“Um, and cause what's happening, it's not only that daytime city. The other thing it's doing, and we'll talk about this when we talk about supplements, but melatonin. So melatonin naturally your, your natural melatonin will drop in the morning down to like almost from its peak to almost nothing.”
“Light suppresses melatonin naturally. That's what it does. And so the early, if your melatonin is still kind of high and it's dropping by getting that light, you accelerate its ability to drop. It's like coffee. Yeah, kind of.”
“but you know, obviously the most, the top of mind supplement people think about when they think about sleep, I think melatonin. Melatonin. So melatonin is a hormone. It's a very old molecule. It's in plants. It's in other stuff. It's not a sleep hormone.”
“A great example of how it's not a sleep signal. It has no sedating properties whatsoever. Melatonin doesn't. You give melatonin to a nocturnal animal. It wakes them up because it's a nighttime signal to the degree to which your body gets a nighttime signal.”
“Now, some people, when they take melatonin, they might be taking the wrong dose at the wrong time. So the way we've started using melatonin as a treatment for something was our natural rhythms are about 24 hours.”
“where you just can't reset your rhythm with light. What they found is, you give someone a third to a half a milligram of melatonin in the evening, and a blind person fixes the whole thing. Sends the nighttime signal at the time when it needs to see it, and the system responds beautifully to it”
“like right around dinner, or like, usually two to three hours before your typical bedtime is when you start producing melatonin. You give it a couple hours before that, it's in the zone where you're looking for it. Like give it in the middle of the day, your body's not looking for it. It's in the zone where your body's looking for it,”
“That also means you'll wake up a little earlier, because the whole thing got shifted. Same thing as if you take that low dose melatonin as soon as you wake up in the morning, that drop gets delayed a little bit. So it ends, so that ball lands a little further along than it expected to, so your day started a little bit later than it thought it was going to”
“Well, A, people think more is more, and sometimes more is less, especially with melatonin. If it's just a nighttime signal, more isn't more. Five, you can take closer to bedtime, that's a little more of a sleep promoting dose,”
“with it, you know, closer to bedtime, it can have that sleep promoting effect, not because the melatonin was sedating, was it sort of got, was that strong enough signal to kick you into gear a little bit. Now, a lot of times people will feel groggy in the morning with it. That's because you just couldn't metabolize it fast enough,”
“So you were, you were, oh, you overfilled your bucket. And so by the morning, you still have melatonin floating around, backfiring. So now you're telling your body it's nighttime when it's daytime, because you couldn't get rid of the nighttime signal fast enough.”
“And, and it had built up over time. So often when I say, if you're taking melatonin at night and it's helping you, but you're feeling groggy during the day, cut your dose in half. And then there's the other problem. There was like a few studies have been published where, I mean, almost all these melatonin supplements that are out on the market have huge variations.”
“or reduces your ability to naturally produce it at night. What about, and that's also what the conclusion I came to, um, what about the ability to like your melatonin receptors? Like, um, is there remodeling? I don't know. I, I haven't seen anything that's concerning in any way. I, I just, I just haven't.”
“sleep on the plane. when I can, I got my earplugs, got my eye mask, got my melatonin, got like, you know, whatever. Um, I will do what, and, and I'll do whatever I can to catch a little bit of sleep on the plane. I'll have a crappy fragmented night of sleep on the plane land in the morning localtime”
“So yes, they are shifted and it changes with age. Um, so yes, you can use light behavior and melatonin to physically shift that you can do that, but they are more naturally inclined to staying up late. I mean, it's high school. It should not start before 9 AM.”
“know, melatonin. Yeah. You can help with that. You can give people melatonin to, you can give melatonin low, that low dose half milligram melatonin. As a phase shifting dose and light as a phase shifting dose of bright light, you can, you can do that.”
“You can, I mean, you can essentially jet lag yourself on purpose without traveling by doing that, by giving light and melatonin at the time you want. I mean, that's good to know, right? I mean. Yeah. Some people are more resilient to it than others. Some people are more sensitive to it than others. But you can do it.”
“I mean, really, really, there's no other way besides either looking. I mean, you can, you might in the future, might even be easier to look at the wearable data. Check your oxygen levels during the night. Check your heart rate during the night. See if you have these spikes that you used to have. And most importantly, see how you feel the next day.”
“and so getting that feedback can sometimes be helpful. Yeah, no, I mean, I, I will talk about wearables later. Yeah, we'll definitely get into that. Um, okay. I mean, any other of these, there's caffeine we could talk about. Yeah. I mean, caffeine, probably the most used psychoactive substance in the world.”
“We were there in the room. We were arguing over this. And those recommendations are not based on wearable data. They're based on, on average, how much sleep do you feel like you get? Because that is what's correlated with the health outcomes. The wearable data is a lot more murky in terms of its correlation with the health outcomes.”
“the wearable data can fall under that and you're totally fine. Like up to maybe an hour even under that and you should be totally fine. So that's, I trust it to be correct and accurate for what it is, but it doesn't mean it's measuring the same thing.”
“And so it's, you got to interpret it with that caution. So that's the caution with the sleep stages. If I show you what a brainwave tracing of sleep stages and a wearable tracing, that you can tell you could, if it's a good device, you can easily tell these are the same person on the same night if you looked at them.”
“And I was explaining this wearable stuff to her. And as we were developing our own trainings with this, and she came up with this way of thinking about it as a bathroom scale is not a weight loss program.”
“What happened? It's like it, that is the number it's probably best at. So if I'm going to make a decision based on wearables, the first number I'm looking at is the, how much sleep did I get and where did it detect the awakenings? Because those were probably correct, especially if they were more than a couple of minutes.”
“they were up and down. So they could use the wearable device to sort of de-stress a little bit and find the sleep that they may not remember. On the flip side, if it's detecting awakening, if you're trying to figure out why you're tired and you feel like you slept okay, you can look at the device and say like, oh, I see what's happening.”
“Kelly Barron. She's at the University of Utah. She's, she's, she's like me. She studies sleep and sleep health and wearables and stuff. And so she came up with this idea, um, putting a name to what we would see in clinic of people who overly fixated on the data to the point of where,”
“We will probably, I'll look at your wearable data, but most people in my world don't even do that. They don't look at your wearable decks. They don't care. If you have a problem with your sleep, I will ask you the questions I need to ask, do the tests I need to do to figure out what that problem is and use all the tools I have to fix that problem, irrespective of whatever your wearable says.”
“I would say most people probably need seven by self-report. That might mean six or six and a half on your wearable. Right. Okay. And then one practical tip for aligning lifestyle with your chronotype. Yeah. I mean, give yourself permission to schedule stuff out in different times.”
“light, you accelerate its ability to drop. It's like coffee. Yeah, kind of. That's also why I don't recommend that people caffeinate as soon as they wake up. I recommend people wait an hour because if, if you caffeinate, as soon as you wake up, the, the amount of adenosine that that caffeine is blocking is still very low.”
“yes, it's called placebo. And then, so they laugh and like, what do you mean? I'm like, coffee doesn't work olfactory. It doesn't work through the nose. So if you smell it and you start perking up, it's because you're predicting what its effects are going to be before you even ingested it.”
“So like, wait a little bit. Cause you're, cause you don't need it. That's why I drink decaf coffee, like, you know, at 11, 11 a.m. And I feel like it's totally working and I'm totally fine with that placebo. Right. Cause you had it in you all along. Right. So, so it sounds like the morning routine would be wake up.”
“you know, wait a little bit. Then you make your coffee. Obviously there's some people are kind of rushing to get to work, but you can drink your coffee in the car on the way to work. Yeah. Or wait till you get there. Or wait till you get to work. Yeah. Okay. I'm going to try that. Yeah. I mean,”
“the whole calf nap, or the nappuccino or whatever they call it, where like they drink the coffee, take a nap for 15 to 20 minutes, wake up right when the coffee starts ramping up and then they, then they go. I've never heard of that. Oh yeah. It's a thing. I mean,”
“It works. It's relatively safe. Um, coffee is actually a great source of antioxidants and, and phenols. Um, especially if, if you're actually just, if you're drinking it from, from coffee, not just the isolated caffeine molecule, it picks up, peaks at around 30 ish minutes.”
“can't, you can't get into that stage if your brain's sort of still wired and active. So for those people that say I can drink a cup of coffee and then go to bed 30 minutes later, it may be disrupting their sleep architecture. It might be, it might be. Um, but also again, people, there's huge variability in how people metabolize caffeine also.”
“to be honest. Right. It's more like clinical reports. Yeah, I could do this and sleep fine. And I've, and I've seen people who drink coffee at night and their sleep looks fine. So like, who knows? Another one that I've talked about with Dr. Sachin Panda, who's been on the podcast a few times, is late night eating.”
“Strategically? I mean, you should use it as, think of it as, I will drink coffee in about 30 minutes. It'll have its peak effectiveness. And I, in about six, for at least the next six hours, I will not be in a sleep window.”
“Watch the space next 10 years. I think more stuff is going to come out. Okay. What about CBD? CBD? Much more murky of a story. CBD is, is a legit molecule, especially in terms of the things that it does. But the sleep data from CBD are extremely murky.”
“I don't, I don't have any clear answers about CBD, except I would keep, I'm just, I would keep an open mind with it, but expectations in check. How does it, how does it work?”
“If, if what you need is one of those. What about mouth taping? Mouth taping. So, all right. Mouth taping. So mouth taping for decades in the sleep medicine field,”
“Okay. Chin straps have been great. They're there. They've been again, used for decades. Mouth taping, I think is just sort of the same thing where you're essentially just keeping your mouth closed. You're just keeping your mouth closed in a way that you can breathe through. Like it's, it's special tape where air flows through fine.”
“So, some of them block blue for eye stream, but that's a different thing. So, if you put on, say, orange-tinted glasses and you can't see the color blue, then the environmental light is not going to interfere with your sleep in the same way because it's not going to send a daytime signal.”
“at least the light, so it's the blue green frequency of light that sends information to the clock. That's why the orange lenses block it. But wear like a blue or green or tinted sunglasses if you're going to wear sunglasses in the morning. So that actually works where you can see it. I don't know. There's no data on this.”
“They're related, but they do function somewhat independently. And so sedatives boost that sleepiness signal. A lot of times with insomnia, what happens because of the excess activation arousal, your sleep signal could be just fine.”
“you're doing so that it's not too activated. Why are a lot of people that have insomnia, why are they prescribed, you know, these sedatives like Ambien or? Well, they don't not work. I mean, like, like I was saying, like, what they do is they drive up that sleep drive so much it overpowers whatever's in the way.”
“That's why the orange lenses block it. But wear like a blue or green or tinted sunglasses if you're going to wear sunglasses in the morning. So that actually works where you can see it. I don't know. There's no data on this. I just made that up, but, but it should work because as long as you're getting that frequency of light,”
“Yeah. Cause I would imagine, like you were saying earlier, obviously the early morning light, it's not as damaging. So you play, don't need sunglasses then, but you're talking about being outside long, like hours during the day and how that also protects you from the, the, you know, the blue light inhibiting melatonin later.”
“Like if you're not, so if you do it earlier, then you're, if you're, if you're, if you're having wine at dinner and then you've still got a few hours, alcohol is probably out of your system by the time you get to bed. The only thing you don't want is to time it so that, that the activating part of the alcohol being out of your system, is it when you're going to bed?”
“And I've had a number of patients come in thinking like, well, I used to, you know, I used to drink some wine before going to bed and I thought that would mellow me out. And then I looked at my wearable data and realized it made my sleep crappy. It made my sleep terrible. And so I stopped. Um, and so getting that feedback can sometimes be helpful.”
“That's fine. Okay. Well, is your air very polluted in that case? In that case, you know, maybe you need an air purifier. So from a sleep perspective, it's, is there anything physically that's preventing you from getting deep sleep if you wanted it? Do you have some sort of systemic inflammation going on?”
“Why, why are a lot of people that have, that have insomnia, why are they prescribed, you know, these sedatives like, you know, Ambien or. Well, they don't not work. I mean, like, like I was saying, like what they do is they drive up that sleep drive so much. It overpowers whatever's in the way.”
“Yes. Lots of them out there. Aura, the Whoop. Yeah. What do we have? Apple Watch, the Fitbit, and Pixel. You and I are both on the scientific advisory for the Google Google. Yeah. Which is where we first met. But I want to know what metrics do you think are truly good at being captured accurately?”
“helpful, that's where things like the L-theanine and some of these other more calming things like the chamomile and some of that stuff that can be calming. Can actually be helpful. Even if they don't actually technically do anything on the sleep side. Other things that can help promote sleep.”
“tongue falling back and they can breathe through their nose. Okay. Chin straps have been great. They're there. They've been again, used for decades. Mouth taping, I think is just sort of the same thing where you're essentially just keeping your mouth closed. You're just keeping your mouth closed in a way that you can breathe through.”
“interventions? So the thing about CPAP is it's a blunt instrument because it's, it's think of it. It's just, it's just a split that keeps open your airway. It's it's, it creates a pillow of air that sort of, so if your airway wants to collapse, it can't.”
“There's a device called excite OSA where, where it's, you put it on your tongue when you're awake and it's sort of electrically stimulates your tongue muscle.”
“to better test scores the next day. That's just one example. Like eye masks and earplugs, some of the best cheap sleep technology that exists. Yeah, so darkness and darkness. Well, but it's not, and but it's also you might need to just that extra layer of insulation, extra layer, yeah, yeah, like a white noise machine could be good for something like that.”
“I don't know because none of it's transparent and forget the transparent. I know Google did a study with on the, the net was a Google Fitbit before it was Google, I think where they had their sleep score and they correlated the actual global sleep score to an app, outcomes, and they presented the data at a conference as a global thing.”
“branch chain amino acids in general could be good for recovery, especially after trading. And, and if it's got some extra glycine in it, all the better, but if it's got a lot of glutamine in it, you want to not be using that. Cause glutamine is, is, is activated. And so, I mean, I've had athletes I've worked with who like complain, complained about their insomnia.”
“There's a new device. People have maybe seen commercials called inspire, which just means breathe in. But it's, it's sort of like a pacemaker that they install.”
“Well, with that said, are there any other, I mean, I've heard of a variety of supplements like magnesium, lavender, glycine, L-theanine, any, I mean, you know, moderate evidence that some of these work. So a lot, a lot of them have evidence that they're definitely not nothing.”
“The one I tend to use the most, especially with athletes who are often presenting with more mild to moderate sleep apnea anyway, or what are called mandibular advancement devices.”
“So take your multivitamin in the morning, not in the evening. Yeah, if if I-I-I have I have this dream that one day I have an AM vitamin and a PM vitamin, where like some stuff might be better at night”
“if you do them in different places, in a different hotel room or whatever. Especially if you can bring things with you, like bring the pillowcase with you as a conditioned stimulus. Use the same toothbrush, whether it's at home or on the road, if you travel a lot.”
“or rhino med makes these, these nasal splints. We can keep your nose open.”
“It doesn't, and it works well by helping people gain control. It doesn't necessarily add hours to your night, but neither do sleeping pills either. What it does is it removes some of those barriers. About, again, about 85% of the time, not 100%.”
“Like a white noise machine could be good for something like that.”
“Use the same toothbrush, whether it's at home or on the road, if you travel a lot. Do the same things in the same order. So even if they're at a different time in a different place, find alternate ways to build predictability if time itself is not the predictable one.”
“get two twin XLs, put them next to each other. Sleep in a set with, you know, you can sleep with somebody, but not on the same mattress.”
“None of them have beaten placebo to treat insomnia. The closest that came was valerian. But when you put it in, pull the data, it still doesn't beat insomnia, a placebo for insomnia. So it can't, but it is sedating. It can be calming.”
As referenced on air, with the quote and the moment. Reported, not evaluated.
“In a sleep deprivation study, if you take somebody and you sleep deprive them, there've been a number of studies that did this. And they look to see what you see, what calories they're consuming. And on average, people tend to consume about 350 to 600 extra calories per 24 hours when you sleep deprived them in the lab”
“I know Google did a study with on the, the net was a Google Fitbit before it was Google, I think where they had their sleep score and they correlated the actual global sleep score to an app, outcomes, and they presented the data at a conference”
“a colleague of mine, Teresa Aurora, she led this project that I, that I also helped on. We looked at, we basically scoured the entire medical literature on resilience and sleep”
“There was a study, I think it was in Switzerland. Where they had an eye mask, just a plain old cloth eye mask, and they had a placebo eye mask where they cut the holes out in the middle.”
“my colleague, Wendy Troxell, she has a fantastic Ted talk on this, um, on school start times.”
“there's this great study where they did in tennis players, semi-pro tennis players. When they took them down to five hours of sleep, impaired their serving accuracy by...”
“There was a study, I think it was in Switzerland. Where they had an eye mask, just a plain old cloth eye mask, and they had a placebo eye mask where they cut the holes out in the middle.”