Unlocking Better Sleep: Insights from a Sleep Disorder Specialist

Unlock the secrets to better sleep as we welcome Dr. Michael Breus , a distinguished PhD in clinical psychology and a medically board-certified sleep disorder specialist. Discover how enhancing your sleep quality can transform your life, from boosting athletic performance to fortifying emotional resilience. Dr Breus sheds light on the profound effects of sleep deprivation and unravels the mysteries behind insomnia, while providing practical strategies to align with your natural sleep rhythms. Explore the nuances of deep sleep, the significance of REM sleep, and the common misconceptions around sleep aids like alcohol.

Explore the intriguing landscape of melatonin and CBD, delving into their roles, optimal usage, and potential drawbacks. Dr. Breus shares a wealth of knowledge on how these substances can impact sleep health, drawing insights from both personal experiences and medical expertise. The conversation touches on the realms of cannabis, shedding light on the balance between THC, CBD, and CBN, and why understanding these components is crucial for effective sleep management. From the pitfalls of long-term medication use to the importance of sleep hygiene, Michael offers a comprehensive guide to natural and effective sleep solutions.

As we conclude our enlightening discussion, Dr Breus ventures into the world of sleep apnea treatments and the potential benefits of lifestyle choices that can elevate your sleep experience. From the innovative Excite OSA device to the art of balancing caffeine, exercise, and diet, this episode covers it all. Adding a playful twist, Dr Breus shares insights on the benefits of sex before bed, highlighting how personal and relational wellness intertwine with sleep health. Tune in to "Experimental" for a mix of humor, expert advice, and transformative tips that promise to enrich your approach to sleep and overall well-being.

Episode Transcript

Speaker 1 (00:17):
we're with the sleep doctor that's me and and I think
you're not just a sleep doctor,I mean right.
I remember when I first met you, you passed the medical board
right, sure so.

Speaker 2 (00:29):
So there's a lot of different kinds of sleep doctors
out there.
Some sleep doctors are medicaldoctors that specialize in
particular areas of specialty.
The most popular would bepulmonologists.
Now, I don't understand exactlywhy, because you know
pulmonologists are lung doctors,right?
So they're kind of areas fromhere to here.
Most people go to them forsnoring, which is kind of an ENT

(00:51):
issue, right, it's an ear, noseand throat issue.
But pulmonologists for thelarge part maybe 70% to 80% of
sleep specialists are pulmonary.
Then you got about maybe 10%15% are neurology, for
narcolepsy, restless legsyndrome, things like that.
Then there's a whole mishmashof different types of doctors
who've decided to get into sleep.
I fall into that category.

(01:12):
I have a PhD in clinicalpsychology, but I'm medically
board certified in clinicalsleep disorders.
So a lot of people like wait asecond, you just said you had a
PhD and you're a psychologist.
Now you're saying you'remedically certified.
How does something like thathappen?
So I took the medical boardswithout going to medical school
and passed.
I'm one of 168 people in theworld that have ever done it,

(01:33):
and Carrie went to medicalschool, took the medical boards
and passed.

Speaker 1 (01:36):
And passed that's right, and I have sleeping
disorders.
So this is the perfect.
This is the perfect combinationof people, and I'm obsessed
with sleep.
I mean, how important is sleepto the human?

Speaker 2 (01:45):
body.
So when we look at it, here'swhat's interesting is we don't
exactly know the exact functionof sleep, but what we do know is
that, in fact, if we don'tsleep, really bad stuff has a
tendency to happen, or death.
Or death.
Death is definitely one of theseveral things.
So with a lot of people, ifthey become so sleep deprived,
like a lot of people think, well, can you sleep deprive yourself

(02:07):
to death?
Well, you can, if you fallasleep while driving a vehicle,
right, and that happens more.
I mean, how many times in yourpractice have you talked to
somebody where you're trying todiagnose some sort of sleep
disorder and they say, oh, Ifell asleep at a stoplight?

Speaker 3 (02:22):
Oh, I mean, it happens all the time.
Unfortunately, people don'tlike to report that happening.

Speaker 2 (02:27):
Right, especially truck drivers, by the way.
Yes, anyone with a commerciallicense Right Is certainly not
going to be interested in doingany of that.
But we know that if we don'tsleep, certain things are going
to happen on the physical side,on the emotional side as well as
on the cognitive side.
So physically, we know,reaction time slows down
significantly.
As a matter of fact, when Ideal with athletes, one of the

(02:47):
things that they tell me all thetime is they're like oh dude,
if I'm sleep deprived, like I'mnot moving, in practice, I'm not
doing well in the game.
When you actually look at thedata, they're about a third
slower.

Speaker 3 (02:58):
Yeah, the reaction time is actually measurable.

Speaker 2 (03:00):
Right.
And then when you look at theirtestosterone levels,
specifically in the, in the maleplayers and they're sleep
deprived, they tank tanks.
So a 22 year old who is sleepdeprived is playing like a 33
year old in in a lot ofinstances, and so sleep turns
out to be incredibly importantAlso, I mean not just in sports,
but I mean sports is kind of afun analogy to look at.

(03:21):
I mean, if you want to rememberthe plays, you better have had
a good night's sleep, right.
So memory consolidation, thingslike that.
And then, emotionally speaking,your emotions are highly driven
by sleep.
As a matter of fact, I wouldargue that almost every
emotional state gets exaggeratedwith sleep deprivation.
Depression gets more depression, anxiety makes more anxiety.

(03:42):
I mean, I say it all the time,but it's really true Literally
everything you do you do betterwith a good night's sleep.

Speaker 3 (03:49):
Can we walk it back, though?
Because I think sleep is a wordthat is misunderstood and
misused, and I have a sayingthat I say to people all the
time.
They say, oh well, it's not mysleep.
I, you know, I'm in bed eighthours, I go.
Well, you may be lying in bed,you may not even know that
you're awake half the time,because we have what's called
light sleep, deep sleep.
We'll go into all that, but,you know, I think we need to

(04:09):
define what are the stages ofsleep, what are the amount?
of times that a healthy's only afew stages that are really
important for you to kind ofstart to understand more about,
and that's stages three and fourdeep sleep, as you correctly

(04:30):
identified, and then REM sleepor REM sleep, right?

Speaker 2 (04:34):
So stage three and four, deep sleep, that's the
wake up and feel great.
That's the physical restoration.
Okay, Turns out that happens inthe first third of the night.
Okay, turns out that happens inthe first third of the night.
So whoever created this unitthat we're all living in, um
decided that we need deep sleepat the front end of the night to
really get that physicalrestoration going.
Then we have a period of timewhere there's a lot of kind of

(04:54):
extra and then we got more remsleep towards the end of the
night.
Rem sleep is that mentalrestoration.
So you want to do things toeither positively accentuate
deep sleep and REM sleep or, forthe very least, don't add
anything that takes away fromeither one of those Two big
insulters, caffeine and alcohol.
Okay, and so when we start tolook at these things, those are

(05:17):
the sleep stages that turn outto be the most important.
If you were looking at themlike on a tracker, I would say
you would want those to besomewhere, depending upon your
age, in the maybe 18 to 25% foreither one of those, either deep
sleep or REM sleep, roughly inyounger people so we're talking
18 to 25, should be about 25% ofyour night.

(05:39):
Can you give that in hours?
So if you, as an example, ifyou did slept, slept eight hours
, then it would be two hours ofdeep and two hours of REM.
That's for a younger, for ayoung person, 18 to 25.
Now I'm 55 years old.

Speaker 1 (05:52):
There's no universe where I get that much of either
one of those what's the mostdeep sleep you get at 55 years
old as a sleep doctor?

Speaker 2 (05:59):
so it depends on several different factors.
It can depend upon my hormonelevels, it can depend upon my
stress levels, it can dependupon my stress levels.

Speaker 1 (06:07):
How much?

Speaker 2 (06:07):
caffeine did I have?
Oh, my personal one.
I rarely get more than probably.
I'm trying to think I couldpull it up on my thing Maybe,
maybe 65 to 70 minutes.

Speaker 1 (06:19):
Okay, yeah, can that go up?
Because that's that's roughlywhere I my big nights, is that.

Speaker 3 (06:24):
Yeah, so.
So it's a great question, butyour sleep cycle is really short
.

Speaker 1 (06:27):
Right, but I mean right now I'm on vacation.
So I'm really trying to doeverything I can to get as much
deep sleep as possible.
I hit a 94 the other day that'sawesome On my ordering and the
things I do to get that sleep.
I want to run by you PleaseSomething and some of you said
so at her facility.
I work out there, right.
Me too, and I did this thing.
Have you done the lights yet?

Speaker 3 (06:47):
The light bed.
Okay, oh yeah, the red bed.
Oh, I love that thing.

Speaker 1 (06:50):
No, not the red bed no, no, the blue lights.

Speaker 3 (06:51):
Oh, he hasn't done the blue lights Okay.

Speaker 1 (06:53):
So she has this new thing.
Now it's freaking.
Nuts have to hit the bluelights a certain time.
Got it Now.
You know, I do a radio show andI don't sleep a lot, right I I
I've learned a lot about sleepin the last couple of years.
I'm increasing my sleep, butfor 30 years I'm getting four
and a half hours sleep and Ithink I've made horrible
decisions in the past and doneterrible things because of the

(07:14):
lack of sleep, right, I'm sureeating bad food.
So anyway, I've been onvacation about a week now, 10,
15 days, right and I got greatsleep on my ring.

Speaker 3 (07:24):
Okay.

Speaker 1 (07:25):
I go do the blue lights with her.
Her place Right and I got myall-time personal record, which
is the second highest record inthe building.

Speaker 3 (07:32):
Oh, wow, we don't want to keep rubbing that in.

Speaker 1 (07:36):
And I think it's because I got a good night's
sleep.
I mean, you know what I mean.

Speaker 3 (07:39):
So your reaction time .

Speaker 1 (07:40):
Right.

Speaker 3 (07:45):
Was so much faster.
Yeah, because that thing, thatskill, if you want to call it,
that is all about reaction time,right, that's what's crazy,
because I got a deep, I got goodsleep.

Speaker 1 (07:49):
I had about an hour and 10 minutes of deep sleep,
right, about 70 minutes, yeah,and I was like, I was like blown
away that I got that much,because when I look at the rain,
it's all blue and I get allblue looks great.
Most of the time I'm red, red,red, red, red, red, right right.
So that's how important sleepis.
I mean, it's a game changer.
Lebron James talks about it.
He has to get at least eighthours of sleep a night.

Speaker 2 (08:07):
Yeah, and I mean not the best example of athlete, but
an interesting one, lanceArmstrong.
He would say every single timebefore a race he was getting 10,
11, 12 hours of sleep becausehe had such a major expenditure
of energy during races that hefelt like he absolutely had to
have that kind of level ofrecovery.
But how do you get that muchsleep?

Speaker 3 (08:28):
Yeah, was he augmenting to get that much
sleep?

Speaker 2 (08:30):
Well, he was augmenting a lot of things, so
it's kind of hard to figure thatone out.
But, like at the end of the day,here's the good news is, your
body will only sleep as much asit needs, right?
So there's never a time whereyour body is going to sleep too
much right now.
Now I will tell you that thereare some times where people are
like well, dr Bruce, is it okaythat I sleep nine and a half
hours a night?

(08:51):
10 hours a night, that's alittle much, right?
So, on average for an adult, wewant to see somewhere between
seven and nine hours.
Me personally, I never get morethan about 615.
Just don't just is my body go tobed at exactly the same time
every night.
My body just wakes me up.
It's natural, it's kind of howI work.
But we're looking for generallybetween seven and nine hours.
When somebody says they getmore than nine hours, then I'm

(09:14):
looking at a quality issue.
So far we've only been talkingabout quantity minutes, hours,
things like that right, but it'sreally about the quality of the
minutes during the sleep thatreally make up, I would argue,
the bulk of what it is thatwe're kind of looking here for,
which is optimization.

Speaker 3 (09:32):
So when we talk about sleep efficiency, which we
haven't touched on, and that'ssomething you specialize in
which I find incredibly uniqueso he actually will take
individuals, prominent CEOs,athletes, who say I only have
six hours to sleep, and that's areal statement for some people
how do you still get the qualityof the sleep and condense the

(09:52):
amount of time that you'respending in bed?
And so that's what you'retouching on, right?

Speaker 2 (09:56):
now Correct, Correct, so I have a secret weapon.
So in my third book called thePower of when I started looking
at these things calledchronotypes so a chronotype is a
genetic predetermined sleepschedule I can actually look at
your 23andMe data or yourAncestrycom data and I can go
toa very specific part of thehuman genome, PER3 area in

(10:16):
particular.
And if it's switched one way,you're automatically a night owl
.
If it's switched another way,you're automatically an early
bird.
If it's where it's supposed tobe, you're kind of in the middle
.
And then there's one that'sjust kind of random.
If you fall into one of thosefour categories which, by the
way, almost every single personon earth does, if I get you to
sleep when your body wants to,genetically you sleep more

(10:38):
efficiently.

Speaker 1 (10:39):
But what if you're a night owl but your career is an
early bird?

Speaker 2 (10:44):
Okay, so that's a great question, right?
So let's take you for anexample.
Let's just claim that you're anight owl, but you got to get up
at the butt crack of dawn tostart your radio show, right?
So how do we deal with somebodylike that?
So number one is we have youstill going to bed at a night
owl's bedtime.
You would wake up after acertain period of time, probably
.
I would probably do 90 minutesegments, so I'd probably do

(11:04):
three 90 minute segments for you.
So I'd say you'd sleep for fourand a half hours.
I'd have you wake up, shower,do your thing, go do your radio
show, get there in the morning,and then, when you came back,
I'd have you take a nap in theafternoon.
Wow, right.
So I would parse out your sleepthat way.
I know you're getting the bulkof the physical restoration that
night so you can perform, andthen during the nap time during
the day, I can get you to get alittle extra sleep in there.

(11:26):
And it's not as hard as youmight think.
People are like I don't havetime for a nap, michael.
Like what are you talking about?
You would be shocked.
It's not a one for one ratio.
I don't have to give you twohours nap of sleep during the
daytime for it to actually catchup to a lot of the sleep that
you need, because I'm giving itto you at the right time for
your genetics.
But what if you?

Speaker 1 (11:45):
are in the situation where you just described.
Could those pieces of thepuzzle fall into place
organically?
Because you just describedpretty much what happens.
I get up early, I go to workand then I'll come home and do a
10, 20 minute nap, if I can,just automatically, without even
talking to you, and I'm kind oflike, oh, that is my schedule.

Speaker 2 (12:01):
So what that tells me is you are particularly in tune
with your body.

Speaker 1 (12:06):
I'm trying right, I've been trying the last couple
of years Right.

Speaker 2 (12:09):
Well, I mean that's what she did for both of us
right, I mean.
I had a massive body change aswell, working with Dr Brudinko.
So, like I get it.
But your body will start toadapt to what it's naturally
supposed to do, right?
So it's almost like you're notadapting.
You're kind of going backwardsto like the origins of sleep,
because your body wants to sleepand it knows when it wants to

(12:29):
sleep, and you feel so good whenyou get a good night's sleep,
right.
But it's a game changer, dude.
It's huge.
But we have these things calledcaffeine that make us think
that we don't need sleep, right,you know.
And then we have adrenaline andcortisol that kick in due to
stress, and then we feel like wedon't need sleep and then, all
of a sudden, we're kind ofwandering into this universe of
insomnia, right?
So that's my area of specialty,that's where I have a tendency

(12:50):
to play.
Insomnia is your thing, mybiggest thing, is insomnia.
Well, because I have a PhD inclinical psychology and I
believe there's a largepsychological side to insomnia.
But having the medicalbackground, I know the biology
behind the insomnia as well, andso when you can take those two
together now you're in somethingdifferent.
Now you're kind of thinkingthrough a few different ideas
here.
Now I will tell you that a lotof people try to treat their own

(13:12):
insomnia right Withsupplementation or medication
which is number one would bealcohol.

Speaker 1 (13:19):
Yes, it would.
So you mean they take alcoholto help them go to sleep, they
believe.

Speaker 3 (13:22):
They believe that alcohol actually gets them to
sleep, and it does.
Alcohol does get you to sleep.
It doesn't get you to qualitysleep, right, and then it also
allows you to wake up midstream,which is a big problem.
But alcohol is probably thenumber one tool that people turn
to to treat insomnia on theirown.

Speaker 1 (13:38):
See, I know people that they say they have insomnia
and they drink, right.
And I say, well, you'redrinking In so many words, same
thing you said, so insomnia is areal thing.

Speaker 2 (13:52):
So there's no question insomnia is a real
thing.
Yeah, so a lot of people.
At one time people used tothink, oh, insomnia is just a
mental health issue.
There is true biology toinsomnia.
Let me explain.
So when you're falling asleepat night, your core body
temperature rises, rises, risestill about 1030, hits a peak and
then it begins to drop.
That drop has to happen inorder for your brain to release

(14:14):
melatonin.
So as soon as it recognizes thetemperature drop, your pineal
gland kicks off some melatoninand you start to fall asleep.
Now your core body temperaturekeeps dropping, but if it keeps
dropping all night long, you goto this thing called hypothermia
.
Not good, right.
So your body wants to warm backup.
Now most people, when they turnto me and they say they have
insomnia, it's rare that theysay I can't fall asleep.

(14:36):
It's usually I fall asleep,fine, but I wake up somewhere
between one and three o'clock inthe morning and I'm up for
three hours.
What the hell is that, michael?
I'll give you one guess whattime most people's core body
temperature starts to heat up.

Speaker 3 (14:50):
Between one and three , between one and three in the
morning, exactly.

Speaker 2 (14:53):
And so what happens is you automatically go into a
lighter stage of sleep.
I'm here to tell you, everyperson on earth wakes up between
1 and 3 in the morning.
You just don't know it Exactly,right, because you have to be
up long enough for your body torecognize it.
So what most people do is theywake up, they roll over and they
fall back asleep.
The problem comes is when theywake up and they say, hmm, I

(15:17):
wonder what time it is, and theylook at the clock.

Speaker 3 (15:20):
Big mistake and they instantly do the mental math.

Speaker 2 (15:23):
And then they say oh shit, it's three o'clock in the
morning, I got to be up at six.
Sleep, sleep, sleep.
And they try to mentally forcethemselves to sleep.
Now I want to be honest withyou, john Jay in the history of
time, no one has ever mentallyforced themselves to sleep.
Nobody has.
Because you're doing literallythe opposite of what you want
the brain to do.
You want the brain to calm down, not heat up.

(15:45):
And so when you're sittingthere telling yourself, go to
sleep, go to sleep, go to sleep,you're firing all these neurons
and you're doing exactly theopposite of what we want you to
do.
So what do you do?
A sleep meditation.
Exactly what you wanna do isyou wanna lower your heart rate.
So I'm going to teach everybodyright now the easiest way to
lower your heart rate in themiddle of the night.
It's called four, seven, eight,breathing.
Okay, this was developed by DrAndrew Weil.

(16:07):
Uh, this is a very interestingtechnique.
It's very simple and you can doit in bed in the middle of the
night.
So you breathe in slowly for acount of four, you hold for a
count of seven and then you pushout for a count of eight.
All right Now, if you can't doexactly that, you can do four,
five, six right Until you getthere.

(16:27):
But what it does?
So it was originally developed,believe it or not, for Navy
SEALs, specifically snipers.
So when you're shootingdownrange right, if your heart's
beating too fast, you canactually change the trajectory
of the bullet.
So we teach those guys and galsto shoot in between heartbeats.
The only way we can do that isto slow their heartbeat down.
So this is the method that'sused to slow their heartbeat
below 60 so they can shoot.

(16:49):
What most people don't know is,in order to enter into a state
of unconsciousness, you need aheart rate of 60 or below.
So this is the perfecttechnique to use in the middle
of the night to be able to allowyourself to kind of get
yourself back to sleep.
Now there's another problemthat happens in the middle of
the night Urination.

Speaker 3 (17:06):
Okay, very very prominent issue.

Speaker 1 (17:08):
Right, I deal with that right now.
I went four times last night.

Speaker 2 (17:14):
Okay, so we can talk about that in just a second.
But here's the thing is I tellthis to people all the time Do
you really have to pee?
That's the question I askpeople.
And here's why?
Because here's what happened.
Remember, got to have a heartrate of 60.
Most people are like, well, I'mup, I might as well see if I
have to go.
And then they go from a lyingposition to a seated position,
to a standing position.
Guess what?
They just jacked their heartrate up.
They probably went into thebathroom and flipped on the
light, which told their brainit's morning.

(17:35):
So no more melatonin, right?
If you got to pee, please gopee.
I'm not telling you not to gopee, but if you really don't
have to pee, stay in bed.
Try the breathing.
Okay, Michael, I don't have topee.
I tried your damn breathing.
I did it eight times.
My heart rate's lower.
But you know what?
I'm not falling asleep.
What's going on?
Here's the good news there'snow been research on something

(17:56):
called non-sleep, deep rest.
This is just quiescent.
So in the dark, quiet, nothinggoing on, just lying there.
It turns out it's rejuvenativeNot the same as sleep.
Right, it's worth about an hourof that is worth about 20
minutes of sleep.
So if you have a patient who'slying there for three hours,

(18:16):
they're actually getting aboutan hour's worth of sleep.
So once you educate them onthat fact and they let they know
that, then their anxiety startsto go down.
This is an anxiety issue in themiddle of the night, that's it.

Speaker 1 (18:29):
That's what I was saying when I went like this,
because I always feel thatpeople I know they can't sleep,
they're dealing with a lot ofstuff in the daylight hours.

Speaker 2 (18:36):
Well, and that's that's.
The other thing is, whathappens is is, once they start
thinking, they start thinkingabout stressful things.
What I try to get them to do isagain focus on the breathing.
What's nice about the breathingis it forces you to count.
It's very difficult to countand have negative thoughts at
the same time.
To actually try to do that,it's very difficult to do,
that's why they say count sheepExactly.
Now, by the way, if you wantanother method for counting

(18:57):
sheep I was talking about ittoday the old one, two, three
over the fence doesn't reallywork, but if you count backwards
from 300 by threes, oh that'stough, it doesn't it's
mathematically so complicatedyou can't think of anything else
, and it's so damn boring.

Speaker 1 (19:13):
You're out like a light.
You know what I do to help goto sleep.
I have two things I do.
One is I try I pray and I justcontinue to to pray, I love that
I think that's great, or.
I have this one visual thatworks every time.
This is so weird.
I picture myself bowling in astreet Bowling in a street A
bowling ball.

Speaker 3 (19:33):
Did you used?

Speaker 1 (19:33):
to do that as a kid.
No, I think I've always wantedto, though.
The bowling ball goes to themiddle of the street, just a
normal neighborhood.
My vision is I'm following theball and you can hear the the
bowling ball hit the gravel.
Yeah, yeah, I'm listening to itand I just follow this?

Speaker 3 (19:47):
are there pins in this video just going, it's like
, it's like infinity bowling.

Speaker 1 (19:52):
Yes, and every time I'm just picturing this bowling
ball in the hearing.

Speaker 2 (19:54):
You can hear the sound that's the last thing I
remember, and then you're off inla la yeah yeah, it works,
every time it it works everytime.
For me it's almost like amantra right, so a lot of people
will have For a simple person.

Speaker 3 (20:04):
Yeah, absolutely.

Speaker 2 (20:06):
So, remember, mantras don't have to be complicated.
Mantras are not even, sometimes, full words.
So having a visual mantra whichis again so, it fits the
purpose, and here's why itlowers your anxiety.
Right, okay, your anxiety,right, okay, and that's really
what we're talking about here isbiology wakes us up.
Anxiety keeps us up, okay, sodon't so understand that you

(20:29):
didn't do anything wrong to wakeup.
But now it is kind of your jobto stay chill and be able to get
yourself back to sleep.
And how do we do that?
By lowering our heart rate andletting anxiety reduce, so the
natural sleep process can couplemonths ago you're on my show
and we were talking aboutmelatonin.

Speaker 1 (20:41):
You just brought up melatonin, I know.

Speaker 2 (20:42):
Let's talk about it.

Speaker 1 (20:43):
I was so I was like sometimes I was taking extra
melatonin.

Speaker 2 (20:46):
Please don't do that.

Speaker 1 (20:46):
I know he warns people every day about that, I
thought see, I thought so now Ionly take the two that I
normally take, perfect.
But then I started I don't, Ihaven't run this by anybody but
I started taking CBD.

Speaker 2 (20:59):
So you just hit on the two big topics that I wanted
to talk about within insomnia,which is melatonin and cannabis.
Oh good, All right.
So so let's address both ofthose, because, uh, Carrie and I
were talking about that on theride over and we were thinking,
you know, these are two thingsthat a lot of people use
externally for sleep.

Speaker 3 (21:15):
And they use them without any medical guidance.
So we want to give them medical.

Speaker 1 (21:18):
Like me with my doctor right here Exactly, I
have not run this by her at all.

Speaker 3 (21:21):
Yeah, I'm just finding this out right now.

Speaker 2 (21:23):
Yeah.
So let's start with melatonin,since it's very easy to grab a
hold of and it's legal in all 50states.
So, first of all, melatonin isa hormone.
A lot of people don't realizethat.
They think, oh, it's a root ora supplement or a thing.
I don't know exactly what it is.
It's a hormone.
So there's a really good reasonwhy you don't go down to the
local drugstore and gettestosterone and estrogen as

(21:46):
hormones, because those have tobe regulated, because hormones
tell your body all kinds ofmessages to do all kinds of
things, and that really issomething that a healthcare
provider should be, you know,monitoring and seeing what's
happening.
And unfortunately, melatoninthe FDA decided to not make
melatonin classified as ahormone in 1974, I think it was

(22:08):
in the Supplement Act and so nowyou can get it everywhere.
Here's what's crazy.
Did you know it's byprescription only in most places
outside of the US Go to othercountries.

Speaker 3 (22:17):
Dhea, melatonin all the things that we just use over
the counter are prescription.

Speaker 2 (22:22):
Yeah, and here's another one that a lot of people
don't know is high doses ofmelatonin are used for
contraception.

Speaker 1 (22:30):
You mean?

Speaker 2 (22:30):
they make you fertile .
They do the opposite.
They do the opposite.
They don't allow you to befertile.
So here's where it gets weirdfor me, right, is there are lots
and lots of pediatricians outthere who turn to parents and
they say oh, your child isn'tsleeping, give them some
melatonin, it's not going tohurt them.
I personally can't think ofanything worse than entering a
contraceptive into a youngfemale body when there's no

(22:52):
immediate need for it Makes nosense to me, right?
So, number one nobody under theage of 18 should be using
melatonin.
By the way, children up to thatage have roughly four times the
amount of melatonin that theyrequire.
They don't need it, they don'tneed it.
There's one group of childrenwhere I like melatonin in, and
that's children on the autismspectrum.
There's been significant datato show that higher dosages

(23:15):
we're talking about four, five,six milligrams will work well in
that particular population.
Now, you probably just heard mesay a high dose of four, five
or six milligrams and people aretaking 10, 15 over the counter.
Right, and that's part of theproblem is it's readily
available and people are takingway too much.
Oddly enough, there was areally interesting study done

(23:36):
about nine months ago where theypulled 25 different melatonin
brands off the shelf and testedwhat was in the bottles.
Not a single bottle had whatwas on the label not one.
It was either too much or notenough.
So, buyer beware, there's a lotof hanky panky going on in the
melatonin universe.

(23:57):
Okay, now let's be fair.
There's really only threereasons you would need melatonin
shift work.
You, by the way, are a shiftworker.
Okay, you don't have any choice.
You got to get up at what Fouro'clock in the morning to get to
your show earlier Right soyou're up at two 45 in the
morning.
That makes you a shift worker.
Melatonin makes sense for aperson like you, okay, but for

(24:17):
somebody who's just says I'vegot insomniaomnia, melatonin's
not what they're looking for anathlete not good for an athlete.
Generally speaking, I don't likein in athletes because the
hormone has, uh, other othereffects that are in their bodies
and, to be fair, most athletesshould sleep like a stone.
I mean, they put out so muchenergy, they are such good shape
.
They really should be doing youknow pretty well.
Um, the right dose, by the way,is somewhere between a half and

(24:39):
one and a half milligrams,which also is almost impossible
to find outside in the universeright.

Speaker 3 (24:45):
Yeah, I think three milligrams is commercially.
What you see is the lowest doseout there.

Speaker 2 (24:48):
Yeah, like threes, fives, tens, and so what I tell
people is if you're going to geta gummy which most people do
chop it in half.
Also, by the way, gummies ortablets it takes almost 90
minutes for melatonin to get upand in, whereas if you do it
sublingually, so if you take adropper like a tincture and you
put it underneath your tongue,you can get it up and in about
20 minutes.

Speaker 1 (25:07):
Well, that brings me to CBD.
Yeah, so I was taking some CBDpills to go to sleep, yep.
And then my trainer, who is atBenacer, said he takes CBD for
other issues he has.
And I said, yeah, I take thesepills.
And he goes.
They're like 90% of it doesn'twork.
When you take a pill form orsomething like that, it doesn't

(25:28):
get in your system to whereveryou take the tincture.
So now I do a tincture beforebed, perfect, but I've never run
it by anybody.
I don't know if it helps mesleep, because I heard that it
does.

Speaker 2 (25:37):
So I don't know.
Let's talk about CBD and sleep.

Speaker 3 (25:39):
Well, as I say, we could be tracking that because
we wear trackers, so you wouldbe tagging on your tracker when
you're using it.
When you started using it, lookfor the difference in the data.

Speaker 1 (25:47):
I've never tagged it.
I don't tag all the time.

Speaker 3 (25:50):
I don't tag all the time, but I tag when something
is unique.

Speaker 1 (25:54):
But do you tag like?
You wake up in the morning.

Speaker 3 (25:56):
I tag hyperbaric when I do hyperbaric, but do you?

Speaker 1 (25:58):
tag what happened yesterday, or you tag when you
go into bed.
You go here's what happenedtoday.

Speaker 3 (26:02):
I tag when I go to bed.
Here's what happened today.
Okay, Impacting what's going tohappen that night when I clutch
my dad.

Speaker 1 (26:09):
I've never done that before so I should tag.

Speaker 2 (26:11):
Well, it would just be helpful, just because we can
start to look at the data andsee where there might be some
data differences.
As a general guideline,cannabis and sleep do mix and
they mix okay, but there's a lotof things you need to
understand.
So number one the higher thelevel of THC, the worse the
sleep.

Speaker 1 (26:27):
I don't think there's any THC in the there can be in
CBD.

Speaker 2 (26:30):
yes, there can be very, very trace amounts but
also I want to give people anunderstanding of cannabis in
total, and then I'm going tobreak it down into the different
constituents and just so thatwe're clear, I personally am
okay with THC, but you need tohave a small amount.
So when you have large amountsof THC, it raises your heart
rate and it lowers REM sleep.
Those are two things we do notwant to have happen.

(26:52):
So going to bed stoned is nevera good idea.
Okay, now, if you use amedicinal product right, and
what I would say is you wouldhave a small amount of THC, then
you would have something calledCBN as in nighttime.
So there is actually only onestudy literally in the published
literature that shows that CBDdoes anything for sleep.

(27:12):
What CBD does a great job of islowering anxiety and helping
with pain If you have a painissue or an anxiety issue that's
messing up your sleep.

Speaker 3 (27:21):
You're not sleeping.

Speaker 2 (27:22):
Right, then that's what it's going to attack.
But I want to be very, veryclear CBD in and of itself
really does not have atremendous effect on sleep.
It has effect on.

Speaker 1 (27:32):
So you treat the anxiety and then maybe you can
sleep better.

Speaker 2 (27:35):
Right.
But what I would do is if I wasgoing to be using a cannabis
product for sleep and Irecommend cannabis products for
several of my patients what Iwould do is I would use a ratio,
so I would say, for every onemolecule of THC, I would want to
have three of CBN and three ofCBD right and so when?
And you can buy products thathave already got this setup in
there, right and so what you dois you look for a sleep related

(27:57):
product that's got CBD, cbn anda small amount of THC, and I
think that's really where you'regoing to probably hit your best
mark.
Believe it or not, I actuallytake patients to dispensaries
sometimes just to teach them.
Mike can kind of see what'sgoing on.
Here's a really interesting.
We were talking aboutprescription aids and cannabis.
Here's a really interestingstudy out of the state of
Colorado.
So they found a county inColorado where there were no

(28:20):
dispensaries and they monitoredthe OTC sleep aids so the
Benadryls, the Tylenol PMs, theAdvil PMs and looked at
consumption right, and then adispensary opened up in that
county.
Guess what happened to thenumber of OTC sales?
They dropped.
They dropped dramatically, likeby 25%.
A second dispensary opened upin the same county and they

(28:40):
dropped again.
People are looking for asolution.

Speaker 3 (28:45):
Absolutely.

Speaker 2 (28:45):
Okay, and cannabis is the next Ambien.

Speaker 1 (28:48):
No question.
But cannabis is also.
They say it's natural, you'renot going to get addicted,
you're not going to get thattype of thing.

Speaker 2 (28:55):
Look, at the end of the day, if you take something
every single night, there's alevel of addiction that's there,
whether it's psychological orphysiological.
I don't think I want to splitthose hairs, but what I can tell
you is there's also nothingwrong with needing something to
help you sleep.
Like, if you're a paranoidschizophrenic, you probably need
to take Ambien.
Okay, like that's just part ofwhat happens in that regimen.

(29:17):
If you're bipolar disorder, youmay need something to help you
sleep.
Okay, if you have majordepression, you might.
Like there's no shame.
I want to be very clear.
There's no shame in taking asleeping pill, but that is a
relationship between you andyour doctor and that's one that
you have to be very tight on andunderstand how it works.
Sleeping medication is notcandy.
A lot of people are like oh,I've got sleeping pills, you

(29:37):
want one.
You know, I mean, it'sunbelievable.
People pass out these thingsall the time.
They can definitely bedangerous.
Like you never mix them withalcohol, which a lot of people
do.

Speaker 3 (29:46):
Everybody mixes them with alcohol.

Speaker 2 (29:47):
Right, and then you end up with real problems on
your hands, like people gettinginto cars, cooking food, doing
all kinds of crazy stuff intheir sleep.
So like you have to thinkthrough the idea.
If you're not sleeping, well,okay, what are the things that
are going on in my life that Imight be able to improve?
Caffeine, alcohol, stress wouldbe the biggies.
Understand what my chronotypeis.
So I go to bed at roughly theright time.

(30:08):
Honestly, after that, if youcould just do a little bit of
exercise during the day, maybeget some sunshine, I think I'm
good, you know, like that'sreally kind of what you need.
But most people don't do allthat right.
They're stressed, they don'thave an opportunity to, you know
, work on a lot of thesestressful things.
They drink too much caffeine oralcohol.

Speaker 1 (30:26):
When should you stop?

Speaker 2 (30:27):
caffeine.
I tell people to start stoppingcaffeine at around 2 PM.
Oh wow, that late.
Well, here's the thing.
Caffeine has a half-life ofbetween six and eight hours, so
it's a good place to start.
Now, what do I want?
I would prefer it if peopleonly had one cup of caffeinated
beverage roughly an hour and ahalf after they woke up, and
then they never had another one.

Speaker 1 (30:46):
You know, I was experimenting with that.
I never drank coffee, and thenCarrie, I started him on it she
started me, dr Carrie started meon coffee, right for the whole
fasting thing, yeah, and it gotto the point where I don't like
coffee and it kind of calms medown a little bit, but it was.
It was working as far as theappetite suppressing, right.
But what I started doing was Iwas drinking a cup of coffee

(31:07):
every time we played commercials, every time we played a song.
I'd get up.
I was doing about 10 cups ofcoffee before 9am, right, and
then I was.
It was not good, I wasn't, Iwasn't feeling it.
So then I cut immediately downto one cup and that's it.
And it's the same effects, likeone cup Absolutely.
And I feel like I discovered Idid some sort of case study,

(31:28):
clinical trial One cup of coffeeis all you need, it's all it
takes, that's all it takes.

Speaker 3 (31:31):
So I'm an anomaly.
She is.
So we joke about this all thetime.
It drives me crazy.
I drink four espresso on mynightstand as I'm going to bed
and he always says there's noway you're sleeping.
So, we got an aura ring and Isend him my sleep data and he's
like damn, you go like into deepsleep within three minutes and
you crash hard and I get we weretalking about normals right For

(31:54):
deep sleep.
I get right around two to twoand a half hours of deep sleep.

Speaker 1 (31:59):
an hour and a half to two hours per night, and rem.

Speaker 3 (32:03):
So I get over four hours, yeah, between every night
, pretty much every night.
Well, you know everything's notconsistent, but 80 of the time
90 and he's like how is thatpossible with that espresso
going to bed?
And I'm like you know, I'vedone it since I think I was like
five years old, honestly haveyou done the test on anybody
else, so what, what I?

Speaker 2 (32:20):
think is going on and so.
So it's very difficult whenyour doctor and you're a sleep
doctor drinks espresso beforeshe goes to bed.

Speaker 3 (32:29):
I don't counsel anyone else to do this.
I just want to be really clear.

Speaker 2 (32:33):
And so you're talking with your doctor which I do on
a regular basis because she'salso my friend, not just my
doctor and I'm like Carrie,there's no universe like, come
on, cut the doctor.
And I'm like Carrie, there's nouniverse Like, come on, cut the
bullshit.
And so we looked at her ringand she was right, and so what I
think it is is I think that shedoes not produce the enzyme
that metabolizes caffeine, andso I think it just runs right
through her Um.

Speaker 3 (32:52):
I would agree.

Speaker 2 (32:53):
And so there's, there are people out there that do
this.
Now some people will take thisenemy oh, caffeine.
No, caffeine really does notaffect her, at least not in the
sleeping realm.

Speaker 3 (33:03):
Or in the heart rate or blood pressure.

Speaker 1 (33:05):
Which is quite remarkable.
Does it suppress your appetite,though?

Speaker 3 (33:08):
No, not that much.

Speaker 1 (33:10):
It totally does that for me.

Speaker 3 (33:11):
I pretty much eat stuff all the time.

Speaker 2 (33:14):
Yeah, I was going to say you eat all the time.

Speaker 1 (33:15):
I can do a cup of coffee and not eat all day.
It's really weird.

Speaker 2 (33:25):
Yeah, that does not happen to me.
Yeah, that doesn't happen to meeither.
But I mean, look at the end ofthe day, when you're looking at
the different things that areout there cannabis, melatonin,
caffeine like you need to startthinking about, like whatever
I'm putting in is going to havean effect, right.
And so whatever you're tryingto accomplish whether it's six,
seven, eight hours of sleep,whether it's not waking up,
whether it's more REM, more deep, whatever your goal happens to
be my goal personally is just towake up and feel good.

Speaker 1 (33:47):
That's the only goal.

Speaker 3 (33:48):
I have.

Speaker 1 (33:48):
Well, sometimes I wake up and I feel good and I
look at my ring and it says Ihad a shit night's sleep.
I'm like wait a minute, Right.

Speaker 2 (33:54):
So that happens more often than not, Right and so?
So a lot of people don't likethat.
So what I tell people all thetime is you should only look at
your data once a week.
You don't need your data everyday.
What good is it going to do you?

Speaker 3 (34:06):
You're still going to do what you need to do that day
.
You're not going back to bed.

Speaker 1 (34:10):
No way.
Whenever I have a good night,what did I do last night?

Speaker 3 (34:14):
Well, you compete in the aura ring.
Yes.

Speaker 2 (34:16):
I do.
That's part of the week do Isleep the best?
You might find that everysingle week, thursday nights is
your best night, for whateverreason, because you've got
something else that goes on,because Sunday nights have
anxiety, because I've got a showto prep the next day that it's

(34:37):
been a couple of days and I getpretty nervous.

Speaker 1 (34:39):
I also find this Sometimes, if I sleep, let's say
, four hours, five hours a night, there are nights where I get
the most deep sleep during thatshort amount of time, absolutely
, and that's okay.

Speaker 2 (34:51):
Here's the thing to remember is, this unit that we
live in is much smarter than weare and it will get what it
needs when it needs it.
And so there's some nights,nights and just to be clear, I'm
the sleep doctor, right,there's some nights I don't
sleep so good.
Okay, there's nights I've hadinsomnia, right.
Some nights my body is moreinterested in doing something
else and sometimes you just haveto be like, okay, it's not like

(35:14):
your head's going to pop off,right, because you didn't get
enough sleep that night, becausethat's probably happened to you
tens, if not hundreds of times.
So, just under, kind ofunderstanding.
It's really about acceptance inin an interesting sort of way,
because I I talk with peopleabout insomnia a lot and and one
of the big things is, peopleare like it's the competition.
My bed partner can fall asleep,why can't I?

(35:35):
My co-worker says they get ninehours, I can't even get three.
You know it's.
It's.
Look, I'm five foot nine.
I'm never going to dunk abasketball.

Speaker 1 (35:43):
It's just not going to happen.
Okay, it does happen.
There are five foot nine.
Trust me.

Speaker 2 (35:47):
Muggsy bows and, uh, you know, spud Webb was my
favorite growing up, but I mean,at the end of the day, those
they're outliers and I'mprobably not right, and there's
some things you just have toaccept about yourself.

Speaker 1 (35:57):
Okay.

Speaker 2 (35:58):
And that's okay, right.

Speaker 1 (36:00):
Okay, very good.

Speaker 3 (36:02):
So I have a question because, obviously I deal with a
lot of insomnia.
I think the statistic I readyou can weigh in on this was
about one in three people willdeal with insomnia at some point
, or lifelong or situational.
We've talked about situationalimpacting it, but there to me
there are medications that areover prescribed by a lot of
providers that I like to tellpeople.

(36:23):
It's not just about saying no,you shouldn't do this, but that
actually do long-term harm topatients.
So can we touch on a couple ofthose?
Because I think it's differentthan the occasional Unisom or
Benadryl Advil PM, which isreally just Benadryl, using
those on occasion to followsleep.
It's the addiction, like yousaid, be there physiological,
psychological, whichever waythat I say you're actually not

(36:46):
just taking a pill that you'readdicted to.
You're actually never gettingactual sleep.
Your brain is not registeringthe thing.
So we do see early onsetdementias, which is a big issue
that I think is not ascorrelated to it as it should be
.
I don't think people talk aboutenough about sleep aids and
early onset dementia.
Um, hopefully we'll starttalking about it more.
But if you had to say what arethe big three pills that you say

(37:09):
, you know what if you can avoidthese, or you can find a way to
get off of them.
What would you advise?

Speaker 2 (37:13):
So the easiest way to answer that question is to tell
you about a patient that I have.
So I have a patient who wastaking Sonata to fall asleep,
ambien in the middle of thenight, waking up and taking
Adderall to start the day XR,like the extended release, and
then taking an IR at threeo'clock.

(37:34):
Okay, this person was 78 yearsold, okay, and they came to me.
They're a very famousconsultant in the
entrepreneurial world.
Do we have their name?
I cannot say their name.
And he came to me and he saidI've been going to my
neurologist who's beenprescribing different

(37:54):
medications for a while and he'sbeen trying to tell me that I
need to get off of these.
And he turned to me and he toldme that at 78, if I stay on
these, my brain will turn tomush.
And I said that is probably oneof the more accurate statements
that I have heard.
So to to long way around.
To say, long-term use of thesemedications, again with your

(38:16):
doctor and understanding what'sgoing on, may be appropriate in
a small percentage of cases, butthere are very few people in
the universe that have what Icall a broken sleeper right,
that have to be on drug forever,right, I mean.
And so just as a caveat to thisstory, so number one many
people might not know this, butAmbien has a much longer
half-life than Sonata, so he hadthe reverse.

(38:38):
So the first thing I said wasyou're a mess, can you do me a
favor, put the Ambien in thefront of the night and the
Sonata in the middle of thenight?
Because I was going to get ridof the middle of the night,
sonata, eventually.
So I got him off of the middleof the night, sonata, then I
halved him on the Ambien, then Istarted working on the Adderall
right and, by the way, this isall in conjunction with his
physician.
And so while we start doinglower the XR and move the IR to

(39:02):
the beginning of the day, andall of a sudden I got him off of
everything.
Just click, boom, and he wasmotivated.
And the reason he was somotivated was because he was
like I can think it wasfascinating.
This guy makes his living offof creating these intellectual
tools that he gives toentrepreneurs and he gets
patents on them and things likethat.
He said, michael, since I'vebeen working with you, my

(39:23):
productivity rate has tripled.
He said my staff is furious.
He said I'm doing more workthan they know what to do with
at this point.
And it's all because you got meoff of those drugs, so he's off
of everything and he's sleeping.
Sleeps like a charm, no problem.
So the point of the story isyes, we do know that many of
these medications out there canhave long-term effects, and it's

(39:46):
not even the ones that we think.
So anything with a PM is not agreat idea, and I think that's
where you were going with yourquestion, because when we look
at Benadryl, which is the PM,there is direct evidence now to
show that daily use of Benadrylwill in fact lead to Alzheimer's
Correct.
It's a very direct link.
We know exactly what's going onnow.

(40:06):
This is not necessary Now.
If your allergist has you onBenadryl for extended periods of
time, that's a different story.
You want to talk with themabout that.

Speaker 3 (40:15):
But there's alternatives to using that as
well.

Speaker 2 (40:17):
And there are alternatives to using that.
But at the end of the day, ifyou are taking allergy
medication every night to fallasleep, it's going to turn your
brain into mush and that'sreally not the direction that we
need to go in.
When I use medications withinthe practice and you know this
because we've worked together onmany patients the physician
will prescribe a medication tobreak the cycle of insomnia, not

(40:40):
to leave people on drug foryears and years and years.
And, to be fair, sometimes ittakes a while, right.
Sometimes people need to be ondrug for three, four, six months
before we get a steady sleepcycle.
Then we teach them how to sleepand we slowly taper off the
medication and, lo and behold,they sleep.
They sleep right.
It's really has a lot to dowith stress and your stress

(41:00):
management and then just reallyunderstanding yourself, your
body and your sleep cycle.
What about?

Speaker 1 (41:06):
like with this insomnia, talk sex.
Does sex help you sleep?

Speaker 2 (41:11):
So sex helps men sleep, not women.
So, as the age old joke goes,you know, most men fall asleep
after sex and women are up andready to go.
So there's actually been twostudies, unfortunately all in
Drosophila.
So I don't know how close weare to fruit flies.
But one of the things thathappens with fruit flies male
versus female is males have atendency to relax and sleep,

(41:33):
Females have a tendency to nestyou mean they haven't studied
this in humans.
They have not.

Speaker 3 (41:38):
There's, I'm not aware it's time to start a study
.
Yeah, really.

Speaker 2 (41:41):
I mean, we could definitely do a fun survey and
we could probably figure it out.
But the question then becomeswhy, right?
And so it may have something todo with orgasm, it may have
something to do with sexualpositioning.
There's a whole host ofdifferent things that they think
it could have something to dowith.
The position could help.
So if you really want to getinto it.

(42:05):
So the process is physicalexertion they're talking about.
Oh so the, the goal, the, thethought process is men are
exerting more physically thanwomen, especially if you're in
the classic, uh, missionaryposition with man on top, woman
on bottom okay, because, like I,I'm so competitive with my aura
ring that I'm looking at.

Speaker 1 (42:21):
okay, I got, let's say, 20 or 18 minutes of deep
sleep, no orgasm the nightbefore, oh hour and 10 minutes,
guess what.
We had sex, right.
And so now I'm telling my wife,this is really going to help me
get some deep sleep, and itdoesn't do anything, she still
shuts it down.

Speaker 2 (42:39):
So here's where I would go with that if I were you
is.
I wouldn't say that it wouldhelp you every night, but I
would say that it woulddefinitely probably be somewhat
helpful, probably two to threenights a week, yeah.

Speaker 1 (42:50):
Okay.
So then I thought, like for fun, but also seriously, as I'm
monitoring, I'm like, okay, wedidn't do it two nights ago, we
did it tonight.
And then nothing this day,something this day.
And I'm literally thinking thatis one of the important things
in getting deeper sleep is anorgasm.
And then it's like, well, I wasin Hawaii last week by myself,
got things under control, sleepwasn't that great.

(43:12):
So is it not the orgasm you?

Speaker 2 (43:14):
know what I mean, right?
So the question is is it theconnection or is it the orgasm?
The connection is another thing, and I think it's the
connection.

Speaker 1 (43:22):
Well, I think it's a natural anti-anxiety drug for
sure sex or yeah, sex yeah, butI mean just also the connection
with the sex is the natural skin.
The skin, yeah, it's like, yeah, it produces oxytocin and
that's exactly where I was gonnago.

Speaker 3 (43:36):
I think it is the oxytocin right and I.

Speaker 2 (43:38):
So I I would argue because, like you know, if you
look at it, if somebody justgives themselves an orgasm
versus being with someone tohave an orgasm, it's very
different, right, and so that'skind of what you're talking
about here.
And, from a sleep perspective,it's not just the physical act
of orgasm.
I think that's allowing peopleto fall asleep.
I think it has more to do withthe connection.

Speaker 1 (43:56):
So then, that's so stated, though in the morning,
every once in a while, as earlyas I get up, something happens.

Speaker 2 (44:03):
It hasn't happened in a long time, but when it does
happen, before I go to work, youget up at 2.45,.

Speaker 1 (44:06):
Dude, I know, but sometimes something happens, and
when it does I have the bestday.
Yes, you do, do you know?

Speaker 2 (44:12):
what.

Speaker 3 (44:12):
I mean, that's the oxytocin again, though For sure
it's not only the oxytocin.

Speaker 1 (44:27):
It's.
It's literally like smoking agreat big oxytocin joint in the
beginning of the morning andit's just, you're just got that
high all day long because itlowers that stress.
Then I thought it's gonna makeme tired.
That's why I remember they usedto say there was that no sex
before a fight boxers right,because it would make them tired
right, which is not true oh,it's not because then I'm like
oh wait, I don't know if I wantto do this.
I gotta go do a four hour, fivehour show.
I need to be on, I don't wantto be tired, you'll be fine.
Okay, good, I know my wife'scoming here today for some stuff
and I wish she was here now.
But then it's like oh wait,this is going to be a podcast.

(44:47):
I need you to zoom into thispoint here the podcast.

Speaker 2 (44:51):
Absolutely, don't you worry.

Speaker 1 (44:54):
Let's talk about sleep apnea.
Sure, Since you're the sleepdoctor, I'm an expert in sleep
apnea.
I haven't been tested.
Now I'll just say I was gettinga haircut for this broadcast
today and my beard cleaned upand my barber says to me he goes
, I snore, my wife is furiouswith me.
I think it's starting to causeproblems.

(45:14):
He's like happy wife, happylife and he goes I might have
sleep apnea.
And I said to him, I said and Imight be wrong I said if you go
to the sleep doctor's websitethere's a sleep apnea test or
something right, absolutely,that you can order.

Speaker 2 (45:26):
So you can order a home sleep test and figure it
out yourself.
You get to talk with aphysician, so it's not like
you're completely on your own oranything like that.
But yeah, here's the bottomline when we start to think
about sleep apnea and you hadbeen correctly diagnosed with it
.
If you have undiagnosed sleepapnea, it leads to a whole host
of so many different medicalcomplications.

Speaker 3 (45:47):
Chronic medical diseases yes.

Speaker 2 (45:48):
Right.
So hypertension, all kinds ofcardiac problems, stroke, death,
I mean, the list goes on and on.
Literally every organ systemgets affected by getting bad
sleep, and so when you do thatto the system, it kind of
screams out at you, and solooking for treatment modalities
turns out to be a really big,important thing.

(46:08):
Now a lot of people know aboutthis thing called CPAP, right,
continuous positive airwaypressure.
So basically it's kind of likea hairdryer that blows up your
nose and pushes air down intoyour lungs, right Kind of basics
behind the physics of it.
Um, about 40 to 50% of peopledo really good on CPAPs.
I want to be clear though 99%of people it fixes them, but
only 40, 50% of people willactually tolerate and wear it.

(46:31):
So they now make oral appliances, which is a mouth guard kind of
like you see the athletes wear,but it's an upper and a lower,
and the lower comes out a littlebit past the front and it opens
up your posterior airway andallows for you to breathe a
little bit better.
The front and it opens up yourposterior airway and allows for
you to breathe a little bitbetter.
So that's another option.
There's also something nowcalled Excite OSA, which is

(46:51):
basically a TENS unit for yourtongue.
So this is something that youwear during the daytime for
about 20, 25 minutes.
It reduces the size of yourtongue very small, does not
affect taste, does not affectvoice, nothing like that.
Gives more space in the oralcavity, thereby allowing you to
breathe better.
Some people we get them off ofCPAP for that.

Speaker 1 (47:07):
So they literally have a fat tongue.
Exactly.

Speaker 2 (47:08):
Like you've been diagnosed.

Speaker 1 (47:09):
Oh yeah, absolutely you lay back, your tongue covers
your airway.

Speaker 2 (47:12):
You nailed it.
That's exactly right and itworks by.
The TENS unit shrinks yourtongue.
It's amazing.
It's truly remarkable.
I would argue it's probably thebiggest innovation that we've
seen in sleep apnea treatment ina very, very long time.

Speaker 1 (47:25):
Well, well, I mean, as a guy who has, I've had sleep
apnea for maybe 15 years maybe,and I love my c-pap, I love it
like you're again one and two,hate it well, the problem.
The problem I have now are linesfrom like I in my radio show,
I'm doing tv hits or they'refilling stuff and I'd be on tv
and I see the line right.
So I started modifying things.
Where you know, thank god forcovid, when everyone's wearing

(47:48):
masks?
Yep, I found this mask for saleat a booth in san diego and
it's like a ninja mask so youknow where the eyes.
I put the mask nice and wherethe eyes are, I pull it down to
my mouth and then I put the tank, the mask over, and then it
kind of gets rid of the.

Speaker 2 (48:02):
You got to take a picture.

Speaker 3 (48:03):
He has pictures At one point I put the mask on.

Speaker 1 (48:06):
Then I put a pair of underwear over my head Lululemon
underwear Even better.
And then it would help keep themarks away.

Speaker 2 (48:11):
So don't wrench the mask so tight, yeah, but the air
comes out and then I have thisbeard.
Okay, okay, no-transcript.

Speaker 1 (48:29):
Oh, come on.
I wonder every drugstore in theuniverse?

Speaker 2 (48:33):
And what happens is, if you use a water-based
lubricant, it'll form a seallike a gasket would on your face
, so you don't have to wrench ittight, and so it actually
blocks.
Because right under your noseis where we have the most air
leaks, because it's this creaseor up here, then it gives me dry
and it gives it in your eye.
But again, if you have a littlebit of ky and you put it on the
mask itself and then when youplace it on your face, it forms

(48:53):
this gasket and it worksbeautifully, you don't have to
wrench the mask so let me tellyou my newest thing.

Speaker 1 (48:57):
All right, and I know you know about this, but
sometimes you forget.
A friend of mine had covet andwas put in the hospital and she
was like dying.
She gets out of the hospital,they give her this oxygen tank,
right, right.
So she's fine now and she saysI have this oxygen tank, do you
want it?
I'm like sure.
So I have it hooked up to myc-pad.
Yeah, right at level two andthere, and, and it made too much

(49:18):
noise so I could only use itwhen I was going to nap in the
daytime because my wife couldn'tsleep right.
But now I got 50 feet of tubingand I put it down the closet.
I turn it on, I close the closetdoor, then I close the bathroom
door, the tubing comes all theway up and I just a little bit
of oxygen and I feel that withmy aura ring sleep that let's

(49:40):
say I was going to have a 70sleep, with the oxygen I think
it takes me to an 80.
Does that make sense?
So it.

Speaker 2 (49:47):
So number one I would be well, it probably doesn't
change your oxygen concentrationall that much right, it's such
a low flow right, I actuallydon't have that feature in my
ring.

Speaker 1 (49:56):
I don't know.

Speaker 2 (49:57):
But.
But I would say that, um,having oxygen in the system is
always going to be good fordeeper sleep.
So if I had to guess and Idon't think anybody's done a
study where, like, we'veadministered oxygen at night to
see if it increases deep sleepor increases REM sleep If I had
to guess I would say it probablyincreases deep sleep.

Speaker 1 (50:17):
physical restoration Because I would think oxygen is
good no matter what, any time.
Pretty much, well, you can havetoo much oxygen.

Speaker 3 (50:22):
I think that's where he's hedging on, so normally
good, no matter what, any time,right, pretty much you can have
too much oxygen.
I think that's where he's he'shedging on.
So normally we prescribe oxygenas a bleed through into a c-pap
if your oxygen levels dropbelow 88 is kind of the
traditional benchmark.
But that doesn't mean peopledon't benefit, if they have
higher oxygen levels, from stillhaving supplemental oxygen
right so you could still begetting a gain.
We just don't really know whatthat gain is, because we don't
treat that normally.

Speaker 1 (50:42):
Because I was going to ask you too.
You told me to put it at two.
I feel like you should gohigher.

Speaker 3 (50:46):
Well see, that's what we're getting into.

Speaker 1 (50:47):
So then, you can start but now what are you all
prophyl like Michael Jackson,yeah.

Speaker 2 (50:51):
That's a whole different story.

Speaker 3 (50:52):
Well, yeah, you can actually get oxygen toxicity.
You can decrease therespiratory drive by having too
much oxygen, so you're going totell your brain I don't want to
breathe, and then you'll stop.
Now you're on CPAP, which isforcing breaths.

Speaker 1 (51:04):
So there's a paradox there.

Speaker 3 (51:06):
To begin with, but you don't always want to over
oxygenate.

Speaker 1 (51:10):
At what level is that ?

Speaker 3 (51:12):
I think most of us healthy people walk around 96,
97%.
I mean if you're tipped in 99,a hundred all night, long over
time, that could cause somenegative effects.

Speaker 2 (51:23):
Yeah, I mean, there's a reason why we don't sleep in
a hyperbaric chamber, right,right.

Speaker 3 (51:27):
All night long but could you, though?
You could not sleep in amedical grade hyperbaric chamber
all night long, you would getwhat's called oxygen toxicity,
which would induce seizures andyou would not do well.
So there is a theoretical limitof how much oxygen you can feed
into your brain, into yourorgan system, before you start

(51:47):
to see negative effects fromwhat you're doing.
So there's a balance.

Speaker 1 (51:51):
The tongue thing you were talking about.
How do you, how does somebodydo that?

Speaker 2 (51:54):
It's by prescription.
You just go to exciteosacom andyou punch in your zip code and
they'll find a doctor near youwho can.
But how do you get diagnosedfor having a fat tongue?
Like, you literally go to yourdoctor and then you just have to
have the diagnosis of sleepapnea.
Oh, okay, because most peoplewith sleep apnea have got larger
tongues.
Um, that's really, believe itor not, one of the big
physiological markers.

(52:14):
Um, that we look at a bigtongue.
That and weight loss uh, thatand weight gain and weight loss
because I've lost the weight.

Speaker 1 (52:21):
I feel pretty healthy .
I think I am healthy accordingto you absolutely yeah, why do I
still have sleep apnea?

Speaker 2 (52:26):
because it's not just a weight-driven disease.
It's also got to do with yourtissue and your, your anatomy,
right and so, and also, don'tforget, as you continue to lose
weight, you'll lose more weighthere in your neck, because, guys
, we have a tendency to loseweight or gain it right here in
our necks and then cut rightaround our bellies and that's
kind of the last places that wehave a tendency to lose it from.

(52:46):
So once you continue on thatjourney, I think you'll find it
gets better and better.
It also begs the question thatwe were talking about earlier,
which was these new GLP-1 drugsthat everybody's getting on the
Vigovis and the-.

Speaker 3 (53:00):
Manjaros Vigovis semaglutide.

Speaker 2 (53:02):
So a lot of people are looking at those and saying,
hey, should I get on that andthen can I get off my CPAP
machine if I lose enough weight,and so the the potential is
possibly, but we need to do astudy on you after you've lost
the weight to see.

Speaker 1 (53:15):
I don't really mind the CPAP.
The only time the CPAP everbothered me is when my son, a
boy scout, became an eagle scout.
We'd go camping, yep, and I'dhave to bring it, or I'd get a
portable one, you know, with awith a generator at one point
and it was like that took up allthe room in my backpack, right
where all the other dads arepulling out hibachis and stuff
like that my backpack was ac-pap.

Speaker 2 (53:34):
Yeah, it sucked absolutely, but you also did.
You probably didn't keepeverybody up all night long with
your snoring.

Speaker 3 (53:40):
You're right, um, greatly appreciated by,
appreciated by all, I'm sure.

Speaker 1 (53:42):
Okay, so real quick around the room.
We'll correct about a moresleep out, because we know you
got to catch a plane, yep, sowhat's up?
Anything else?

Speaker 3 (53:48):
Well, I want to go back to the Wagovi question
because I mean, I think that isreally cutting edge, and a lot
of people are trying to figureout how to repurpose this drug
and the FDA is trying to notmore years under different names
.
So we've been using it inmedicine very long time and we
weren't really paying attentionto the side effects, but someone

(54:09):
got really smart and said, heygosh, people who take this drug
for diabetes don't really wantto eat that much anymore.
And so then we figured out itwas a weight loss drug, and I
love the idea that they're nowkind of correlating that with
other diseases beyond justweight loss using it.
Obviously, cardiovasculardisease is hitting a lot of
indications now, and people aresaying this could reduce
cardiovascular risk, which isstroke, heart attacks, and it's

(54:31):
all tied to the same thingthough Lose weight, be healthier
.

Speaker 2 (54:35):
Correct.

Speaker 3 (54:35):
Eat better Correct, because it's not just weight
loss.
I always tell people the drugdoesn't actually make you lose
weight.
It makes you make betterchoices about life, which you
can do without a drug.
So you don't have to have thedrug, but the drug definitely
tells the brain to act better,make better choices.
I don't want fried foods, Idon't want sugars, and by doing
that you know what happensPeople lose weight.

(54:57):
They start to feel better andthey sleep better.

Speaker 1 (54:59):
Yeah, because we didn't even get into that before
, about what to eat before yougo to sleep.
Right, you know that guy who'skind of a freak, brian Johnson.
Yes, yes, you know that.
Dude's last meal is 10 hoursbefore he goes to sleep 10 hours
.

Speaker 2 (55:12):
I got to be honest with you.
I'm not a fan Right Agreed.
I don't see what he's doing ashelpful.
Or healthy or healthy, I think.
Unfortunately, he's showingevery extreme that he possibly
can as a very wealthy man.
He's going out there and he'strying all these extremes and
unfortunately I don't think he'ssetting the right precedent for

(55:32):
people out there.
And I don't really understandwhat his goal is.
Like he wants to actually getyounger.
Is what he states in his videosLike that doesn't seem.
I'm pretty sure that doesn't.
It doesn't work that way.
Um, and I just don't.
I don't understand what hismotives are and kind of where
he's at.
So I'm I'm concerned about alot of his methodology.

(55:53):
Also, he's not a physician, sohe has no idea what the
long-term consequences are ofthe stuff that he's doing.

Speaker 1 (56:00):
He doesn't look healthy to me.

Speaker 2 (56:02):
He doesn't look healthy to me either.
I mean nothing against himaesthetically, like I mean he's
a muscular man and he's anattractive person, but he does
look quite pale.
Maybe he just doesn't get a lotof sun, I don't know.
But I mean he could probablyuse some vitamin D.

Speaker 1 (56:15):
But we jump into foods.
So is there a time limit?
Stop eating before you go tobed to get a good night's sleep?

Speaker 2 (56:20):
What I like to tell people is what I kind of do is
what I say.
It's a three, two, one rule.
So stop alcohol three hours.
Stop food two hours.

Speaker 1 (56:33):
Stop fluids one hour before you lights out as a
general guideline One hour willstop you from peeing four times
in a night.

Speaker 3 (56:36):
Well, there's a lot of caveats, Obviously talking to
your physician if you're aperson who does get up four
times at night to urinate, whichI did not know about- it was
last night.

Speaker 1 (56:44):
It was the first time this hour.

Speaker 3 (56:45):
And that gets into the whole issue of insomnia.
So we end up flipping back intothat.
But I mean, then you're goingto stop fluid six hours before
you go to?

Speaker 2 (56:51):
bed.

Speaker 3 (56:51):
And that's a state of dehydration which we don't want
people to be in.
But you have to pick and chooseyour battles, because getting
up and truly having to urinatemultiple times a night is not
helping you get a good night'ssleep.
It's not getting that deepsleep, it's not getting the REM
that we've been talking about.

Speaker 2 (57:06):
Right, but are there?

Speaker 1 (57:07):
foods.

Speaker 2 (57:07):
You shouldn't eat before Anything with high sugar,
anything with caffeine in it,that kind of stuff, although I
have to admit, my wife told me Ican never tell people they
cannot have chocolate becauseshe eats chocolate every single
day and it does have caffeine init, you can have a small square
of chocolate every day.
The sleep doctor says it's okay.

Speaker 3 (57:23):
Carbohydrates tend to make you feel sleepier.

Speaker 2 (57:26):
Yes.

Speaker 3 (57:27):
But the truth is, for health, you should actually be
eating protein before bed, 100%,because we don't get enough
protein and our bodies becomeanabolic.

Speaker 1 (57:34):
So they eat up our muscle Before bed, like I'm
eating protein.
Good night, or eat protein isthe last thing you eat.

Speaker 3 (57:40):
Well, if you, if you listen to Dr Bruce he's saying
two hours before bed and I meantwo hours is not that long of a
time before you go to sleep.
So a lot of people do haveproblems if they eat a large
meal immediately go to bed.
Then we get into issues withreflux and laryngeal
regurgitation and not feelingwell and they have to sleep
sitting up and so you have awhole new saga of health

(58:00):
problems.
So we say don't eat a big mealand then go lay flat.
The body's not really designedto accommodate processing a
large meal and then not being inthe upright position, Right
either lying down?

Speaker 1 (58:13):
Yeah, so it's bad.
Is there a better sleepposition?

Speaker 2 (58:16):
So I would argue that the back is probably the best
sleep position, unless you havesleep apnea, and then your side
would be.
Backs are great because it'sthe best way to displace weight
across the skeletal framewithout jacking your neck one
way or another, being in someweird position.

Speaker 1 (58:31):
So a quick recap.
You said sex every night beforebed is great for you to get.

Speaker 2 (58:35):
I did say that as a matter of fact.

Speaker 3 (58:37):
Oh, my wife is here, sorry, blake.

Speaker 1 (58:40):
All right, thanks, doc.
I know you got to go.
Thanks for jumping on ourpodcast Experimental.
It's a lot of fun.
Thank you, thank you, thank you, thank you.