep, and so we don't want to. We want nap
Speaker 2: to facilitate the process.
Speaker 1: So to recap, naps are fine, but not if they
Speaker 1: mess up your bedtime. So do it earlier or just
Speaker 1: save that sleepiness for sweet sweet night slumber. Now, if
Speaker 1: sleep is an issue for you or for someone in
Speaker 1: your life, maybe take like a nerdy approach first and
Speaker 1: just gather some data, and so what is the best
Speaker 1: way to track it? Because knowledge of your sleep will
Speaker 1: probably motivate you to get better sleep. Our fitbit trackers good.
Speaker 1: Should you wear like a headband with electronics on it?
Speaker 1: Should you just try to keep a journal next to
Speaker 1: your bed, Like, what's the best way to figure out
Speaker 1: if you're getting enough?
Speaker 2: So all those things are good. I think the personally
Speaker 2: the best way to figure out you're getting enough sleep
Speaker 2: is to look up, either in my book or online,
Speaker 2: something called the Epworth Sleepiness Scale.
Speaker 1: So I was hoping that this quick test was named
Speaker 1: for like a Lord Epworth, the Duke of Knaps, who
Speaker 1: fell asleep playing croquet, But it was actually coined by
Speaker 1: an Australian doctor, Murray John's for the hospital that he
Speaker 1: works at. Okay, a little bit of a snoozebust on
Speaker 1: that backstory. Anyway, you can take it at Epworthsleepiness Scale
Speaker 1: dot com. I myself scored an eleven mild excessive daytime sleepiness.
Speaker 1: Now doctor Winter explains what this scale is.
Speaker 2: Which is a series of scenarios that you might find
Speaker 2: yourself in and the question is how likely would you
Speaker 2: fall asleep if you were in that situation. How likely
Speaker 2: would it be for you to fall asleep reading a book,
Speaker 2: watching television, passenger in a car for an hour. If
Speaker 2: you're answering the question all the time, always fall asleep.
Speaker 2: Can't read because I fall asleep as soon as I
Speaker 2: start reading. I really can't sit down in the evening
Speaker 2: or I'll fall asleep. That's probably a good indication that
Speaker 2: you're not getting enough sleep. There's something wrong with it.
Speaker 2: So I think all those modalities that you mentioned sleep
Speaker 2: diaries fitbit tracker. I'm wearing one that's made by Nokia,
Speaker 2: which I think is outstanding because it uses movement and
Speaker 2: some heart rate variability. All those things are great. You
Speaker 2: just need to understand sort of what they're built to
Speaker 2: do and what they're not built to do. But they're
Speaker 2: a great way. All of these things do such a
Speaker 2: good job of keeping us honest about our sleep. I mean,
Speaker 2: I would go around tell people I'd get seven hours
Speaker 2: sleep at night, go bed around eleven o'clock, get up
Speaker 2: around six, which is such a lie. Like when I
Speaker 2: started wearing these, I wore several trackers on my arm
Speaker 2: for a month to see which ones were good and
Speaker 2: not so good, And then I did a sleep study
Speaker 2: of myself, and then last night wearing all of them
Speaker 2: to see how they compare to the actual sleep study.
Speaker 2: And the thing I learned the most about that process
Speaker 2: was what a liar I was about my own sleep,
Speaker 2: you know, and not even knowing that. I'm not deceiving
Speaker 2: people intentionally. It's just that, yes, ideally I would like
Speaker 2: to go about eleven to get up at six, but
Speaker 2: my son swims, so he's got to get driven to
Speaker 2: the pool early. Or Stephen Colbert looks really funny, So
Speaker 2: I'm watching some of his monologue and by the time
Speaker 2: you get the dog put away and I get some
Speaker 2: water and kind of get things, turn the lights out
Speaker 2: from my wife's fallen asleep on the couch, check on
Speaker 2: the kids. Oh god, check one more email, and you
Speaker 2: see what's going on here. It's closer to midnight or
Speaker 2: even later sometimes. So I think those things do a
Speaker 2: very nice job of kind of keeping us honest about
Speaker 2: how much sleep are we really getting, And I think
Speaker 2: that can be a very valuable first step in terms
Speaker 2: of solving a problem. But I do think that there's
Speaker 2: a lot of questions you can know do you sleep
Speaker 2: well at home versus your girlfriend's place. Do you sleep
Speaker 2: better after a bunch of beers because you feel like
Speaker 2: you do versus when you don't drink? And I think
Speaker 2: you know, posing a question to something like a fitbit
Speaker 2: can be really interesting. I'm really on an exercise kick.
Speaker 2: Look how my sleep looks now versus a few weeks
Speaker 2: ago before I started. Oh wow, it looks a lot
Speaker 2: more efficient. Or I seem to have more deep sleep,
Speaker 2: or I fall asleep a lot faster. Generally, they work
Speaker 2: best when you're comparing data to itself, like your own
Speaker 2: data pre this sky, I'm dating post this sky, I'm
Speaker 2: dating pre this supplement, I'm taking post That's where it
Speaker 2: tends to work its best, I think.
Speaker 1: And in general, if someone saying I'm having trouble sleeping,
Speaker 1: I'm having trouble falling asleep, I'm having trouble getting the
Speaker 1: right amount of sleep, is there like a one basic
Speaker 1: piece of advice that you're like, start here and see
Speaker 1: if that helps.
Speaker 2: Yeah, it's interesting. I think if somebody says to me
Speaker 2: I'm having trouble sleeping, they've already sort of moved past
Speaker 2: the biggest barrier, which is the person who comes to
Speaker 2: me and says I can't sleep.
Speaker 1: Doctor Winter says that a lot of times we're getting
Speaker 1: a little more sleep than we think we are, because
Speaker 1: if you literally did not sleep.
Speaker 2: You would not be alive.
Speaker 1: Wait, what's the record?
Speaker 2: I mean, the world record is something like eleven days
Speaker 2: and even and that was a sham. The investigator said,
Speaker 2: we couldn't keep him awake. He kept having these little
Speaker 2: micro sleeps even he was standing on his feet.
Speaker 1: So, provided that we're not seeking the world's attention by
Speaker 1: not sleeping, how much should we sleep?
Speaker 2: A lot of people are seeking ten hours of sleep
Speaker 2: at night, but they're only capable of getting six hours
Speaker 2: and forty five minutes. So that difference of three hours
Speaker 2: and fifteen minutes I think is insomnia. It's also important
Speaker 2: to make sure that there aren't things that are happening
Speaker 2: within your body that are impairing your ability to sleep
Speaker 2: as well too. That can be something from this insomnia
Speaker 2: to restless leg syndrome to sleep at me. There's a
Speaker 2: lot of things that happen at night that can't impair
Speaker 2: our ability to sleep.
Speaker 1: And how necessary is a sleep study?
Speaker 2: Usually?
Speaker 1: Is it like go.
Speaker 2: Figure out out? I mean, I really work hard to
Speaker 2: keep people out of a sleep center. I think most
Speaker 2: you know, we learn as doctors, most of the diagnosing
Speaker 2: and treatment of problems has to do with the clinical interview.
Speaker 2: So that's why we spent a lot of time talking
Speaker 2: to our pay because we need to understand what the
Speaker 2: problem is. You know, the sleep study is often confirmatory,
Speaker 2: like I already think this is what's going on, so
Speaker 2: we'll do sleep study to confirm it. Or sadly, in
Speaker 2: twenty eighteen, a lot of times this study is done
Speaker 2: because that's the only way you can get insurance to
Speaker 2: pay for something. They won't take the expert's word for it.
Speaker 2: They want proof that this person has narcillabsey. They want
Speaker 2: prove this person has restless like syndrome, even though clearly
Speaker 2: from their story that's exactly what's going on. So not
Speaker 2: everybody who has a sleep problem needs a sleep study,
Speaker 2: And of the people who need sleep studies, many of
Speaker 2: them can be done in your own home with these
Speaker 2: little simple devices. So don't let that be a stopper
Speaker 2: in terms of getting help. But you know, when they're necessary,
Speaker 2: they can be incredibly helpful.
Speaker 1: So sleep studies can be a great ally in terms
Speaker 1: of convincing doctors that you do indeed have a serious issue.
Speaker 1: They can also be a little bit like mister snuffle up,
Speaker 1: I guess, and if insomnia is caused by anxiety in
Speaker 1: your life, taking a break and sleeping in a hotel
Speaker 1: hell room like environment can be just the vacation you
Speaker 1: need from your usual mental anguish, even if you have
Speaker 1: a bouquet of wires taped to your face. So if
Speaker 1: you want to start small, you can jot down the
Speaker 1: hours you sleep, of course, or you can try a
Speaker 1: sleep tracker. I bought my fitbit at bed, Bath and
Speaker 1: Beyond with one of those twenty percent off coupons that
Speaker 1: my neighbor left near the mailboxes for a week, and
Speaker 1: it's been a nice gaze into the underworld of my
Speaker 1: sleep issues. Now. Tune in next week for Part two,
Speaker 1: which features more remedies to your sleep issues. Patrons rode
Speaker 1: in with over two hundred questions. We got to as
Speaker 1: many as we could. We covered sleeping pills, supplements, genetic
Speaker 1: factors in sleep, blue light making, good habits, stick alcohol
Speaker 1: to get you drowsy, sleepwalking, sleep talking, the best positions
Speaker 1: for snoozing, and of course my mom birthday girl, Nancy
Speaker 1: Ward's magic cure for insomnia that I use all the
Speaker 1: time when I've had too much caffeine or at seven,
Speaker 1: but I have to go to sleep to get out
Speaker 1: for the airport. So all of that is next week,
Speaker 1: so make sure to come back the extra hour or
Speaker 1: so for part two. Could add years back onto your
Speaker 1: life now. Meanwhile, doctor Chris Winter is at sports sleep
Speaker 1: doc on Twitter and his book is called The Sleep Solution,
Speaker 1: Why Your Sleep is Broken and How to Fix It.
Speaker 1: And he also has a kid's sleep book that came
Speaker 1: out in twenty twenty one called The Rested Child. Why
Speaker 1: You're tired, wired, or irritable child may have a sleep
Speaker 1: disorder and how to help. So just fyi, that's another
Speaker 1: book he's got. Now. You can follow Ologies at ologies
Speaker 1: on Twitter and Instagram. I'm Ali Ward with one L
Speaker 1: on Twitter and Instagram too. You can get a comfy
Speaker 1: ologies T shirt to sleep in at ologismerch dot com.
Speaker 1: Thank you Shannon Feltas and Bonnie Judge for so many
Speaker 1: great designs that are up. You can join the Ologies
Speaker 1: podcast Facebook group, which is just a haven for benevolent
Speaker 1: and curious nerds on Facebook. I love each and every
Speaker 1: one of you in there. Thank you. Eric Talbert for admitting.
Speaker 1: Thank you to editor Stephen Ray Morris for losing sleep
Speaker 1: piecing this all together. Each week a Nick Thorburn of
Speaker 1: the band Islands wrote and performed the theme music. And
Speaker 1: now at the end of each episode, I tell you
Speaker 1: a secret, and this is part life hack in part you.
Speaker 1: But okay, so sleep masks always annoy me. They fall off,
Speaker 1: the velcrow gets stuck in my buffalo hair. And so
Speaker 1: a few years ago I started using a sock. You
Speaker 1: take a knee high sock. Might have all been worn
Speaker 1: on my feet before. I just don't care. I wash
Speaker 1: them anyway. Take a knee high and you pin it
Speaker 1: in a big loop like a snake eating its bud.
Speaker 1: Put a safety pin in it, and then you pop
Speaker 1: that thing on your head and it stays all night.
Speaker 1: It is weird if you begin dating someone and you're like,
Speaker 1: good night, I'm putting this old sock on my face now.
Speaker 1: So if you're crafty, you could probably artfully sew it together.
Speaker 1: If you don't have knee socks, invest in a pair
Speaker 1: wear them on your face. Bonus, if you lose one,
Speaker 1: you have a spare, and they're very machine washable. If
Speaker 1: you do this, please take a photo for me and
Speaker 1: tag it hashtag ology sock face. I promise to post one.
Speaker 1: Also also Hi, It's twenty twenty two. Ali Ward again,
Speaker 1: just saying thank you for bearing with these Encore episodes.
Speaker 1: The last couple weeks of my life have been maybe
Speaker 1: the hardest. On Friday, if you've been following along with
Speaker 1: what's been on with my family, my dad had emergency
Speaker 1: brain surgery for a brain tumor. He also has some
Speaker 1: long tumors and some of the things that are not great.
Speaker 1: And on Friday, my dad's oncologists made the call that
Speaker 1: it is time for treatment to stop, and so we're
Speaker 1: just starting a hospice and which is why I'm whispering
Speaker 1: at my sister's dining room table. So while you listen
Speaker 1: to these Encore episodes, just know that you're just letting
Speaker 1: me have some of the most the most precious time
Speaker 1: of our lives. So we are spending time as a
Speaker 1: family and just hanging out. And thank you for that,
Speaker 1: for being so patient and supportive and all that, and
Speaker 1: thank you for everyone who's been sending me sweet messages. Okay,
Speaker 1: go get some sleep. Okay, just go get some sleep.
Speaker 2: Just get some sleep.
Speaker 1: You have earned it for by pacodermatology, hombiology or doo zoology, lithology, technology, meteorology, pathology, methology,
Speaker 1: zeriology
Speaker 2: Elithology, Sleep, yes, I sleep