Snooze-Worthy Strategies with Dr. Kansagra: Unraveling Sleep Science

Episode Transcript
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Speaker 1 (00:00):
Hey everybody, welcome to the podcast, Episode
20.
Something doesn't really matter.
And as an introduction firstdigit right, it's 20 something.
I know it's 20 something as anintroduction that we didn't plan
at all.
Hey Rob, how'd you sleep lastnight?

Speaker 2 (00:13):
I didn't.

Speaker 1 (00:14):
Hey, that's a good transition, because right now we
have a guest where we're goingto be talking about sleep.
So why don't you introduceyourself?
Because, again, we know we'reterrible at it.

Speaker 3 (00:25):
Sure Happy to do it.
I'm Sujay Kansagra.
I'm a child neurologist and asleep medicine physician by
trade.
Sleep is my life.
I treat kids that have avariety of sleep disorders and
recently have been out on socialmedia trying to educate folks
about how great sleep is.
So it's good to be here.

Speaker 1 (00:42):
Oh, yes, that's the thing that I always tell people
about and they immediately rolltheir eyes I don't know what it
is about sleep.
But as soon as you tell peoplesleep, they're like, yeah, I
know, like I don't do it, like Idon't know what it is.
What is it about sleep?

Speaker 3 (00:54):
You know, I'll tell you what it is.
It's a cultural thing.
You know to be sleeping and weshould wear sleep deprivation
like a badge of honor, and thethe less you sleep, the harder
you're working.
And you know lots ofmisperceptions and, honestly, we
just didn't know much aboutsleep science until like the
last few decades, and it's takena while to sink in.

Speaker 1 (01:12):
So I think I think that's what it is, you're a
hundred percent right with that,especially because, like I will
listen to, like you know, thepresident will say something
like I only sleep four hours anight and I get I'm like no,
please, don't, please, please,don't tell me that.

Speaker 2 (01:26):
Listen that means you have the missile codes, launch
numbers.

Speaker 1 (01:29):
Whatever it is like, don't tell me you're sleep
deprived.

Speaker 3 (01:33):
That's not good.
Please tell me you're sleepingmore, more.

Speaker 2 (01:37):
Am I supposed to press again?
I don't really remember.
I'm getting too much, surgeonyou know, come on.

Speaker 3 (01:43):
You don't want your surgeon saying they're not
sleeping.
You don't want your pilotsaying they're not sleeping.

Speaker 1 (01:46):
Imagine you're going in for your surgery and they're
like fuck, I did not sleep welllast night, let's cut them open.
Like that's not good.

Speaker 3 (01:54):
Healthcare and sleep deprivation is like a whole
other topic we can talk about,but it's scary, it's kind of
frightening.
You should probably have theright to ask these questions to
your surgeon, like, did yousleep well last night?
Like how much did you sleep,how long have you been on call?
Because that probably affectsyour outcomes.
But at this, point we don't askthose questions.

Speaker 1 (02:15):
It's a good thing, I'm not performing open heart
surgery today.
Man, I just I don't even wantto get down that rabbit hole,
listen.
So I think a good place tostart with sleep is what is
sleep.

Speaker 3 (02:29):
Now for the listeners who have never heard of sleep
before, why don't you tell thema little bit about what it is?
Yeah, it's a fairly new thing.
You know some people are intoit.
Well, yes, sleep the definitionthat I like.
It's a reversible state ofperceptual disengagement from,
and decreased responsiveness to,the environment.
That's my definition of sleep.
Wow, it's reversible,thankfully right, I mean it's
reversible.
because you wake up in themorning.
You have a decreased level ofresponsiveness.

(02:51):
You're not unresponsive whenyou sleep.
That's why you know you mighttoss and turn on your bed all
night.
You don't fall off your bed andyou also have like some sense
of how much time has passedwhile you're sleeping.
And if you've ever had a dreamwhere the fire alarm is going
off and it's actually yourbedside alarm, you can
incorporate some of thatexternal sensory stimuli into
your sleep state.
So that's the definition that Ilike.

Speaker 2 (03:14):
Everybody has a slightly different definition.

Speaker 1 (03:16):
That was like the sleep version of dihydrogen
monoxide right there.

Speaker 2 (03:18):
Dihydrogen Water, yeah it's the fancy term.
What do you?

Speaker 1 (03:20):
want to sound smart, like I work as a sleep tech.
So for anybody listening, Ididn't talk about this podcast
before, but I work as a sleeptech, so I help people with
sleeping disorders.
But when I want to set when,when I don't want to talk about
people's dreams, I say I'm apolysomnography technologist,
because if you say you work insleep medicine out and about,
they're always like you got tostudy me.
I'm like, yes, I know, everyonesucks at sleeping.
It's all terrible.

(03:41):
You want to talk about yourdreams?
Yep, they really don't meanmuch, as really I'm sorry to
break that news if you're firsthearing this now, but dreams are
kind of at least from what I'veseen, pretty much mind garbage.
Yeah, yeah, that's, that's harsh, that's harshly.

Speaker 3 (03:58):
And yeah, I mean I, we don't.
We really don't even know whatdreams are you know?
Like are they just a byproduct,the fact that we get into these
weird sleep stages?
You know, are we rehearsing?
You know new learned skills?
Nobody really knows.
Yeah, it could be mind garbage.

Speaker 1 (04:09):
I don't want to get into it, but basically, like REM
is when your brain starts to,like you know, move some of the
memories around no-transcript,and that's how your mind copes.
But again, we don't really know, as far as I'm aware, yet

(04:30):
really what dreams are, sothey're just fun or terrible,
depending on the night you're at.

Speaker 3 (04:36):
That's right.
Yeah, I mean it can reallybother people.
You know it can lead to a a lotof sleep disruption for folks
that have recurrent nightmares.
It's a challenge, yeahabsolutely.

Speaker 1 (04:44):
So I mean, I guess just, kind of start with sleep.
Like you know, I guess you gothrough the basic questions
right, like okay, how much I?
I don't really know anythingabout sleep.
How much sleep should I begetting per night?

Speaker 3 (04:54):
yeah.
So the typical adult, the rangeof seven to nine hours is, is
average.
Now, when it comes to theamount of sleep you need, people
say, okay, well, I get sevenevery night but I'm still sleepy
, and and it's funny becausethat range is not permission to
sleep how much ever you want towithin that range.
That range is what encapsulateswhat the sleep need is for the
vast majority of adults, and sowhat your sleep need is is
genetically determined, like youcan't really change it.

(05:16):
So you might be an eight and ahalf hours.
I'm an eight and a half hoursleeper.
Some people are seven hoursleepers and they do just fine
off seven.
I would die with just sevenevery single night.
I would not do well.
So seven to nine is average.
There are short sleepers andthere are long sleepers, but
it's the vast, vast, vastminority of the population.
And it's tough for the longsleepers because they are
labeled as being lazy and notwanting to get out of bed and

(05:38):
that's just the genetic handthey've been dealt.
And short sleepers are the envyof everybody, like you know in
like healthcare and like youknow in the corporate world,
because they can just churn itout.
They tend to be high energy.
They tend to be very positive.
Folks tends to run intofamilies, and so it's.
You know, that's just theirgenetic hand.

Speaker 1 (05:55):
Do you know any associations between like I
honestly I don't know.
I'm asking.
You might not know any, butlike between like the short
sleepers, do they have any other?
Like you know, is there any umrisks that come with that
increased risk for you knowserious diseases or anything
like that?
I mean, I don't know, it's agreat question, none that we
know of.

Speaker 3 (06:12):
You know, we think their short sleep is actually a
byproduct of a genetic change, agenetic polymorphism that we
think lets them go through sleepcycles more efficiently.
So we're, but it's.
It's still an area of researchthat's needed.
But no, no, no negativeconsequences.
They seem to function greatduring the day.
Don't need caffeine, don't havethat lull that a lot of us
experience, as long as they'regetting their so we all just

(06:33):
collectively don't like them.

Speaker 1 (06:35):
Basically is what you're saying.

Speaker 3 (06:36):
That's probably true.
Yes, that's true.

Speaker 1 (06:39):
I'm like man, I need nine hours.

Speaker 2 (06:43):
I just need to conveniently leave the room.
I definitely not one of thoseshort sleepers.

Speaker 1 (06:49):
Yeah, I know, it's definitely more than eight to
nine, like I try and get eightto nine every night.
That's how you know I feel bestand I have a five month old
right now.
So you know, you know you dowhat you can, but I, I mean,
it's just yeah, so don't feelbad if you're like I need the
eight to nine hours.

Speaker 3 (07:04):
Yeah, absolutely not, because I think you're
absolutely right with that.

Speaker 1 (07:07):
They do get kind of labeled as like oh you, just,
you know you need to buckle up alittle bit more, right.

Speaker 3 (07:13):
Yeah, and this is why I like to tell folks,
especially in the corporateworld, like don't compare
yourself to your boss o'clock, Ishould be able to grind it out
until 2 o'clock.
No, your boss is probably inthat position for a reason.
They probably keep you behindvery little sleep.

Speaker 2 (07:29):
And that's probably not you, as the person that is
working to 2 o'clock in themorning.
Please don't do that If youdon't have to work overnight
don't do it, I do it and it'sterrible.

Speaker 1 (07:45):
You really don't want it, you don't?
No, we could get into thatlater about like night shift and
how shitty it is, but anyway,so let's.
I mean we don't want to be onhere for hours and hours okay,
so why do we?
Need sleep.
What's like.
What's the deal like?
We just decide to do it becauseit's fun, like what's what's
going on.

Speaker 3 (07:56):
Well, you know it's funny, it's becoming an
increasingly hard question toanswer because there's so many
reasons why we sleep.
You know, it's kind like beinglike hey, why do we wake, why
are we awake?

Speaker 1 (08:06):
Why are we awake?

Speaker 2 (08:08):
That's a much better question.
Why can't we just stay asleep?

Speaker 1 (08:11):
I'm going to steal that when people ask me.
I'm actually going to stealthat I like that.

Speaker 3 (08:15):
So I'll tell you so some of the reasons.
We think it's good for energyconservation you don't need to
be awake for 24 straight hoursto meet the needs your body has
to maintain hydration andnutrition, et cetera.
We think that it's good formemory consolidation, right?
We move a lot of our memoriesinto long-term memory storage
when we're in deep stages ofsleep.
We know it's good forunforgetting, so you don't
remember what you had for lunchfive days ago because your brain

(08:37):
forgot that while you slept,because you don't need that.
You know you want to have room,you want room for other
information and we know thatthere's also active brain
cleaning that goes on.
There's a fascinating paperthat shows that the fluid that
runs between your brain cells,it opens up and it washes away
toxic proteins that build upthroughout the day.
So you know tons and tons ofreasons.
But it's really conservednicely throughout evolution,

(08:58):
like if there wasn't a greatreason for it.
There's a famous evolutionarybiologist.
He's like it's the worstmistake evolution has ever made.
Because what are you doingwhile you're asleep?
Nothing.
You're like a sitting duck forpredators.
You're not mating, you're notfeeding, you're not doing
anything to promote yoursurvival.
Why is it so conservativeamongst animal species?
There's got to be a good reasonfor it.
It's probably because itmaintains us at our top

(09:19):
standards when it performanceduring the day so I don't need
to drink lemon water in order tocleanse my brain.

Speaker 2 (09:25):
My brain does it on its own it adds I'm not saying

Speaker 3 (09:28):
the lemon water won't help but you know, your brain
has been cleaning itself finefor eons without the lemon water
.

Speaker 1 (09:34):
Yeah, lemon, water so good.
So because I think that reallyshows you across animal species
right.
Like we see, it's not just likea human thing.
So we know, like this is a partof life, like this is necessary
, for, like all animals, we alldo it.
It's important I do find itinteresting that like um between
, like I've looked at animals,like how much they sleep, and
that can vary a lot.
And you know we're not.
I'm not an animal expert oranything like, but I know

(09:56):
giraffes are like one of theones that sleep the fewest
number of hours a day, whereas,like koala bears, sleep like 27
hours they sleep pretty much.

Speaker 2 (10:03):
He's not an expert.

Speaker 3 (10:04):
He just knows all these random animal facts.
Yeah, Tell us all about themating habits of the red panda.

Speaker 1 (10:09):
Leah, I don't know.

Speaker 3 (10:10):
I'll be right.

Speaker 2 (10:11):
Shush Go ahead.

Speaker 3 (10:14):
No, I mean, animal sleep is fascinating actually.
But yeah, you're right, youknow koalas tend to be the
biggest sleepers.
The bigger the animal usually,the more they sleep.
You know, the bigger the animalusually, the more they sleep.
You know that's.
That's the the trend amongstanimal species and you know
animals have adapted a myriad ofways to sleep, despite their
environment.
You know, like dolphins, wetalk about sleeping half their
brain at a time.

(10:34):
You know we talk about otherspecies that have like a kind of
like a quiz in time wherethey're not really that active
but they're kind of really, youknow, quiet it looks like sleep.
It's weird, that's right yeah, alot of these marine folks that
actually have to come up for air.
You know they can't sleep,otherwise you'd you'd drown in
the water, so, um, so yeah,sleep is fascinating.
Uh, and the other weird thingabout animal sleep is that you

(10:56):
know we talk about melatonin andhow melatonin is, you know, is
helping us.
It's a dark hormone.
Well, you know, nocturnalanimals also secrete melatonin
at night and for them, melatonintells them to do the opposite,
tells them actually it's time,time to be awake.
You know that is interestingyeah, so it's kind of a fun
little you know, yeah,veterinary sleep stuff that's
about all I know, though.

Speaker 1 (11:17):
Animals, veterinary sleep.
Oh man, what are you gettinginto?
that's um okay, so I mean we, sowe need sleep, for for a lot of
different things you need sleep.
So if you didn't know that, nowyou do good.
Um, so if someone is nowstruggling with sleep, I think
we should.
I definitely.
I'm sure one of the mainreasons people like listen.
It's like okay, my sleep sucks,it's shitty, I want to sleep

(11:38):
better.
So, like they want to know,like some things that they can
do.
We could probably get intosupplements and stuff, but let's
get into like the tips of justlike what you can do throughout
your day

Speaker 3 (11:49):
to make sleep easier yeah, well, I'll tell you, like
the low-hanging fruit whicheverybody that has a true sleep
disorder rolls their eyes at,because they're like we've tried
all that basic stuff, you know.
But but I got, but I gottastart there.
You know, I gotta start withthe foundation, which is sleep
hygiene.
So if you're not practicinggood sleep hygiene, you should
try to practice good sleephygiene.
You know, sleep hygiene is acure for sleep disorders caused
by poor sleep hygiene.

Speaker 1 (12:10):
So five main kind of elements.
That's where I brush my eyesright, Brush my sleep, that's
right.
If that's part of your routine,you go for it.
Now I'm just thinking of atoothbrush to the eyeballs and I
hate everything about that.
So much.

Speaker 3 (12:21):
That can't help.
That can't help.
Um, yeah, that's pretty nasty.
Well, routine is important.
So having you know three orfour relaxing activities before
bed, um, it's important to youknow, when you're laying in bed.
You want to use your, your, yourbed, ideally just for sleep and
intimacy and not for, you know,your room for exercise, et

(12:43):
cetera.
You want your room to becomfortable, quiet and cool.
68 to 72 degrees is kind ofwhat we usually tell folks on
the cool side.
You want to avoid things thatare going to disrupt your sleep.
So bright lights in your faceat nighttime, nicotine, alcohol,
caffeine, all of those aresleep disruptors.
And you want to try to keep yourschedule the same weekdays and
weekends as much as possible,because it's really easy,

(13:04):
especially for night owls, topush your bedtime late.
Right, I mean Friday night,saturday night really easy to
stay up and then sleep in,particularly for teenagers and
young adults.
It's really hard to move yourcircadian timing earlier.
That's why it's hard to travelfrom west to east, much easier
to travel east to west.
That's why spring daylightsavings, which we just had, is a
rough one, because you'reasking your buy do everything

(13:24):
one hour earlier, and that'sjust hard to do so.
You want to try to keep yourtiming and say that's the, the
foundation on which we thenbuild for other sleep related.

Speaker 1 (13:33):
I need to just stress again.
I need to stress again becausepeople always roll their eyes at
me and I don't care, fuck you.
I'm gonna say it again you'regoing to bed at the same time is
so important and you can.
You said on weekdays andweekends, because I think a lot
of people on weekends I go tobed three, four hours later,
Like your brain likes routine.
It really helps so much.
If there's one thing I wouldsay, it's going to bed at the

(13:55):
same time because your brainjust wants to do the same thing
and it just makes it so mucheasier for you.
So if you can try and go to bedat the same time every night,
that's right.

Speaker 3 (14:06):
Be a friend to your future self is what I tell
people.
Like, be a friend to yourSunday night self, you know.
Like don't kick yourself in thefoot Friday, saturday and then
make your future self suffer.

Speaker 2 (14:16):
Yeah.
So the one thing I shouldn't bedoing, and that I probably
shouldn't have done last night,is pulling out my phone and
watching tick tocks that make meangry and anxious, that are
slandering me, and so I sitthere all night going oh, I
can't wait to make the response.

Speaker 1 (14:37):
That's the worst thing to do, but it's up.
I feel like it's pretty upthere with some.

Speaker 3 (14:42):
It's pretty bad you two are.
You two are kind of in thespotlight and you know in prime.
You know prime target forpeople that have different
thoughts and feelings, etc.
Tiktok and all these platformsare really good at getting our
mesolimbic cortex and our limbicsystems activated and getting
dopamine revving up andnorepinephrine revving up and

(15:03):
all the neurochemicals that arenot ideal for for sleep.
You know those are the onesthat you want to shut off the
norepinephrine, the dopamine,etc.
Uh and so yes, I I purposelymake sure I'm not looking at any
of the comments if I'mscrolling and looking at social
media because if I come acrosssomething that angers me, it's
going to make it much harder tofall asleep.

Speaker 1 (15:23):
So yeah, yeah, I especially just screens in
general not great, not great foryour sleep.

Speaker 2 (15:28):
I say try like an hour before bed, but I know
we're all there.

Speaker 1 (15:31):
You know like you're scrolling before you go to sleep
.

Speaker 2 (15:33):
I think we've all been there um the single best
thing I did for my sleep habitswas making the room dark.
So no screens, no lights, no um, get putting a little bit of
tape over the surge protectorlights on my plug-ins so they're
not glowing all across the roomI yeah working in sleep
medicine I've noticed a widerange of some people like I need

(15:56):
a little bit of light too.

Speaker 1 (15:57):
If I have any light it'll destroy.
You know, like I will just bewaking up all the time.
So find kind of what works foryou.
And you know I prefer, yeah,nice and dark, a nice dark room
and cold.
I like in, like the 63, youknow, degrees fahrenheit, like I
like.

Speaker 2 (16:11):
I have no idea what 63 is, but I like that's 147
fahrenheit or something, I don'tknow.

Speaker 1 (16:16):
It doesn't matter, no one cares when it's america um
so yeah, it's dry cool, dark.
Uh, what would you say?
Like you know, just for people,some pre-bed routines, like do
you have anything?
I always say, like I like ashower, actually like before bed
, like a nice warm shower,because actually if you take a
warm shower after you get out,your body cools down Because you

(16:36):
know you have that water on youand just kind of that cooling
effect can kind of helpfacilitate, you know, relaxation
, at least in my experience.
So that's something I like, butyou know.

Speaker 3 (16:44):
That's totally right.
Yeah, there's actually goodscience to support that.
Yeah, no, I like a warm shower.
It artificially raises yourbody temperature and that quick
drop off can help you fallasleep.
The same reason why we don'trecommend exercise too late if
you're having trouble sleeping,because it raises your core body
temperature and it stays highfor longer.
It's harder for that to calmback down.

Speaker 1 (17:01):
So so if you have trouble sleeping, exercise is
not your friend late at night,but it's funny because earlier
in the day, like if you exerciseearly in the day, it can help
you sleep later, but if youexercise later in the day that
can be so the timing you have tofind that that's right now,
that being said, some peopleexercise late and fall asleep is
fine, and that's the time theycan exercise.

Speaker 3 (17:19):
Go for it.
I don't want to stop you fromexercising, that's's the time
that you have.
But you know, yeah, so theother things, you know, anything
that you find relaxing andcalming.
So you know, like your typicalstuff brushing your teeth,
getting you know, wash your face, getting your clothes ready
brushing your eyes, if you wantBrushing your eyes, as Rob likes
to do, you know, whatever worksfor you, you know.
And avoids excessivestimulation, some mindfulness or

(17:40):
meditation, whatever works foryou.
There's no magic, you know.
There's no magic here, it'sjust fine.

Speaker 2 (17:45):
Well, there is magic.
It's called playing with thekitten as you hold your kitten
right now yeah animals

Speaker 1 (17:54):
in the room too, you know and I did want to go back
to, as you said, avoid alcohol,and I know I always get people
like, oh, but alcohol helps mefall asleep.
Yes, it does, uh, reduce sleeponset, meaning it helps you fall
asleep faster, but it kind ofjust fucks your sleep.
You know.
It fragments, it means you wakeup more.
It, especially your REM sleep,your REM sleep, is super
important, so it'll, it'll,it'll fuck that up like it's

(18:16):
really trying to avoid alcoholbefore bed, especially large
amounts of alcohol, because yourbody will be dealing, because
alcohol is a is a toxin, it's apoison that your body has to
deal with.
So you don't want to deal.
You're dealing with that asyou're sleeping, which is, you
know other things like, uh,eating large meals right before
bed.
If, like I don't, I prefer tohave like a small snack or
something, just becauseotherwise I wake up hungry, I

(18:37):
don't know fast, and I was, yeahwhatever I wake up 3am like I'm
starving, so if I havesomething small, a little bit of
protein cottage cheese.
Yeah, I do like it mentioned alot of episodes ago.

Speaker 2 (18:46):
I like a little bit of popcorn some, just something
like something small.

Speaker 1 (18:50):
But if you have a large meal, that and then you
I'll deal with gird gastricupset, you know, if you have a
large meal, you're dealing with,you know, heartburn, that sort
of thing.

Speaker 3 (18:57):
So then try to avoid yeah and then and then we even
you know we're talking aboutjust our blood sugar.
You, the nice protective thingabout sleep is when we fall
asleep our blood sugar doesn'tchange all that much.
It's kind of protective, soyou're not bottoming out your
blood sugar at night.
Well, if you go to bed after ahuge meal and your blood sugar
is kind of staying high thewhole night, that's not great
for you either.
So, yeah, lots of reasons toavoid a big meal before bed.

Speaker 1 (19:19):
Okay.
So yeah, is that pretty muchseal it?
On the tips, I'm just trying tothink if there's any other like
tips for sleep Keep the roomdark, cool, something to relax.
Oh, I did want to say like onething that I do see a lot of
people they wake up after likean hour or two and then they try
and force themselves back tosleep.
It's something I see a lot Like.

(19:39):
They just lie there.

Speaker 3 (19:40):
Let's talk about that , yeah yeah, so this

(20:12):
no-transcriptpsychophysiological insomnia,
but it all just falls into thebucket of insomnia.
So the core answer is cognitivebehavioral therapy for insomnia
and a lot of the things thatpeople recommend as part of CBTI

(20:35):
.
It sounds a bitcounterintuitive to what you
might think if you're sufferingfrom insomnia.
So, for example and again I'mgiving just general advice here
and for anybody that's out therelistening that truly has
insomnia find a sleep specialist.

Speaker 1 (20:46):
you know find a sleep psychologist or a sleep
therapist.

Speaker 3 (20:50):
They can do wonders for you.
And if you don't have access toone, there are some online
resources that are that are, Ithink, fairly legit and you can
probably access, but as long asit's CBT.
I base cognitive behavioraltherapy for insomnia and the
whole goal is to reverse thatprocess of excessive arousal
response when you're laying inbed.
You want the bed to be yourfriend and not your foe.
You want to bed to be yourfriend and not your foe.

Speaker 1 (21:10):
You want to sleep, to be a welcome friend, not a foe.
Which I think brings back towhat you said earlier, where you
said, like the bed is forsleeping, so a lot of people
just hang out in their bed andjust watch TV or do other things
.

Speaker 3 (21:18):
Yeah.

Speaker 1 (21:18):
If you can avoid that and just this.
Your bed is for sleeping, theircouch and other things are for
everything else.
Try and make your bed justwhere you sleep.

Speaker 3 (21:27):
It's amazing how powerful your brain is and how
quickly it links things together, like when you walk into like
your your gym.
You know you're revved up,you're ready to go.
Your brain knows what happensin the gym.
You know you walk into yourfavorite restaurant, you're
going to start salivating beforeyou even see the menu, because
your brain knows what happensthere.
Right, and so that's what youwant your bedroom to be the
place your brain's like yeah, Iknow what happens here.

Speaker 2 (21:57):
Let's let's start shutting things down, yeah, okay
, so, yeah.
So for me, like, just stepthrough, step, step by step
through.
What goes on with me basicallyis starts getting late at night
and I'm like, okay, time for bed, head to bed, turn all the
lights off, lay down and thenjust pervasive thoughts, anxiety
.
I basically bottle up all theanxiety from the day and then
release it at night, and thenyou know I'm laying there An
hour later.
It's like, okay, I can't sleep,turn on the TV, play a game or

(22:18):
something, and then it's just,you know.
Next thing, you know it's 3 am.

Speaker 3 (22:22):
Yeah, yeah.
Well, you know it's interesting.
The main question I often askfor a lot of the teenagers that
I see in my clinic is whenyou're laying in bed, do you
actually feel sleepy and tiredand your brain just won't turn
off, or do you feel wide awake,like you're just ready to go?
You know, and you know TaylorSwift said it best you know,
midnight's become my afternoon,right?
This is like a delayedcircadian rhythm, when your

(22:43):
midnight feels like yourafternoon because you're wide
awake, you know, and you'regoing to bed like three or four
o'clock.
And so some people have bothnight owl tendencies and
insomnia, which makes it hard tofall asleep, and so the classic
kind of cognitive behavioraltherapy interventions oftentimes
include sleep restriction,because most people think, well,
I'm only going to sleep fivehours, let me lay here for 10
and see if, hopefully, I cansneak out five hours tonight.

(23:04):
but the opposite is actuallywhat you should be doing, which
is restricting your time in bedto try to fill, you know, a good
chunk of that with sleep.
It doesn't have to be perfect,and so we usually restrict down
to the number of hours thatsomebody reports are actually
sleeping each night, like I'monly sleeping five or six.
I'm like, okay, we're going tonarrow your sleep window down to
five or six hours, and then,once you're sleeping that time
consistently, because you'rechronically getting sleep

(23:25):
deprived with that timing andyou're sleeping more and more of
that chunk, then we start toopen up that window, and so
that's, that's called sleeprestriction, which is one of the
most effective ways to, youknow, help with classic insomnia
.

Speaker 2 (23:36):
So that's really interesting Cause.
Um, like, going back to whatyou said, what we were saying
about how if people naturallysleep longer, they shouldn't
feel bad for sleeping longer.
That also goes right into thiswhere, if you need to take time
to sleep shorter, don't feel badabout not going to bed and
staying up and doing stuff andrestricting that sleep window.

(23:58):
Don't feel bad about it.

Speaker 3 (24:00):
Yeah.
So if it's part of yourcognitive behavioral therapy
plan, yes, you shouldn't feelbad about it and know that
intentionally you're kind ofsleep deprived of yourself.
But know that if you have aterrible night with a six-hour
window, the next night is goingto be easier to fall asleep.
And if the second night isterrible night, your brain is
keeping track.
Your brain knows that you'resupposed to be getting sleepier
and sleepier.
Then it makes the third nightthat much easier.

(24:21):
So at some point you know yourbrain accumulates enough of a
sleep drive that you're going tofall asleep and hopefully stay
asleep for a good chunk of thatwindow and then you start
opening things up.

Speaker 1 (24:30):
Okay, I like that I will say for for people that you
know, if you wake up during thenight cause a lot of people
tell me they sleep for a couplehours, two, three hours they
wake up and you know they'rejust, they're just awake and
they try and force themselvesback to sleep.
Now you do have kind of haveyour.
Your sleep does go in cycles.
I, I, we have so many things toget to.
I don't really want to get toointo the nitty-gritty, but
basically you go through thesecycles and they'll happen every

(24:53):
few.
You go into like rem sleepevery 90 ish minutes give or
take and then you'll kind ofwake up from that and you'll go
back into another cycle, soyou'll have these throughout the
night.
So after a rem cycle you mightwake up and you might feel a
little bit more awake, andtrying to force yourself back to
sleep can be really difficultand frustrating.
Anyone who's who's alive, I'msure has had a time where you're

(25:13):
lying in bed trying to fuckingsleep and you're like I can't.
And it's so frustrating becauseyou're like this is my body
needs this or I die.
Why won't I sleep like this isso stupid.
So I I recommend personally, Ithink getting up out of bed, not
trying to force your sleep,just going for a walk, listening
to I love to listen to apodcast and go for a walk.
I find that relaxing.
But whatever works for you,something that is just away from

(25:34):
screens.

Speaker 2 (25:34):
Liam, what's a good podcast for people to listen to.

Speaker 1 (25:37):
I like the dollop and sawbones and my brother, my
brother and me.
Oh wait, we have wait a second.
Hold on, you were trying to getus.

Speaker 3 (25:51):
So you've gotten to the core of, like, the next cbti
technique, which is stimuluscontrol, which is, you don't
want to spend too much timeawake in bed.
But the one important thingthat I'll go back to, which is
what you mentioned we all sleepin sleep cycles and it's a
hundred percent normal to havemultiple awakenings at night.
You should, every human beingwakes up at night.
You know your infant is goingto wake up.

(26:13):
You probably know this already,but your infant is going to
wake up multiple times a nightas your infant goes through
sleep cycles.
It is normal and it's not afailure of your sleep.
So many people get into thiskind of catastrophization where
they're like ah, I'm awake now.
This is terrible, my sleep hasfailed me.
No, it hasn't.
You've done exactly what you'resupposed to do, what your brain
is supposed to do, so don'tconsider awakening a failure.
The second thing is, if you'rein a situation where you're

(26:34):
getting frustrated it's beenmore than like 20 minutes or so
you're like I'm not sleepy.
Yes, the cognitive behavioraltherapy technique number two is
yeah, you can get out of bed fora little bit.
Do something boring, relaxing.
Usually don't recommend, youknow, getting too active or
getting into something that'stoo interesting, something
that's really just kind of calmsyou and relaxes you.
You know, read the.
You know, if you have a copy ofthe yellow pages, read the
yellow pages or something, andthen get me Some of you probably

(26:56):
know what the yellow pages arethat are listening.
You know Rare, yes, but you know.
You know what I mean Like amagazine or something dull and
boring.
But then the other part aboutthis I love the technique called
paradoxical intent, which isanother CBTI technique, which is
when you're laying in bed,instead of telling your brain,
God, why can't you sleep, Justfall asleep, why You're failing

(27:18):
me and revving yourself up,Instead you tell yourself you
know what?
I'm awake and I'm totally finewith that and I'm going to try
to lay here awake quietly.
I'm actually going to try tostay awake, just restfully,
calmly, awake in my bed.
Oh, look, I'm still awake, butthat's okay, that's what I'm
trying to do, and that sometimestakes that pressure off of
trying to fall asleep andparadoxically, you end up

(27:40):
falling asleep.
So that's called paradoxicalintent.

Speaker 1 (27:43):
I love that because I see people like in the sleep
lab, I can tell like, I can seethoughts like through the camera
, just because they're sofrustrated.

Speaker 3 (27:51):
They're just like no, Don't tell them that no one
will ever sleep in a lab.
Liam's got a superpower, butit's just because they're so
frustrated right, and they can'tsleep.

Speaker 1 (28:00):
And I will tell you this.
I will tell people we are verypoor at judging our own sleep.
I get people every single nightin the sleep lab who swear to
me they didn't slept.
They didn't sleep at all and II've listened to them snore for
hours.
I have all their brain waves.
They absolutely slept.
They were very poor.
If you are in bed for six hoursand you were awake for an hour,
lying there for an hour awakefeels like six, so you feel like

(28:22):
you were awake all night.
You will not remember the timesyou were sleeping.
So try not to be too hard onyourself.
I'm going to say that that overand over, because you get into
this cycle where you getfrustrated with yourself and the
more frustrated you get withyourself, the more it's harder
to fall back asleep.
So I love what you said Justlie there.
I'm just going to lie here, I'mjust going to relax, it's fine.

Speaker 3 (28:41):
It's not a big deal.
It's what it is.

Speaker 1 (28:43):
I'm not going to get frustrated.

Speaker 3 (28:45):
Yeah, we, you know, we, we call that it's.
It's fascinating, we call itsleep state and misperception,
where it's all it's.
As you get older it's actuallytends to become more of an issue
, and caffeine will make that alot worse.
And so, people that you know,oftentimes there's multiple
awakenings where you havefragmented sleep and then your
brain puts all those together,thinking you're awake the whole
time, like I did.
I did a sleep study when I wasa sleep fellow as part of my

(29:15):
like my like you know it was apart of a study and I could have
sworn.
I was awake for like 45 minutesstraight and then I was scoring
my own sleep study the next dayand I'm like I was in like
stage two non-rem sleep for likea good chunk of that time.
So I have pretty wicked sleepstate misperception so I'm sure
how often you fall asleep.

Speaker 1 (29:24):
Yeah, I'm sure I would do the same thing as
someone who works in sleepmedicine.
I'm sure I would say I wasawake during the night.
So, like I tell people it's notyour fault, like the morning
questionnaire will ask you howlong it took you to fall asleep,
you will get it wrong.
Literally everyone gets itwrong.

Speaker 3 (29:37):
It's okay, just make your best guess like totally
don't be too hard on yourself.
Geez, that's right, that'sright yeah um.

Speaker 1 (29:45):
So yeah, we got into some some of the sleep tips.
Um, is there any other thingelse I guess you wanted to add
towards, like just kind of?

Speaker 3 (29:53):
Yeah, I mean CBTI kind of goes on and on.
But I'll tell you that otherthing is, you know, we talked
about decatastrophizing, so it'sperception that everything is
going to be terrible if youdon't sleep, etc.
And my tagline here is, youknow, as a sleep doc, I
sometimes have to tell people,yeah, sleep is important, but
let's take, let's not make itlike our primary life focus, you
know, like it's important butit's not that important, you

(30:15):
know.
And and my tagline is uh, youknow, uh, sleep is important,
but not important enough to losesleep over think about that for
a little bit, you know it'sjust not important to lose sleep
over, yeah um, well, I mean, Ijust want so.

Speaker 1 (30:28):
If we're through there, I had so many people ask
me like questions and stuff.
I'm like, listen, I'm gonna askthe, the doc when we get like
the, the, when we start talkingabout sleep, because I've gotten
so many questions fromespecially like people asking
about any connection betweenadhd and sleep, like, do you
know anything?
Um, like, I have so many things, anything that you have, people
are just like, please, anythingto do with adhd and sleep.

(30:49):
I'm struggling.

Speaker 3 (30:52):
Yeah, I'm happy to talk about that yeah, yeah, I
mean, I'll tell you anecdotally,I do see folks that have that,
suffer from adhd, that certainlyhave a harder time going to
sleep and turning their brainsoff, etc.
Right, and oftentimes,particularly for children, we
see that if you have a sleepdisorder like sleep apnea, it
oftentimes mimics the symptomsof adhd, where you have
hyperactivity, impulsivity, you,you know, hard to focus, etc.

(31:12):
And so you know the question ofchicken egg, like what's
causing what.
I always say that if you sufferfrom ADHD and you worry about
your sleep quality, you reallywant to make sure you're finding
somebody to help you with thatsleep quality, because that
might improve the ADHD symptomsas well.
So you're really kind offocusing on both.
Yeah, but they do have hugeties.
Yeah, okay, yeah.

Speaker 1 (31:31):
Cause people ask me all the time and I'm like that's
just, I'm honestly I don't knowmuch about that field I will
say, yeah, like sleep apnea.
You, uh, most people who I'vehad in the lab who have sleep
apnea, most of them don'trealize they have it.
There's every once, in mainthings, I check for, because you

(31:54):
get people yes, it's morecommon with men.
Yes, it's more common if youhave a larger neck circumference
.
So if you ever see someone that, where it goes head shoulders
and it just skips the neck,there's probably a good chance
they have sleep apnea.
Um, so these are all thingsthat are more common, but I have
seen people who are 130 poundsand have terrible sleep apnea.
So you never really this isthis is.

Speaker 3 (32:13):
This is so important to hear.
You know, it can just beanatomical, you know, like we
know some of our eastern asianpopulation but they notoriously
are very thin have horrendoussleep apnea.
You know, it's all and it's allanatomical.
You know um and so.
And then for post-menopausalwomen, their rate starts to, you
know, become, you know,equivalent to the frequency in

(32:34):
men, just because we thinkestrogen may have some level of
protection against sleep apnea.
And then women's symptoms don'ttend to be as prominent.
Sometimes the snoring doesn'ttend to be as prominent, so it's
often underdiagnosed.
But if you snore regularly,half of adults that snore
regularly have sleep apnea,which is kind of frightening.
So if you have a bed partnerand you both snore regularly,
there's a 75 chance that atleast one of you has sleep apnea

(32:56):
.
You know, like, go get it check.
Go get it checked out.
Yeah, the numbers are not inyour favor, you know.

Speaker 1 (33:02):
So yeah, for anybody listening, you really do have to
talk with your doctor, who willrefer you typically to a sleep
physician.
It's not something.
You generally just walk into asleep lab.
I've had people show up atnight like, hey, I want to sleep
study.

Speaker 3 (33:13):
I'm like that's not how this works unfortunately uh,
no, you don't want that bill,you don't want that bill.

Speaker 1 (33:19):
Yeah, that too so, yeah, just you know, talk with
your doctor, get checked out.
If you snore, like they'll askyou some questions, and if
you're basically like, if youhave enough things like you
snore, you feel tired during theday, even just being male, over
a certain age, over a certainweight, these are things that,
will you know, qualify youessentially to get to get a
sleep study.

Speaker 3 (33:37):
So get it checked out , if you're concerned and you
can do it at home.
There's a lot of home sleepstudies now and a lot of
insurance are pushing folks tohome sleep tests.
The technology is gettingbetter, you know, so they're
becoming more accurate.

Speaker 1 (33:48):
Yeah so yeah, sleep ap, sleep apnea.
You might not know you have it,you might have it, Just get
checked out.
I mean, I see it every night,so obviously.

Speaker 2 (33:55):
I have to, and, on that note, perhaps we should
talk about the stigmasurrounding CPAP, cpap.

Speaker 3 (34:02):
Oh yes.

Speaker 2 (34:03):
CPAP.

Speaker 1 (34:04):
Yeah.

Speaker 3 (34:05):
I mean people.
No, go ahead, liam Sorry.
I I mean people know.
Go ahead, liam Sorry.

Speaker 1 (34:09):
I just get a lot of people who don't want to get
CPAP because of they have towear it at night.
They have a bed partner orsomething like that.
They want to be seen with it.
They're single and they're likeI don't want to have my date
come over and I told on let meput on my Darth Vader mask.
I get that a lot.

Speaker 3 (34:24):
So I understand, yeah , yeah, who is it?
Jennifer Garner, you know, woreCPAP in this movie.
She did recently, and I'm likethat's what we need more of.
You know, like people that areshowing that it doesn't have to
be.
You know this terrible look toyou.
You know, when you're wearingthe CPAP you can look good and
wear CPAP, but it'suncomfortable.
Many people that are prescribedCPAP don't end up wearing it
because of discomfort.

(34:45):
It's important to know thereare a lot of options.
Now you know when it comes tothe type of mask, the fit of the
mask, whether it covers yourwhole face, your, your nose and
mouth just your nose sits underyour nose and so keep working.
And also know that your brainis just is amazing in that if
you do something consistentlyfor like a week or two, even
though it's so painful,magically your brain starts

(35:05):
getting used to it and makessleep much easier.
So, even if the first few daysare horrendous, just push
through it and you might beamazed at what comes out the
other side.

Speaker 1 (35:13):
So yeah, I see that all the time it's patient I've
got.
I've had so many patients gofrom.
I will never wear this to.
I will never spend a nightwithout it because that first
couple weeks are very difficultand I'll tell you, there's a lot
of yeah, like you said, a lotof different type of masks out
there, some that I look.
I'm like actually that's nottoo bad, unfortunately, in like
a lot of times in movies and tvshows you see them with the big
full face masks which are theones that cover the nose and the

(35:33):
mouth, and it looks like darthvader and the machines are loud
as shit like, and I'm like, whatare you doing?
Like is this machine from 1995?
What?

Speaker 3 (35:43):
is going on like the machines are like the size of
alarm clocks now and they'requiet and like there's so much
they're really they're notnearly as bad as they used to be
.
I'll say yep, absolutely yeah,and super quiet and you might be
your bed partner but alsoprobably end up loving it
because you're not going to besnoring and restless and and
jerking around all the time.

Speaker 1 (36:01):
You won't be an asshole during the day, because
you'll actually be sleeping alsoa benefit of c-pap correct yes
c-pap is anti-assholery.

Speaker 2 (36:08):
Yeah, that's, that's it yeah, they should re-practice
that their new tagline yeahforget treat sleep, apia treats
assholery, are you?

Speaker 1 (36:18):
tired of being an asshole or, more importantly, is
everyone tired of you being anasshole?

Speaker 2 (36:23):
there's a lot of people on the internet.

Speaker 3 (36:25):
I want to send some, some c-paps to now, oh no,
that's great, um yeah, so cpaptalk with your doctor, get that
checked out 100 uh and it.

Speaker 1 (36:36):
But it's really true that there's a stigma behind all
of it.
Narcolepsy has a huge stigmafor people of narcolepsy.
You see it on tv where peoplejust fall asleep just like just
standing up and they're likethat's that is like just the
severest severe sleep apnea orsorry, I sleep, not sleep apnea
narcolepsy ever.
So you know like it's common,it's you know you have to get.

(36:57):
If you feel like you havenarcolepsy, you want to talk
with your doctor.
A lot of times it can be tiedwith emotion.
So if you feel strong emotionsyou might feel tired which is
terrible for people.
It's like you know, I just feelbad for people.

Speaker 3 (37:10):
Yeah, I'll tell you any any.
Anyone that feels like they'resleeping, you know adequate time
or even, you know, has a hardtime staying asleep and feels
really, really sleepy during theday, because a lot of our
narcolepsy patients actuallyhave very fragmented sleep.
Um, yeah, definitely talk totalk to your doctor.
You know narcolepsy is amoderate to really severe form
of just sleepiness.
So whenever you're like quietand relaxed and you're in a
meeting or you're the pastor inthe car and you're always

(37:32):
falling asleep, you know that'sthe level of moderate to severe
sleepiness.
And cataplexy, which is whatyou're describing, liam, is some
people have this muscle atoniathat takes over their bodies
when they experience, typically,anger or laughter and that can
be really subtle.
It can be just a little bit ofdifficulty with speaking.
It can be your head starts todrop a little bit, your
shoulders start to drop.
We'll probably diagnose one ortwo people with narcolepsy.

(37:54):
Just listening to this podcast,I didn't know they had it, but
about 60% of folks that havenarcolepsy also have this
cataplexy phenomenon and if youhave this, where you suddenly
start feeling weak in thesetting of laughter or anger and
you're really sleepy during theday, you almost certainly have
narcolepsy.

Speaker 1 (38:15):
So, anger, and you're really sleeping during the day,
you almost certainly havenarcolepsy, so you want to talk
to your physician about that, soremove the stigma behind
sleeping disorders.
Talk with your doctor, get itchecked out.
Totally, um, so, yeah, um, youknow?
Oh, that's the other thingpeople always ask me about.
So I think I think we got totalk about marijuana and sleep,
because I get asked about it alot, which, from what I have
seen, there's not a ton ofresearch on it because it's
still sort of illegal, so itmakes it studying down there

(38:36):
anyway.

Speaker 3 (38:37):
Yeah, true, Is it legal up there?
Yep, yeah, interesting.
Well, most of our studies formarijuana come from the 70s, you
know, and you know it showskind of a mixed picture.
One is that it does, you know,lower doses.
It shows kind of a mixedpicture.
One is that it does at, youknow lower doses.
It does help you fall asleepfaster, and so it does take away
some of that.
You know sleep latency similarto alcohol.

(38:58):
But it's also a potent remsuppressant, you know.
So it does keep you out of remsleep.
And so the question is, youknow, uh, what's you know?
Is it truly beneficial or a netnegative?

Speaker 2 (39:08):
the jury's still out on that, you know my personal
anecdote on it, having tried itfor sleep, is, especially if you
dose it a little too high, itdefinitely is a sleep
interrupter.
You get that kick of being highin the middle of the night.
You're just, and you get likethat hazy wake up like yeah, I

(39:30):
don't know if I'm asleep rightnow but you know, you're not
asleep because you get up in themorning and you're like oh, I
slept like crap right,anecdotally we need to do a
sleep study on you yeah,apparently anecdotally from the
people I talk to.

Speaker 1 (39:44):
they always say, like when I'm, when I'm using it, my
dreams are gone.
I don't have any dreams, whichsort of makes sense because, as
you said, it is sort of a REMsuppressant, and REM is
generally when you dream.
So you know, there's probablysomething that goes along with
that connection.
I would tell people like youkind of just have to wait If you
can't sleep without it, andit's the thing that helps you
sleep.
A lot of people who have PTSDor other you know other things

(40:13):
that make it difficult for themto sleep it's the thing that
helps.
And I'm like well, you know, Ithink you've pros and cons, like
if it's the thing that helpsyou, then you go with it.
I mean it's everybody's right.

Speaker 3 (40:18):
Yeah, you know I, I certainly can't give that my
seal of approval, you know, fromthe medical side.
But you know I, I hear whatyou're saying and sometimes's
working.
But I still always encouragefolks.
You know there there are greattherapies that are effective,
that you know a lot of peoplejust haven't tried and and they
feel like they they skip overthe sleep hygiene in there.

(40:38):
Oh, we'll try the marijuanainstead, right?

Speaker 1 (40:39):
so yeah, I mean, if you've tried everything, sorry,
I was just saying if you'vetried everything else, I'm not

(41:01):
going to tell you to not dosomething, because everybody's
different and you have to.

Speaker 2 (41:04):
We always say on this party you have to find what
works for you, so I'm yeah, I'mnot telling you to go out and
buy weed, but I'm not gonna, I'mnot gonna shame you, but at the
very least do the basics first,first before you go out and buy
weed, yeah yeah which I can say, because it's legal here.
So if you want to go buy weed,go buy weed getting the sleep
car moving forward.

Speaker 3 (41:23):
I kind of say if you have like multiple flat tires,
you know you gotta, you gottafix all of them, you know.
So hygiene, maybe one of yourflat tires you may have insomnia
.
There's another flat tire.
You got to fix them all to movethings forward.

Speaker 1 (41:34):
And that can be tricky to find that combo.
Well, what about?
Like you said, they go tosupplements.
People will ask, I'm sure.
So I think I have to ask, likemelatonin, you know what's your
opinion on that?

Speaker 3 (41:44):
Yeah, yeah, melatonin has become what I call a sleep
candy.
It's just being handed out toeverybody now and the tough
thing is in the medicalcommunity it's also becoming
really common for physicians tosay, hey, try some melatonin as
kind of like the initialknee-jerk response.
But the problem is we getalmost zero training in sleep
disorders in medical school andresidency even in pediatrics
residency, we've got almost zerolectures on how to handle sleep

(42:06):
issues and so if you tell adoctor I don't sleep well, they
may not know what to do withthat information.
They'll might be like hey, thisis not a I'm not a jab at other
physicians.
I, you know same thing with mytraining.
I just didn't get a lot ofsleep training until I did a
sleep fellowship.
Melatonin you know it's asupplement.
It's not FDA regulated.
It's the dark hormone that ourbrain naturally makes, makes.
It has data to support its use.

(42:28):
When you want to adjust yourcircadian rhythm timing and when
you want to do that well, whenyou have jet lag or when you
have shift work, when you havedelayed sleep-wake phase
syndrome, which is, everythingis pushed later, so your
preferred sleep time is muchlater and your preferred wake
time is later, but that doesn'tjive with your work schedule or
your school schedule.
Those are use cases wheremelatonin can be very helpful.

Speaker 1 (42:53):
Turns out it's the timing as opposed to the dose,
so we're talking like really lowdoses, like you know.
Half a milligram, one milligramyeah, take 10 like I take 10
every night.
I'm like I don't think you needthat.

Speaker 2 (42:59):
It's always on the shelf in five milligrams.
10 milligrams, that's right.
It's so hard to find it in oneyep, yep, absolutely, and you
know it's just.

Speaker 3 (43:08):
data shows that if you taking it early, like four
to six hours prior to yourcurrent sleep onset time, that's
good for shifting yourcircadian rhythms earlier.
Now there are other cases.
If you're otherwise healthy andyou don't have a circadian
rhythm issue, melatonin usuallyplays no role whatsoever.
But there are other situationsLike, for example, I treat a lot
of children that are on theautism spectrum.
We know melatonin can behelpful there as a sleep aid to
actually help them withsleepiness.

(43:28):
So there are some cases, butusually under the guidance of,
hopefully, a sleep doc or aneurologist or somebody else
that's comfortable treatingsleep issues in these nuanced
kind of situations.

Speaker 1 (43:38):
So yeah, I always say like I don't recommend it for
like every night, not because Ithink it's going to kill you or
anything like that, butgenerally that's just something
else going on that you're tryingto like treat with the
melatonin.

Speaker 3 (43:57):
So I'd rather try and get that figured out than take
10 milligrams every night, whichis not necessary totally yep
100 agree and these bottles.
They can have whatever they.
You know they can put anythingin them and they've done studies
that show.
Like you know, a lot of thesebottles have no melatonin in
them.
Some of these melatonin gummieshave, like serotonin, like cbd
in them and it's, it's just awild, wild west when it comes to
melatonin bottling.
You know so, do you?

Speaker 1 (44:10):
know anything about cbd.
I don't know jack about likecbd and sleep.
Basically, I'm gonna be honest,yeah there's.

Speaker 3 (44:16):
I don't think there's much out there.
Honestly, you know a lot of thestudies that were done back the
day are really with with thc.

Speaker 1 (44:21):
You know I'm not not much with yeah, with cbd as far
as I know, there's like not alot of research on that, so
that's my response when peopleask.

Speaker 2 (44:28):
I think that's fair, I mean I can give my anecdote
that cbd didn't do anything forme, for me, for some people,
other people seems to help, allright.

Speaker 1 (44:37):
So are there any other, like sleep supplements
that like I don't know, I guessyou get asked a lot about, or
like, yeah, I mean magnesiumeveryone yeah, magnesium is like
the new go-to, you know, andpeople like swear by it.

Speaker 3 (44:50):
You know I'll say that the data just does not
support kind of the hype that'saround it right now.
There is some data in elderlywith insomnia that magnesium can
help, but they're also morelikely to be magnesium deficient
, Whereas the general population, despite what people are saying
online about like oh, 80% ofpeople are magnesium deficient.
Oh, and, by the way, here's amagnesium lotion that you can

(45:10):
absorb through your eyeball whenyou brush it in.
You know like it's Magnesiumlotion.
You know people just aren'tmagnesium deficient.
You know like it's really rare.
You know they've done studiesin like the critical care
population.
Yes, you might see somemagnesium deficiency, but if
you're just walking around, ourdiets are pretty magnesium
fortified.
You know it's hard to be trulydeficient in it.

Speaker 1 (45:32):
So yeah, I mean, what's the other one?

Speaker 3 (45:34):
People like Z-Quil, I can't remember the fucking name
of it.
All of these things have justantihistamines in them, you know
, like similar to Benadryl.
You know they all havedifferent types of
antihistaminergic that areavailable over the counter and
they, you know they market it aslike the ultimate, like sleep
cure.
Well, you're just putting aBand-Aid on that sleep problem,

(45:57):
you know.
And the antihistamines,especially Benadryl, studies
show that, you know, it doeshelp for a few days and then the
improvement goes away afterlike day four or five.
But the side effects persist.
You know the cognitive slowing,some anti-ch, cholinergic stuff
, dry mouth, etc.

Speaker 1 (46:14):
All that persists, yet your sleep benefit goes away
.
So that's a that's a big no forme.
Right for like a day like youhave one day where it's like
your, your sleep is a littlemessed up and you need to go to
bed a little earlier, orsomething.
I'm like okay, I can see it,but taking these things every
day I just don't think is theway to go.
That's basically my attitudetowards all of them.
Yes, 100 agree um, oh, the otherthing that I wanted to make
sure I get to, because I'mfucked by it uh, sleep shift

(46:37):
worker disorder, uh, just likedo you, do you have any
recommendations for people whowork?
You know, the fucking 7 pm to 7am the thing that I work uh,
try not to you know.

Speaker 3 (46:48):
Uh, pretty much, that's I highly recommend that.
That is my biggestrecommendation for that yeah,
well, I mean, I don't want to,we, I don't want to get too far
into the science, but you knowit has shown to have health
consequences of always workingthe night shift, you know?

Speaker 1 (47:02):
okay, sorry, can I just say I have to say this
fucking little thing because Iwent to school for sleep
medicine first day of like sleepclasses.
They're like, okay, workingnights, you are at increased
risk for diabetes, hypertension.
And they're just going down thislaundry list of things and
eventually that she says cancer,one of the kids stands up,
closes the book, walks out,never comes back.
I'm pretty sure he went intoaccounting like he heard that

(47:23):
and he's like I'm done, I'm likeyou know what fair, like, if
you're gonna do it, might aswell do it day one.
Where you're like I'm not, no,thank you, which is 100%.

Speaker 3 (47:31):
That's the right way to do it.
I mean, I think it's only fairto share that information with
you up front, because otherwiseit's I don't think it's ethical
to, like you know, be like, ohyeah, everything's totally fine
in this occupation, like, if youwork with radiation, you should
know that this could be harmfulto your health.
Similarly, you should know thatit could be harmful to your
health.

Speaker 1 (47:47):
I say my condolences.
That's my big last word.

Speaker 3 (47:50):
That's right.
Yes, yes, totally.
Well, I will tell you that ifyou have to flip-flop, that's
the hardest People oftentimesget this question.
Swing shift.
Yes, yes, if you're like dayshift and night shift, you're
working 12 hours.
That is just painful and brutal.
And so my goal here is, ideally, don't do it often.
If you can arrange yourschedule such that you're not
doing it often, and then if youhave different shifts, like if

(48:12):
you have, let's say, it's aneight-hour shift, it's much
easier to go from a morningstart to an afternoon start than
to a night start, as opposed tothe other way around, going
from a morning start to a nightstart to an afternoon start.
So if you can delay, that canusually help you, because it's
much easier to delay your starttime.
And then that's the situationwhere melatonin may be helpful,

(48:35):
after discussion with yourphysician, where, if you're
trying to flip too quickly,melatonin can help you make that
transition much faster.

Speaker 1 (48:38):
Yeah, I will say it's tough, yeah people who work
nights, like myself, staying onthe same schedule is what's best
, so like that's why shift work,swing shift is.
It destroys you, like you'regoing back and forth.
Your brain doesn't know whatthe fuck, which way is up.
Black is white, east is west, Idon't know.
It's terrible, so working ifyou work overnights, trying to
stay on the same schedule.

(48:58):
Even on your off days, like forme, I stay up with my daughter
and I still go to bed at like 7am every every day, so I try and
stay on this which is hardbecause like shit isn't open at
like 2 am, so like you

Speaker 2 (49:10):
know, I understand it's a hundred.

Speaker 1 (49:12):
It's so frustrating.
But if you can stay on thatsame schedule and make sure
especially for my people whowork nights make sure your room
is dark, and quiet and like thatis.
It's always important, but forthe people who are sleeping
during the day it's even moreimportant because there's shits
people are mowing their lawnsand shit it's.

Speaker 3 (49:28):
Listen I know it sucks it sucks.
Yeah, people are playingbasketball and the pets are
barking and there'stelemarketers are calling.
You know, like it's just youcan't get away from it.
Imagine if you were mowing yourlawn at like 2 am.

Speaker 1 (49:40):
People would be like what the fuck are you doing?
Stop doing that, that's you allthe time.

Speaker 2 (49:43):
This is you, because people are mowing their lawn at
the fucking normal times andyou're like god damn it I'm just
trying to get some fuckingsleep here, so I love.

Speaker 3 (49:50):
You know, I'll tell you, I love like a good pair of
earplugs for folks.
You know like I get these foamones from, like like these
purple ones, and then my trickhere is I don't, I don't put
like the rounded edge inside, Iput the flat edge inside, I
squeeze it down and thatactually creates like the
tighter seal.
And then my trip, my, my testis if you rub your fingers next
to it, you shouldn't feel, youshouldn't hear your fingers
rubbing.
That's a good seal for your,for your plug and that can

(50:11):
interest eliminate a lot ofnoise.
And then white noise.
In that situation, white noisemay also be helpful for folks
that are really trying to sleepduring the day and drowning out
somebody as long as it's not tooloud, drown out that can I ask
who the there's got to besomeone out there who's
listening, because I need, Ineed answers.

Speaker 1 (50:26):
Okay, I have a white noise app.
Okay, and there are options forwater dripping what that's the
question.
Yeah, where it's just like drip, drip, drip, or or the clock
ticking, tick, talk, tick youyou need to be you need a
psychiatric evaluation.

Speaker 3 (50:45):
I'm sorry, you need to be checked out by all the
doctors if you listen to thatsort of stuff to go to sleep
you're like having music that'sgoing all night and you're like,
yeah, I can fall asleep forthat is happening.

Speaker 1 (50:57):
The wind chimes.
There's wind chimes to go tosleep.
What?

Speaker 3 (51:00):
the.
My goal is always if you'regonna have a noise, you want the
noise to be steady andconsistent, no fluctuations.
I don't like even music.
I like like white noise,consistent rain.
You know, I don't even likeoceans because it's like up and
down, up and down.
I mean just find like a pinknoise, brown noise, white noise,
uh rain, you know a riverrumbling.

Speaker 1 (51:21):
You know that's, that's all fine yeah, it's like
they took the whole point ofwhite noise and said fuck that,
we're going the opposite way.
I'm just mad.
I'm just mad at whoever decidedcity streets that's an option.
People are just like chattingand talking.
Cars are going by like allright, I'm done.

Speaker 2 (51:37):
I'm done with the white noise fine, whatever well,
everyone.

Speaker 3 (51:41):
You know everyone's different here.

Speaker 2 (51:42):
Liam and some people may have gotten used to it lived
in a big city and then theymoved to like a rural, you know
yeah, we are people that movefrom the city to rural areas and
they want that city so theymight need it.

Speaker 1 (51:54):
They might need it, that's right a little bit
ambulances and police carsrolling by, they might
appreciate it works for yougreat, but you should also get
checked out.
That's all I'm saying um.

Speaker 2 (52:04):
So do you have an opinion on uh saraquil getting
prescribed for a sleep aid,since uh siraquil is usually
prescribed as a sleep aidbecause of a side effect rather
than as a?
Um yeah, on label I would.

Speaker 3 (52:25):
I have huge reservations about using it
solely as a sleep aid.
Uh, huge reservations.
If you're using it as part ofan underlying psychiatric
condition, that merits usingsiraeroquel and you can benefit
from the side effect of thesleepiness fantastic.
But by itself it's a prettyharsh way to get just sleep and

(52:49):
it comes along with its own fairshare of side effects and labs
you have to monitor, etc.
So I would give that a big no.

Speaker 1 (52:55):
What do you feel about going back to the michael
jackson sleeping aid?

Speaker 2 (52:59):
what do you think about?
How do you?

Speaker 1 (53:01):
feel about putting yourself in a coma every time
you go to sleep.
By the way, people coma is notsleep.
There's a difference betweencomas are are.
Sleep is still an activeprocess for anybody listening.
Sleep is not just as, likenothing happens.
There's a ton of shit happeningwhile you're sleeping.
You can't just be like hit themover the head and they'll sleep
.
That's right.
That is different than sleep.

Speaker 3 (53:22):
Sedation is not sleep , anesthesia is not sleep and
this is.
This is another interestingthing that I could share, which
is I think VIPs get like theworst health care.
You know, like the people outin like california thinking they
have access all this new andamazing newfangled stuff and
they're seeking like these magiccures and people are like cting
their whole bodies.
I'm like y'all are getting likethe worst health care.
You know like vips get theworst treatment because they

(53:45):
think they've like stumbled onsome and they're and they're
like charlatans that will belike oh, you know, come with me
and I'm.
You know you guys are.
You guys are uncovering a lot ofthese guys and I know what you
do, I know what you do.
You you call them out, butthese vips out there, you know
they get and there's some datato support that vips.
You know you don't ask themthose questions that we
typically ask that might be alittle personal but that are

(54:06):
important.
We cater to what they want andthey end up getting worse care.
You know.
So any hollywood celebrity islistening.
Just go see like a legitimatedoc and stop talking to dr
doolittle from the.

Speaker 1 (54:16):
You know who's offering you like you know, it's
so true like if you look at wetalk about like the blue zones a
lot, where people like live thelongest, they're like they're
eating like beans and rice andthey just like exercise and move
they don't have fancy, theydon't sit around a lot.

Speaker 3 (54:31):
Yeah, I mean we.
It's an amazing thing abouthealth is like we know what
works.
You know, we actually know whatworks.
And people are looking to doall sorts of other things that
are like no, they want thefountain.

Speaker 1 (54:41):
They want the fountain of youth.
They want that, that fancysupplement, secret pill that
they can get.
Do what works do it.

Speaker 2 (54:48):
Do what's already been shown to work, you know,
but that's kind of why I wasasking about the Seroquel is
because I know that, going backto the doctors don't really know
what to do in regards to sleepand they give you the melatonin
and I see with a lot of peoplethey end up.
The next step from that isdoctors prescribe them Seroquel.

Speaker 3 (55:10):
That's interesting practice and I don't know if
this is more Canada, more canadaspecific, you know, but there
are definitely in down down herefrom what I've seen.
There are some other kind ofgo-tos before we get to the
serocles of the world and andthat can include things like you
know, antihistamines.
It can include things likegabapentin, for example, or
trazodone, or amitriptyline.

(55:30):
These are things that can workdouble as sleep aids that are
usually used for otherindications.
Clonidine is another one that'susually a blood pressure
medicine by trade that can helpwith sleepiness.
So Seroquel tends to be muchfurther down the list in my
experience here.

Speaker 1 (55:43):
Interesting.
Yeah that's why I take Viagrais for my blood pressure.

Speaker 2 (55:48):
Yeah, is that it?

Speaker 1 (55:50):
It's just for blood pressure, it's just for blood
pressure okay, it's a medicalcondition and I prefer you not
make fun of it.
Um, but yeah, no, I I just lovewhat you said about the the
whole.
Like there's the one guy that'strying to like make himself 30
years younger or whatever bytaking like every supplement.
It's it's 100 people, peoplethat there is no magicness, it's

(56:12):
it's all.
We know that.
I know the normal shit isboring.
I know we know hey, get enoughsleep and move around more and
eat vegetables is boring, butwe're gonna fucking keep telling
you that shit because that'sthe stuff that works and there
is no fucking fancy, super crazypill.
You're gonna get here's.

Speaker 3 (56:31):
Here's another one of my what I've discovered which
is when I look online and socialmedia, people that are usually
like harping all these.
Like you know, our solutionsare usually, you know, men that
are at the age where theyrealize they're not going to
live forever, right, and they'retrying to find this magic
solution to help themselves livelonger.
And, you know, when you're 80,you're probably not going to
want to live another 20 years.

(56:51):
To be honest, you know, like,yeah, I don't meet any 80 year
olds.
They're like let me just knockout another 20 and let me just,
you know, take all thesesupplements to get my get myself
another 20.
It's the quality of your lifethat's super important, and in
in quantity, although weemphasize that you really got to
think more about the, about thequality of the years that you
have and you're not going to beworrying about, you know, eking
out extra time when you're thatold honestly, yeah, completely

(57:14):
agree.

Speaker 1 (57:15):
Oh, oh, before we go, okay, so before we go I gotta
run through some like very quick, like sleep things that are fun
, okay, um so because this is myway to talk about sleep.

Speaker 3 (57:23):
Yeah, before you do your sleep thing, fine fine,
what do you gotta do?

Speaker 2 (57:27):
we did have one question that I don't know if
you're gonna be able to answeror anything, but we did have a
viewer question, um, and if youdon't know what to do with it, I
will just cut this part.
Sounds good.
So anyway, I've got uh lolahere who wrote in uh, I have a
disorder where I don't producecortisol, thyroid estrogen,

(57:50):
testosterone, growth hormone.
She supplements all thesethings to get normal levels as
possible, but she notices thatshe doesn't seem to need as much
sleep as the guidelinesgenerally say that you should
get.
And if I try to force myself tosleep more, I sometimes
struggle to fall asleep the nextday and I I think that
instantly goes back to where youstart at the beginning, where

(58:12):
you don't have to force yourselfto feel like you need to sleep
the guidelines.

Speaker 3 (58:16):
Maybe you just don't do that, yeah, I mean it sounds
like she has what we callpanhypopit, which is where your
pituitary is just not making allthe stuff that it needs to make
.
It sometimes comes along withother sleep-related issues or
brain-related issues which couldalso then cause sleep-related
issues.
So, without knowing herdetailed medical history, I
agree If she feels well, offerslower amounts of sleep.

(58:38):
You've got to listen to whatyour body is telling you.
And if you're okay, as long asyou're not like over-treating
with Synthroid, for example, forthe thyroid issue, or you're
not taking too muchhydrocortisone and that's
keeping giving you extraalertness as long as your levels
are balanced and yourendocrinologist is following
along and you feel like you'resleeping well, you could be a
short sleeper.
I don't know if it's because ofthat underlying disorder or in

(58:59):
spite of it.
That's just how her brain wasformed.

Speaker 2 (59:04):
Okay, and what about pets in bed?
Do I have to cover Pippin'sears?

Speaker 3 (59:10):
No pets in bed.
Yes, you know this is yeah, Ifeel you know, and this is tough
because there are some peoplethat say well, listen, I have
anxiety and I love having my petthere and if that's helping you
with sleep again.

Speaker 2 (59:22):
I'm not going to argue with success.
Yeah, that's me.
It's like my animal is anemotional support animal.
I love having him curled upbeside me.

Speaker 3 (59:30):
And that's your situation.
By all means, do what works foryou.
If you have a choice, though,you know and you're not in that
situation ideally out of the outof the room, both from an
allergen standpoint.

Speaker 1 (59:39):
I was going to say, from allergies.
What I'm thinking, too, is yeah.

Speaker 3 (59:42):
Yes, yes, absolutely Allergies.
And then your pets.
You know, they they wrestledany small sound.
They have super hearing, theyhave a super smell, you know,
like an ice cream, like a pizzatruck walks by.
They're probably gonna get upand be like, hey, what's going
on?
And you don't need to, youdon't need to, you know, bear
the brunt of that.
So, um, so yeah, pets out ofthe room, ideally okay, all
yours, liam.

Speaker 1 (01:00:00):
I need to run through some fun things about sleep.
Okay, we've got through the thethings, but we need to go
through the fun things, okay.
So first off, do you know therecord for most times?
Uh, awake, without any sleepwas that 11?

Speaker 3 (01:00:10):
11 days just over?

Speaker 1 (01:00:12):
11 days without sleep , which that is fucking nutso
bananas.

Speaker 3 (01:00:16):
That's bonkers.
That's bonkers.

Speaker 1 (01:00:17):
There was one radio DJ who broke the record.
At the time it was like six orseven days right, and he was
like going to do it for charity.
They kept him awake.
At like day three he startedseeing like spiders in his shoe,
started hallucinating, which isnormal because it's your brain
going like what the fuck ishappening?
Basically, like when you're aPOW, the first thing they do is
keep you awake because it justbreaks your ass.
So he did it for like six days.

(01:00:38):
They kept him awake.
He slept for 24 hours afterthat and he never fully left his
state of psychosis.
He still saw things.
He still had hallucinations.

Speaker 2 (01:00:46):
His wife left him he lost his job.

Speaker 1 (01:01:00):
So like that goes to show you that they're thinking
there's probably some underlyingmental disorder.
That lack of sleep is whatbrought it out.
Now the person who did it for11 days was totally fine after,
so like you never really know.
So just don't.
The guinness book of worldrecords, as far as I know,
doesn't keep track of most timeawake anymore, because people
were getting fucking injuredbasically doing it.
So don't do that by the way notsmart.
Don't keep the record for thefattest cat.

Speaker 3 (01:01:12):
I think because, yeah , people also, don't make your
cats fat.
Yes, yes, yes, yeah.
The the biggest skydive withouta parachute probably is not a
record that they're keepingeither, you know I wouldn't do
it I would tell you thatanecdotally.
If they say that you diequicker of sleep deprivation
than food deprivation, you knowyou can go longer than you can

(01:01:32):
without sleep, you know.
So yeah, I would 100 agree%agree with that.

Speaker 1 (01:01:35):
So, get some sleep REM behavior disorder is a
fascinating one, that's one ofmy favorite disorders when it
comes to sleep.
So, basically, you have REMsleep.
That's kind of when you dream.
Mostly, as I stated before,your body kind of, though,
paralyzes you when you sleepbecause you know you don't want
to get up and move around, ofact out your dreams.
Now, normally it just involvesyou moving your arms and legs

(01:01:56):
and stuff I had.
There was one patient who satup in the middle of the night
and started dealing poker cardsin his sleep.
So that can happen.
Super dangerous there was onecase of not homicide because he
was acquitted, but one guy didkill someone else in his sleep
because he was having anightmare or something like that
, and so they brought him in fora sleep study.
Afterwards, of course, he gotup, walked around.

(01:02:17):
So if you have rem behaviordisorder, you get one free.
Kill one.

Speaker 3 (01:02:21):
Hum, look at that, you did not just say that you
did not, just don't kill anybodyis that where you get your your
lungs and your nose to tryeating liam?
listen, I'm saying go ahead, goahead.
I would say it's funny, becauseyou know it's.
It's actually not funny, butthe legal implications of some

(01:02:42):
of our parasomnia is like theone you just mentioned these
interesting things that happenat night.
You know, it's an area.
There's another one that's anon-rem parasomnia called
sexsomnia, in which and this islikely very underdiagnosed, but
similar to sleepwalk walking youstart initiating like sexual
type behaviors while you'resleeping and, of course, for a
bed partner that can be.

Speaker 1 (01:03:00):
That's what the very concerning I don't need that
during my sex somnia time,absolutely.
You're 100 right.

Speaker 3 (01:03:09):
yeah, so rent behavior disorder, I'll tell you
that.
You know it can be medicationrelated.
But if you have it out of theblue, where you're actually
acting out your dreams andusually you have really vivid
dream recollection and your bedpartner who witnesses it was
like yeah, you were punching,and he's like, yeah, I was
dreaming about being in a boxingring, you know, if you have
that you actually should go seea neurologist, because a lot of
these patients will end updeveloping a neurodegenerative

(01:03:32):
condition, typically in.
Typically this is kind ofnuanced but in the
synucleinopathy family, which isParkinson's etc.
And so it's a fascinatingdisorder and it's also why I
think, of all theneurodegenerative conditions,
we're probably going to be ableto cure things like Parkinson's
earliest because we have acanary in a coal mine.

(01:03:54):
Like we know, it's going tohappen for a good chunk of the
population that has idiopathicREM behavior disorder, where it
comes out of the blue.

Speaker 2 (01:04:00):
So see your doctor.
It can be super dangerous.
I have to send somebody.
I already know somebody thatI'm going to be sending this
podcast to, because he does dothat.

Speaker 3 (01:04:09):
Yeah, very interesting, and again it can be
med related.

Speaker 1 (01:04:19):
You know the SSRIs and SNRIris can sometimes also
cause this type of stuff butbecause it's so dangerous, you
definitely want to talk to yourphysician about it.
What about um so I'm blankingon the name of what it's called
basically where your mind wakesup before your body.
So you kind of wake up but youcan't move yeah, sleep paralysis
, sleep paralysis yeah, so whatdo you?
so like it's I know it's kind ofit can happen to people, like
once in a very blue moon, butlike typically it happens more
with people of narcolepsycorrect or like yes, that's
right, very common if you havenarcolepsy.

Speaker 3 (01:04:40):
But in the folks that don't have narcolepsy it's
often associated with sleepdeprivation.
So yeah, I've experienced thisonce or twice during, you know,
late night studying duringmedical school.

Speaker 1 (01:04:48):
But yeah, sleep deprivation is usually the
culprit for folks that don'thave narcolepsy so you basically
wake up but you can't move, andsometimes it comes with
auditory or visualhallucinations, so you can see
things that aren't real, hearthings that aren't real, so like
that is right.
So if that happens to you thefirst time, I experienced it.

Speaker 2 (01:05:04):
I was like, uh, early teens, and of course I didn't
know what sleep paralysis evenwas, and so I was like freaking
the fuck out.
No, yeah, no, it's freaky shit.

Speaker 1 (01:05:14):
So if that happens to you regularly, see, see a
physician like if it's onceevery, like years and years,
like you know, sleep it might besleep deprivation, something
like that.
But if that's happening to you,people tell me like oh yeah,
that happens all the time.
Like, oh, go talk to someoneyeah you need to talk.
Yes, absolutely for sure.
Okay, um so yeah, that one'sinteresting.
Uh, I, if anybody asks me likewhat's the worst disorder to

(01:05:35):
have, one of them up there forme is Klein-Levin syndrome.
It sounds absolutely awful, so.

Speaker 2 (01:05:41):
Klein-Levin were two doctors.

Speaker 1 (01:05:44):
They were the answer, so basically.
So correct me if I'm wrong,like I don't.
I'm not an expert onKlein-Levin syndrome, but
basically you sleep less andless over time.

Speaker 3 (01:05:59):
You're able to.
Just you're not able to sleepum as much as you need and
slowly it gets more difficult tosleep and you just kind of
sleep less and less until youdie, essentially like ah so
you're, you're.
You're actually talking about adisease known as familial fatal
insomnia okay, so yeah kleinlevin, is much more benign than
familial fatal insomnia, um, butit's still.
It's still a tough disorder,yeah, if, um.
So familial insomnia, we think,is a, I believe it's a
pre-mediated disorder in whichover time you have just no

(01:06:20):
generation, you can't tell sleepversus awake states and you it
is.

Speaker 1 (01:06:26):
So, klein-levin, is it has to do with having
difficulty sleeping right Likeis, or am I wrong?

Speaker 3 (01:06:33):
Well, it's actually, it's intermittent periods of
excessive sleepiness, and soit's periodic hypersomnia in
which you're sleeping, for youknow, it can be like 20 plus
hours in a day.
It can last for like a day ormultiple days when, when you're
awake, during those episodes,you tend to be not yourself
there, you can be confused, youcan be altered, the sense of
like kind of like derealization.
You're just not yourself duringthese episodes and you tend to

(01:06:55):
eat a lot and you can also havehypersexuality type type
presentation as well during thetimes that you are awake.
And it occurs periodically andwe have no idea why it happens.

Speaker 1 (01:07:05):
We have no, yeah, that's just one of those rare
ones, like I know.
It's super rare, super rare,super rare.
That's right, okay, yeah, oh,what about, um, the sleeping
sickness of the west africansleeping sickness by the tsetse
fly?

Speaker 3 (01:07:15):
yeah, yeah, I can't say that I've you know, I've
never I haven't seen any haveyou never seen anybody?
With that I was gonna ask no,no, it's um, but it's yeah.
A lot of these, unfortunately,like infectious inflammatory
conditions, can come along withexcessive sleep, and it's
because you know thatinflammatory mediators can also
make your brain just feelsleepier, you know so it's yeah,
because yeah, if you don't like, so yeah, there's a, there's a

(01:07:36):
tsetse fly in africa like itbites you and then, yeah, you
become.

Speaker 1 (01:07:39):
It's called the sleeping sickness, because you
sleep more and more and I'm likeI don't really know why, and I
don't even know we know exactlywhy.
But yeah, it's just fascinatingyeah, it's so weird.

Speaker 3 (01:07:47):
I'll have to look into that.
I don't know why.

Speaker 1 (01:07:49):
Yeah, yeah, yeah, it's never come across my desk,
but yeah yeah, if you ever get aWest African sleeping sickness
case, I need to know about it.

Speaker 3 (01:07:59):
For sure, for sure, I'll come back and chat with you
all about it.

Speaker 1 (01:08:04):
So yeah, that's.
I just wanted to go throughsome weird things with, with,
with sleep.
Sleep is strange, that's fineSleep is strange.

Speaker 3 (01:08:11):
It's a, it's a fascinating world, you know, and
there's something new every day, which is the amazing thing
about sleep yeah, liam's overthere thinking hey, I'm just
thinking about, yeah, so a lotof rare disorders, but mostly,
um, get your sleep hygienechecked.

Speaker 1 (01:08:25):
Okay, so get that.
You know, figure that shit out.
You know all the things, thesimple things.
We said uh, if that's notworking, go see your doctor, who
will refer you to a sleepdoctor.
Then they're gonna check youfor things, for things like
sleep apnea, narcolepsy, allthose things that are a bit more
common.
Get that fucking treated,because see what is it?
Cpap compliance is like what?
Fifty percent like it's not.

Speaker 2 (01:08:43):
I don't know the exact numbers, but it's not very
good.

Speaker 1 (01:08:46):
Most people who are prescribed CPAP don't use it, so
that's not great.
So if you have an issue, get ittreated.
There are other options besidesc-pap.
If anybody was curious, talkwith your doctor.
Honestly, from my experience,they're not really that great.
C-pap is definitely the goldstandard for a reason it works
the the most effective and thefewest number of side effects.
So you, if you can't do it, tryother things, but definitely
try that first and uh yeah, uh,sleep well and don't be your

(01:09:10):
worst anti-acid.

Speaker 2 (01:09:14):
That's our goal, yes, and brush your eyes, that's
right.

Speaker 3 (01:09:18):
And brush your eyes, sleep.

Speaker 1 (01:09:20):
The anti-asshole treatment yes, we're gonna talk
about, like you know, yourcoffee, like the coffee mugs are
like, don't talk to me till Ihave my coffee.
Like well, definitely sleepfirst.

Speaker 3 (01:09:30):
Definitely sleep well first and then the coffee, sure
is important, but without thesleep, the coffee ain't doing
shit yep agreed and avoidcaffeine before bed.

Speaker 1 (01:09:38):
I think we said that.
But also, yeah, limit caffeinelater in the day next, some
people say oh, I can drink.
It's all the coffee I want tobe fine.
Like, no, that doesn't work.
Oh, people always say, likewith adhd they're like oh,
caffeine has the opposite effecton me.
I'm like, I still don't thinkyou should be drinking a bunch
of caffeine before bed, even ifyou don't feel like it does
anything if you'll invite meback, we'll talk about the
caffeine bad sleep caffeinecycle that's made starbucks,

(01:09:59):
like you know, incredibly rich.

Speaker 3 (01:10:01):
But, um, but that's that's the story for the day
yeah, that's smart.

Speaker 2 (01:10:05):
Yes, we need to do that, okay, but uh, next merch,
we should, we should make likepillowcases that are like sleep
the anti-assholery.

Speaker 3 (01:10:15):
I love it.
I love it.

Speaker 1 (01:10:18):
There's definitely some options we could do with,
like sleeping stuff.
I like it.
I like it.
Well, yeah, you got to tell mewhere to find you.

Speaker 3 (01:10:28):
It comes with some magnesium.
Oh yeah, hey you can find meanywhere that social media is
consumed.
I'm that sleep doc.

Speaker 1 (01:10:35):
That sleep doc, all the good places that social
media is consumed I'm that sleepdoc, that sleep doc.

Speaker 3 (01:10:37):
All the good places that social media is that sleep
doc.

Speaker 2 (01:10:38):
All the good places.
There are no good places onsocial media.
You can find them on all thebad places in social media all
the bad places that are keepingus awake and and angering us.

Speaker 1 (01:10:49):
Yes, uh yeah, find me on the places where you can't
be before bed or your sleep willbe shit.
Don't watch me.

Speaker 3 (01:10:58):
I'll shame you into going to sleep on those.

Speaker 1 (01:11:00):
I'll be like are you still watching me Every night?
You'll be the.

Speaker 2 (01:11:03):
Papa Swoleo of sleep.

Speaker 1 (01:11:06):
Yes, but you could use it for good.
Every 9.30, release a video, Belike go to sleep.

Speaker 2 (01:11:11):
Go to sleep right now .
Turn your phone off.
Oh I love that to sleep.
Go to sleep right now.

Speaker 3 (01:11:15):
Turn your phone off.
I actually did.
I did like an adult bedtimestory.
You know I did that.
I'd be like, hey, here's abedtime story for adults,
because I think adults could usea bedtime story from time to
time.
But um, yeah, yeah, have you?

Speaker 2 (01:11:26):
have you seen paul julio's stuff?

Speaker 1 (01:11:28):
I haven't, no no, jim bro, just yells at yeah, he
just yells at the camera.

Speaker 2 (01:11:33):
All his, all his videos are literally a video.
Go to the gym.
I don't care that you go to thegym.

Speaker 3 (01:11:38):
Yeah, I'm sure you just like shut up you need to go
to sleep or I'm gonna put youto sleep I think he did a video,
actually go to sleep and I waslike actually I don't mind this.
This is the one video I don'tmind where he's like go to sleep
, turn your phone off, right.

Speaker 1 (01:11:52):
I'm like you know what know what.
That's fair, that one.

Speaker 3 (01:11:54):
I can do.
I don't have that same physicalpresence to be able to pull
that off, I think.

Speaker 1 (01:11:59):
You should just follow a pillow at the camera.

Speaker 2 (01:12:02):
Just like go to sleep .
That's a good one too, but Ithink you should just put on a
nice smoking jacket, get a pipesit in your chair and the camera
just comes around and you'rejust like, I guess it should go
to sleep I should be takingnotes.

Speaker 3 (01:12:17):
I should be taking notes on that.
I like it.
I like it absolutely.
Let me tell you the reasons whyyou should be sleeping based on
the data you know.
A more sophisticated plea forsleep?

Speaker 1 (01:12:28):
yes and relaxing, and then the last and the last like
minute or whatever of the videois just like white noise or
something, just like go to, andthen you just let it fly.

Speaker 2 (01:12:36):
There's something that's brilliant, we'll figure
it out.
There's something here.
There's something here.
There's something there.
For sure, for sure, don't beyour worst.

Speaker 1 (01:12:44):
Don't be your worst.
That's our tagline.

Speaker 3 (01:12:45):
Don't be your worst.
The theme for today.

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