Do you struggle with sleep? You're far from alone—especially if you've served in the military. In this fascinating deep dive, research scientist Lindsay Hildebrand reveals how the disrupted sleep patterns military personnel experience can persist long after service ends, potentially leading to serious health consequences.
Sleep isn't just about feeling rested. As Hildebrand explains, it's a critical biological process with profound implications for brain health. Poor sleep quality strongly correlates with earlier onset of conditions like Alzheimer's and Parkinson's. For veterans trapped in the vicious cycle of anxiety preventing sleep and sleep deprivation worsening anxiety, this connection is particularly troubling.
But there's hope on the horizon. Hildebrand's work with the Social, Cognitive and Affective Neuroscience (SCAN) Lab focuses on groundbreaking non-pharmaceutical approaches to sleep disorders. Their research into Transcranial Magnetic Stimulation (TMS) yielded remarkable results—just 40 seconds of targeted stimulation significantly improved sleep quality by quieting the brain's default mode network, responsible for those racing thoughts keeping you awake.
Even more accessible is their light therapy research, now recruiting for the largest Department of Defense light therapy study ever conducted. This completely remote study provides specially designed glasses participants wear for just 30 minutes each morning, potentially resetting disrupted circadian rhythms without medication.
What makes these approaches revolutionary is their simplicity and effectiveness. Rather than just treating symptoms, they address underlying neurobiological processes, potentially breaking the sleep-anxiety cycle that plagues so many veterans.
Want to participate or learn more? Active duty personnel from any branch and veterans separated within the last five years may qualify for the nationwide light therapy study. Visit the SCAN Lab website through the University of Arizona to see if you're eligible to contribute to this groundbreaking research—and possibly transform your sleep in the process.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Scott McLean (00:00):
Welcome to the podcast.
I'm Scott McLean.
My guest today once again isLindsay Hildebrand.
Now, lindsay was on here before.
She's been on the podcast acouple of times.
She did an episode for FloridaLeads, she did an episode for
the Veteran Yoga Project and nowshe's on again.
(00:24):
Lindsay is an amazing youngwoman.
She's on here to promote andtalk about well, I'm going to
let her give you the name, butshe's a research scientist for
scan labs.
This is how we kind of talkedabout it before the episode.
I didn't want to blow it, soI'm going to let Lindsay explain
(00:44):
how you doing Lindsay.
Lindsey Hildebrand (00:46):
I'm good Thanks for having me back on yet
again.
Scott McLean (00:51):
We still have another one in the future
sometime.
Lindsey Hildebrand (00:53):
I know you keep letting me come back time
and time again.
Scott McLean (00:57):
I love it Because every time you come back, you
come back with somethingabsolutely different than before
, which, again, in my opinionand I'm sure I'm not alone in
saying this you're an amazingyoung woman for everything you
do and all the help that youbring to the veterans, which is
what this is all about.
So, research scientist at ScanLab, let's give us a whole
(01:18):
breakdown.
We're all ears.
Lindsey Hildebrand (01:20):
Lindsay, we're all ears.
Oh geez, We'll be here for awhile Well that's fine.
Yes.
So I, before I kind of movedinto the realm of social work,
I'm still involved with the SCAMlab.
So we are the social, cognitiveand effective neuroscience lab.
So what we primarily do is welook into social, cognitive and
(01:42):
effective neuroscience factors,primarily towards, you know,
military and veterans.
So we've done a lot of studies.
It's headed by a primaryinvestigator who is Dr Scott
Kilgore really wonderful, youknow, dod researcher, very well
known in the field.
But one of the primary kind ofareas that we look into is how
(02:06):
sleep or lack of sleep kind ofaffects all of those domains.
So that's kind of, I would say,our specialty.
We're pretty wide, kind of awide swath, because we're really
folks of like anything thatreally interests us and stuff we
usually come up with studiesfor.
But it's really orientedtowards looking at, you know,
(02:28):
non-pharmacological treatments,for you know specific disorders
that we know military servicemembers and veterans kind of
deal with in higher proportioncompared to the general
population.
So a lot of the things that welook at are like insomnia, you
(02:50):
know.
Circadian misalignment, youknow we looked at, you know
we've done a lot of studies onlike post traumatic stress,
traumatic brain injury.
So I would say kind of morecommon or like higher proportion
that of disorders that veteransand, you know, military service
members as a result of theirservice kind of experience and a
little bit more commonly thanyou would typically see within a
normal population.
So that's what we kind of do so.
(03:12):
Like I said, we kind of rangeacross the board for a lot of
things.
Scott McLean (03:17):
So you mentioned there's no pharmaceuticals
involved, right?
So we tend which I'm sorry,which has always been a bone of
contention for a lot of veteransthat medication.
(03:37):
They always just give me pillsand I'm talking about the va and
I I will never disparage the vain any way, shape or form.
They've helped me immensely andI will never disparage the VA
in any way, shape or form.
They've helped me immensely.
But people I talk to have saidthat, oh, all they want to do is
give me pills.
All they want to do is give mepills and I know that snowballs
sometimes and maybe it soundsworse than it really is, but it
(03:59):
is a thing with veterans.
I know that for a fact.
So you guys avoid that.
Lindsey Hildebrand (04:06):
Yeah, we really try to look at kind of
advancing technologies.
So some of the stuff we've usedpreviously are kind of light
therapy.
That's the one that this studykind of concerns and is the
treatment and then for it.
But we've also used differentthings.
Like you know, transcranialmagnetic stimulation is one of
(04:27):
our other big tools.
It's something that is gettingkind of a little bit more common
in the VA, especially at largerVA centers like San Diego.
Scott McLean (04:36):
You know, minneapolis, like Explain more
about what that is.
Lindsey Hildebrand (04:40):
Transcranial magnetic stimulation depends on
kind of.
Scott McLean (04:43):
I'll try not to get too nerdy into the science
oh, get as nerdy as you want,lindsay, all right.
Lindsey Hildebrand (04:48):
Well, that's the best that I do so what we,
you know what transcranialmagnetic stimulation essentially
sends out specific types ofpulses towards the brain.
So there's specific areas thatwe localize to target.
So what you tend to seetranscranial magnetic
stimulation being used for a lotof the times is either to
inhibit activity or to increasecertain activity by kind of
(05:12):
shooting these types of specificwavelength frequencies towards
specific areas of the brain.
So a lot of the times, I thinkat the VA, we tend to see them
using it for treatment of kindof like major depressive
disorder and anxiety.
They tend to use it towards,like, the dorsolateral
prefrontal cortex, becausethat's one of the common areas
(05:34):
that tends to either be likejust kind of misaligned in terms
of, you know, in terms of likeneurobiology and it's linked to
those specific types of mooddisorders.
So that's where you'll see itkind of used.
But it's a really it's likethis huge machine and if we, you
know, we use MRI to basicallymap like where we want to target
(05:56):
the stimulation.
We used it very specificallywithin a clinical trial.
We actually have a secondclinical trial coming up that's
going to be even larger andlonger is using transcranial
magnetic stimulation fortreatment of insomnia, and so we
used it on, we use it on aspecific brain network called
(06:16):
the default mode network.
So that's associated with a lotof like rumination, mind
wandering, so kind of that.
You know, when you get into bedand say you do have like
insomnia, right, it's kind ofhard to turn down the noise,
right, you're kind of sittingthere, your mind's kind of going
on overdrive, like you're kindof left to your own devices.
(06:36):
So a lot of that, a lot of thatlike pre-bedtime anxiety we
tend to find kind of preventsone sleep onset.
You're spending more time inbed than time asleep.
When it comes to sleep, whatwe're looking at is really
efficiency.
So the time that you know youspend in bed we want you to
sleep right.
People who have insomnia a lotof the time spend a really
(06:58):
prolonged time in bed but not alot of time asleep, and not a
lot of time asleep at thespecific stages that they kind
of need in order to feel a lotof those like restorative
effects and stuff.
So we use this particularmachine, you know the
transcranial magneticstimulation, to kind of suppress
the default mode network, tokind of tune down a lot of those
(07:22):
ruminating thoughts and stuff.
And what we found in our studyis that you know it was
effective, for you know, duringour pilot, like for the 20 folks
that came through for ourrandomized control trial and
stuff at the time, that they gotlike the actual, active, real
transcranial magneticstimulation versus when they got
like the placebo stimulation,and so, as we saw, you know,
(07:44):
better total sleep time, bettersleep efficiency and better what
we would call wake sleep onsetor WASO, and so, essentially,
like you know, people who youknow woke up in the middle of
the night, they wouldn't, youknow, spend as much time like
awake during that, during thoseperiods of kind of awakenings,
during the actual like sleepperiod before what we would call
(08:07):
your final awakening, like thefinal time that you wake up.
So so pretty cool.
We got a second phase comingdown the pipeline.
So if anybody's in Arizonathat's listening to this, it's
available for you.
So, yeah, so it's a pretty cool, pretty cool study.
But we also use, like I said,the focusing on a lot more of
the circadian component, becausewhen it comes to sleep, there's
(08:30):
really two different processes.
So this is called like the twostep process of sleep.
So there's the natural kind ofhomeostatic drive, what we call
like sleep drive or sleeppressure, and then there's the
circadian aspect of it.
So those two kind of work inconjunction and in tandem with
each other but they can both getmisaligned and what we tend to
(08:51):
find is that's what really kindof propels or perpetuates a lot
of insomnia, particularly forfolks that have like irregular.
You know sleep-wake cycles likethat might get interrupted by,
you know, being on CQ whilethey're in service, like staff
duty.
You know sleep-wake cycles likethat might get interrupted by,
you know being on CQ whilethey're in service, like staff
duty, you know trainingexercises yeah different things
(09:11):
like that.
But even like on the outsidewith civilian work like if
you're on like a shift workschedule and stuff, it
interrupts kind of both of thoseprocesses.
So we use kind of light therapymodalities to kind of help with
that circadian aspect, becausetheoretically you kind of want
both of those things aligned atthe same time so that way you
can optimize your sleep.
Scott McLean (09:32):
So I have a couple of things to say.
I understand the shift work.
When I first went into USCustoms back in 1997 and I got I
was working at the MiamiInternational Airport behind the
scenes stuff, we changed ourshifts every two weeks.
We went midnight to eight andfour to midnight and then 12 to
eight and eight to four everytwo weeks.
(09:54):
I didn't even do that in themilitary.
Talk about getting just totallyout of alignment.
So I understand all of thatfirsthand.
I totally get that.
Lindsey Hildebrand (10:10):
The magnetic stimulation is that how long?
Yeah, you can call it TMS,because you know, everything has
to be an acronym.
We can call it TMS.
Scott McLean (10:17):
TMS.
There you go, TMS.
How long does each session lastand how many sessions before
results start to show up?
Lindsey Hildebrand (10:26):
So in our initial trial we only did a
stimulation for 40 seconds.
40 seconds like that, that wasfor both the active and the
placebo.
Where you know you can do,there are longer kind of
transcranial magneticstimulation protocols out there,
depending on what you'retargeting.
But for this initial trial wewere like we were like 40
(10:49):
seconds, like 40 seconds of whatwe would call a continuous
theta burst, so that's a veryspecific wavelength of the
transcranial magneticstimulation.
There's also something calledITBS, so that kind of increases
activity, ctbs suppresses andstuff are like quiets down.
So which is what we were goingfor when we were targeting the
(11:09):
default mode networkspecifically.
So yeah, like it's, it doesn'ttake much, like we, you know,
think about it, 40 seconds isnot a long time period at all
and stuff.
And we saw, you know,statistically significant
improvements in total sleep time, sleep efficiency and something
that short, which is, you know,really great.
(11:30):
Hopefully for, you know, thisnext round of piloting and stuff
, we're going to be doingmultiple iterations of TMS and
stuff.
So not just because once againwe only did one single actual
stimulation for 40 seconds.
This time our folks are goingto be coming in week to week to
week and suffer an extendedprotocol and receiving multiple
(11:51):
transcranial magneticstimulation sessions in order to
see, kind of one, the thresholdof when we start to see those
changes and then also how longthose changes last after
receiving transcranial magneticstimulation.
Scott McLean (12:04):
So a veteran goes in.
Lindsey Hildebrand (12:06):
This is just so, unfortunately, this study
will not be open to veterans.
This one is only for those thatare on active duty but it's
going to be, you said eventuallyactually no, you know I might
have misspoke.
It'll be open to because it'san in-person study at the
university of arizona, which isin tucson, not to be mixed up
(12:28):
with asu, which is in phoenix.
Scott McLean (12:29):
I always have to make that distinction because
otherwise people will be like Idon't know where this is and so
we are recruiting folks thathave like active insomnia, but
like veterans, theoreticallycould go in.
Lindsey Hildebrand (12:42):
it's just we're not specifically
recruiting for veterans, or?
Scott McLean (12:45):
Okay.
Lindsey Hildebrand (12:46):
So misspoke on that.
My apologies.
Scott McLean (12:48):
That's fine, that's fine, that's fine.
So they go in the, the, the,the participant goes in and 40
seconds.
They get set up in 40 seconds.
And is that like boom like, ordo they come in like every other
day, or is it a continuous it?
Lindsey Hildebrand (13:06):
depends on the protocol, like there's like
a certain number of sessionsthat will be done per week and
stuff for about a 12 to 14 weektreatment period, once we get
the brain maps and stuff.
So we have folks that need togo into the MRI because we need
to know the location of specificcenters of the brain that we
would be targeting fortranscranial magnetic
(13:27):
stimulation.
So so, yeah, like very exciting, exciting trial and it really
is a cool non-pharmacologicaldevice that we're seeing a lot
of efficacy with a bunch ofdifferent disorders.
So so, really, really coolstuff and right now we, like I
said, said we kind of focus onthat and then also our light
(13:48):
therapy very specifically, andso, once again, another
non-pharmacological device.
So, but it's really fun becauseit's like it's a randomized
control trial and so you know,we're testing to see like, hey,
(14:27):
is this actually helping, youknow, as people sleep and mood
regulation, and it's a studythat, like I said, with this one
we're really trying to targetthat circadian aspects of sleep.
We tend to find a lot of folksgetting out of the military a
lot of their circadian ismisaligned and so because, like
you know, your your circadiancycles, how it typically works
is it runs on a 24-hour clock,right, and we have a bunch of
different types of circadianrhythms want to dispel that myth
(14:48):
.
There's certain peak you knowkind of peak times that hormones
are released and stuff.
That's a circadian rhythm,different types of functioning
like throughout the body, likekind of falls in that 24 hour
cycle.
Same thing happens with sleep,right.
I think that's the one thatmost people think about when we
talk about circadian rhythm,like.
That's like the first one.
(15:08):
And so there's this really coolpart of your brain called the
suprachiasmatic nucleus or yourSCN.
So it is the thing that kind ofgives you the wakefulness and
alerting that is cued by, youknow, daylight and nighttime,
right, neurobiologicallyspeaking, that's the way we
evolved, right.
We evolved to like do stuffduring the day and then at night
(15:30):
to reduce risk, you know,falling asleep and getting that
restfulness.
You know, especially with a lotof like military folks right,
that that circadian cycle canreally get thrown off.
One, you know, if you'reworking in a skiff or something
like that, where you're notgetting a lot of, you know,
sunlight, you know you'reworking weird shifts where your
(15:53):
you know your body clock's kindof getting thrown off because
you're awake at night and thenyou know you're going to sleep
during the day and stuff.
A lot of those have verylong-term implications.
But we know, especially aboutsleep and kind of coming through
the threshold and you know,connecting this to a lot of the
work that I do withneurodegenerative disorders and
(16:14):
stuff is that sleep is like oneof the crucial processes that we
see, kind of predicting, Iwould say, earlier onset of
neurodegenerative disorders butalso the likelihood that folks
get neurodegenerative disorders.
But also the likelihood thatfolks get neurodegenerative
disorders.
These are things, like you know, alzheimer's, parkinson's, lewy
body dementia and stuff likesleep is like one of the most
(16:36):
critical kind of healthcomponents that we see having
that predictive value,especially for folks that aren't
getting like good, consistentsleep, like I could probably
list off all of thecomorbidities that sleep is tied
to, and so it's tied to almostevery single one of them.
And so then, by all means, thatthat relationship gets very
complicated, right, because it'sreally this.
(16:59):
It's really like this criticalfactor, and the easiest one that
I can think about throwing outis like anxiety, right, a lot of
our folks that have insomniaand stuff also tend to have like
anxiety.
So, and it's this really awfulperpetual cycle where it's like
you know you're anxious duringthe day, so you come into bed
(17:20):
wired right and then you can'tget enough sleep and but then
because you don't get enoughsleep, right like your your
mood's thrown off, you have alot of like emotional
dysregulation, right, and itfeeds into that anxiety because
you're worried about going intobed and you're not going to get
enough sleep and that cycle justkind of continues over and over
and over again.
So what we're really trying to,you know, promote because
(17:42):
sometimes it's easier to changevery specific behaviors, like
thinking about sleep anddifferent things.
Sometimes it's easier to changethat initially than it is to,
you know, thinking about, youknow kind of mood disorders,
like, you know, depression,anxiety, like even
post-traumatic stress, right,getting to the root of those
things is really important.
(18:02):
But it's also like thosebaseline kind of behaviors, like
like sleep and stuff, can kindof help that process as well, to
help that treatment process.
So you know, we're reallytrying to take a look at what
can we do to help improvepeople's sleep and so so that
way, you know, when it comes tonot just insomnia but all of
these other kind of comorbiddisorders and stuff, is this a
(18:25):
way that could also help forpeople that have a lot of
emotional dysregulation, or like, can it also help with mood
regulation and stuff, just as aresult of getting better sleep
at night Because you have moreresources during the day.
Scott McLean (18:41):
It's that anticipation like am I going to
sleep, and you go to bedthinking that and then, when
you're not sleeping, turns intofrustration, and frustration and
anxiety mixed together is not agood feeling yeah, it's really
not a good feeling, which justsnowballs every.
Definitely so.
(19:02):
The light therapy is that redlight therapy, or is it white
light or is it?
Lindsey Hildebrand (19:07):
We use different types of variable
wavelength light.
We take a look across a bunchof different ones.
So we look at, you know, white,blue, red, there's even like
purple and green, because thisis a double-blinded randomized
control trial.
I was like I can't say whichones you'll be receiving, for
you know, for this specifically,but we are looking at the
(19:29):
effects of bright light, sobright light wavelengths, on,
you know, on specific types offactors like sleep, and when we
look at sleep we're looking at abunch of different bunch of
different kind of variables.
So, like I said, I'll take thisin a glance over of the nerdy
process of sleep, but there andtalk about sleep architecture,
like a like a good, like a goodsleep person.
(19:51):
So we'll, I'm sure my, my PI,will be proud if I can explain
this well.
So, you know, when it comes tosleep, there there's a lot of
different variables that we kindof specifically look at sleep
apnea, right, you had to like goto an actual sleep clinic and
probably do something called apolysomnography.
What that polysomnography doesis does sleep stage grading.
(20:13):
So there's very specific kindof electrical signals,
respiratory signals and heartrate signals, that kind of point
to when you drop into specificstages of sleep, and so the way
it kind of breaks down is youhave your non REM stages.
So your REM or rapid eyemovement stage is what we would
associate with the dreamingstate, right.
(20:35):
So very early on, when you firstfall into sleep, right, you go
into N1.
So that's kind of like your, Iwould say, the most like when
you're awake, right, so it'slike that very light level of
sleep.
Your N2 is where you get alittle bit deeper into the sleep
but there's still kind of likespikes of activity.
And then your N3 is really thatreally important kind of
(20:59):
non-REM stage.
That's what we call like yourslow wave, your slow wave sleep,
it's your deep sleep.
That's like the sleep where itreally like.
Your slow wave, your slow wavesleep, it's your deep sleep,
that's like the sleep where itreally like you slow down.
And a lot of that deep wavesleep has really high
implications, especially when itcomes to restoration.
So we know in particular thatslow wave sleep has a lot to do
(21:21):
with the glymphatic system.
So that's your brain's kind oflike wasting process.
That's the time when, likepruning happens, a lot of the, a
lot of the gunk in your brainkind of gets washed out during
that time as a result of thatslow wave sleep and so so that
happens really during the firsthalf of the night in more
proportion, so you're not reallyin as much dream state during
(21:43):
that time and then kind ofduring the last half of your
sleep it flips where you'respending a lot more time in that
REM stage, in that dreamingstage, where it's mind really
active, it almost looks likeit's awake, but your body's, you
know, catatonic, it's likeyou're not moving and stuff.
So it's it's a little bitdifferent.
So those are kind of the stagesthat you know we're looking at
(22:06):
is like, you know, as a resultof kind of getting more of your
circadian aligned right, are youspending more time in very
specific stages and especiallysome of those helpful stages
like N3?
And is that helping with likedifferent processes, especially
as it relates to mood regulation, right?
(22:27):
And so you know we're kind oftaking a look at, you know the
percentage of time we're lookingat basic things.
Like you know how much time areyou just in total spending
asleep?
How many times are you wakingup?
How long are you spending?
You know spending when you areawake and like you have those
awakenings like is it reallyshort or are you spending like
(22:48):
15 plus minutes like up duringyour awakenings and stuff Like
how long is it taking you tolike go to sleep from the time
you get into bed versus like thetime that?
you actually like fall asleepand stuff.
So you know we're grading thatthrough a couple different
measures.
So we used to have like thisreally cool five channel EEG
headband.
We did our sub study with that.
(23:09):
But our folks that are in thisstudy are just going to wear a
Fitbit at night Really awesomelike sleep stage grader.
And so we, you know we kind oftrack your metrics through that
and the nice thing is you get,as long as you're compliant with
the study and you go through,you get to keep that Fitbit at
the end.
You don't want it back so yeah.
Scott McLean (23:27):
So like so that way.
So they do this at home, theydo this.
Lindsey Hildebrand (23:30):
Yep, this is 100%.
I guess I'll talk a little bitabout the protocol.
Scott McLean (23:33):
I was going to ask you that, like what's the
process, is it?
Lindsey Hildebrand (23:39):
Yeah, so what we're looking at, like I
said, is the effect of this, ofthis light therapy treatment, on
different sleep and moodregulation measures and stuff.
So what we have people do it isa hundred percent remote study.
It can be, done anywhere in theUnited States.
So it doesn't matter where youlive and stuff.
We ship you your equipment aslong as you meet the criteria
(24:01):
for entering our study.
Scott McLean (24:02):
And I'm going to ask you about that after this.
Lindsey Hildebrand (24:04):
Yeah, don't worry, we'll go through that.
So what we'll do is like,essentially, we, you know, we
send out equipment, so you'llget two pairs of light therapy
glasses.
It's really cool.
You just like flick them on for30 minutes in the morning,
anytime from 6 am to 11 am.
Flick them on, wear them, youcan do, you know dishes, read
(24:27):
the paper, like, do, do whatever, and so they're only set for
that time, so like as, whereveryou're at, it's synced up to
Bluetooth, so it's synced up to,like, your, your time zone and
your clock, and so during thattime, you know, we, you know, we
just have you wear them.
It's a very passive device andstuff, so pretty easy to wear.
I would say it's like one ofthe easiest devices that you
know we're not, you know,dragging a clunky machine.
(24:47):
We all have to scan your brain.
You literally just got to flickthem on and wear them for 30
minutes.
So it's pretty like, like Isaid, pretty low impact.
And so during that time we alsosend you some questionnaires
during that period for you to tokind of, you know report like
you know how did you sleep lastnight and stuff like what's your
level of fatigue?
You know waking up, you knowwhat, you know how's your mood
(25:10):
today, like different thingslike that.
So we asked a bunch ofdifferent questionnaires that
you fill out.
The questionnaires take like 10minutes.
We, on the beginning, before youstart kind of wearing the
glasses, we have you go throughmore of like a 30 minute battery
to kind of get a better idea oflike your baseline.
Have you go through more of likea 30 minute battery to kind of
get a better idea of like yourbaseline, kind of like mood and
just different like demographiccharacteristics and like your
(25:31):
experiences like the military,different things like that.
And then you actually go intothe treatment period so where
you'll wear one set of glassesfor two weeks for 30 minutes a
day, and then we just ask thatyou wear your Fitbit at night
and stuff to track your sleepmetrics, so you just do that.
Then we have a we call it likea two week washout period where
you're not wearing any glasses,you're still wearing your Fitbit
(25:53):
, you're still, you know, takingyour daily surveys, but you
don't, you don't have to wearthe glasses or anything like
that.
Then the the following twoweeks, so it's a six week.
Uh yeah, six week protocol.
The following two weeks, soit's a six-week protocol.
The following two weeks, youwear the other set of glasses,
do the same exact thing, wearyour Fitbit at night, do your
questionnaires during the dayand then that's end of treatment
(26:15):
.
We do our end of treatment orend of protocol surveys.
You ship back the glasses, youget to keep the Fitbit and if
you're 100% compliant with thestudy, you also get a nice $500
gift card.
So not a bad day not a bad dayand stuff.
Scott McLean (26:31):
I'll sign up 10 times a year.
Lindsey Hildebran (26:35):
Unfortunately , you can only complete it once.
Scott McLean (26:38):
There's people I was saying that jokingly with
this people that Ooh.
Lindsey Hildebrand (26:43):
I will say Christmas is coming.
Scott McLean (26:45):
I need some sleep study stuff.
Yeah, I need some sleep studymoney.
Lindsey Hildebrand (26:50):
Yes, so I do want to get into the inclusion
criteria, since you did you didmention that.
So we are looking for anyonewho is actively serving.
So what that means is it youknow any branch, any components,
so you, you can be reserve, youcan be national guard, you can
be active duty and stuff welcometo everybody.
And so we can ship within thedomestic united states.
(27:14):
So so, like we can also doalaska, hawaii and like the, the
continental 48.
Unfortunately we know there's alot of folks that are okonis
and stuff.
We just don't have the capacity, um, to do to do that.
So, sorry, folks that areposted overseas.
We're hoping to change that.
But now we also have an arm ofthe study that's opened up to
veterans.
So in total it's the largestlight therapy trial that will
(27:39):
ever be done with the DOD thusfar, and so it is 400 service
members and or veterans that weneed to recruit for this study.
If you're a veteran, as long asyou've separated within the
past five years and stuff,you're allowed to enter into
this study as well.
And so you know, for folks whohave questions about like hey,
(28:00):
how do you know, like that thisperson isn't like is who they
say they are, we vet folkscoming into the study.
So we look at active duty folksthrough the global list
directory and then for veteranswe ask that you provide a
redacted portion of a DD-214.
And so that's really.
(28:21):
It so pretty much like that.
There's also kind of specificinclusion exclusion criteria as
it relates to sleep and mood.
But the easiest way to figureout whether you're eligible for
the study is to go through ourscreener.
So Scott provided you the flyerwith the QR code and also the
URL with the link and stuff.
So feel free, you can gothrough the screener, see if you
(28:44):
make it.
If at that point you areeligible, you'll be contacted by
a study coordinator for ourbright light glasses study to
start coordinating shipment andtraining and getting you
onboarded into the actual study.
So we try and make it prettyseamless and pretty easy.
Thus far we've had 150 plusfolks already go through the
(29:05):
protocol from all differentbranches, from all different
types of MOSs and stuff.
But, like I said, this veteranspecific, this veteran specific
kind of arm just opened up.
We just got approved for it andwe would love to hear very
specifically about you knowveterans in particular, because
we know there's a lot of folksthat you know still struggle
(29:26):
with insomnia, especially afterthey leave, or struggle with,
you know, mood dysregulation,but also just struggle with
sleep in general, even afterleaving the service.
So we were really wanting tocapture that arm.
But also taking a look at youknow their experiences with
getting things like sleep, likesleep treatment, like you know,
have you been treated for?
(29:48):
You know any any of your sleepconcerns, like, have they been
addressed and stuff.
So we're also looking at it fromin terms of, like, a resource
gap, but also in terms of youknow how easily this could be
implemented at the DOD but alsoat, you know, the VA, to be
hopefully offered as a treatmentprotocol in the future once we
kind of do a little bit more, alittle bit more research and a
(30:10):
little bit more phasing with our, with our research.
But right now it's looking, youknow, pretty promising thus far.
That you know promising thatyou know we're going to
accomplish our, you know ourtreatment goal and then
hopefully assess the efficacy ofthis treatment.
Like I said, don't know becauseit's blinded until the study
closes, can't say, like, exactlywhat we're going to find and
(30:33):
stuff, but you know we're we'rejust really trying to assess,
like whether this is somethingthat you know is feasible or
implementation Right.
I think it's that's reallyimportant, really important
right, because it's not a goodtreatment if people don't want
to use it right and don't anddon't find it easy to use right.
But also to to make sure thatit that it's efficacious amongst
(30:55):
a bunch of differentpopulations, right that and that
is generalizable enough to tomake it effective across the
board so the tms, the magneticstimulation, yeah, you got it.
Scott McLean (31:11):
Yeah, so that is for active duty.
Lindsey Hildebrand (31:14):
It's open to anybody that's in and around
the.
Scott McLean (31:17):
Arizona area.
Lindsey Hildebrand (31:20):
It hasn't opened up yet.
I don't know when it's going toopen up.
It's a very lengthy protocol.
But so if you're in Arizona andyou're interested, just keep
your eyes peeled.
You can find us on Google.
You can just type in you know,scan, just keep your eyes peeled
.
You can find us on Google.
You can just type in you know,scan Lab University of Arizona.
As soon as the study opens up,we usually post it.
There's usually a link to thescreener at that point.
(31:41):
So just you know, kind of keepif you're interested in that.
If you're also interested insome of the results that we
published, there's a couple ofpapers out if you want to read
about the treatment protocol.
I wrote a publication on how wedid essentially that first
pilot round.
My colleague, elisa Husky,posted this amazing paper on the
neuroscientific aspects of whythe transcranial magnetic
(32:06):
stimulation really helped withcertain sleep aspects.
So yeah, take a look at thosepapers if you really are feeling
nerdy and wanna take a look atsome scientific publications.
But we, yeah, and then you know,just keep your eyes peeled for
that coming up.
Hopefully we'll be launchingsometime in the next year.
So, like I said, just feel freeto kind of take a look if
(32:28):
you're in and around the Arizonaarea.
Like I said, it's an in-personstudy.
So look, if you're in andaround the the arizona area.
Like I said, it's an in-personstudy.
So obviously, if you're willingto travel in by all means and
stuff, you won't get reimbursedfor it and stuff.
Maybe there, maybe there'speople who want to, but so I'll
leave it open.
But and the light therapy yeahis national is national so yeah,
(32:51):
and it's anytime it like, sorry, not anytime any like anywhere
right.
So that's for veterans andactive duty yeah, very
specifically so, and I've gottensome questions before about
whether, if you're a dodcivilian, if you're a contractor
, you know if you're a spouse,and stuff unfortunately is not
(33:13):
opened up to y'all unless youwere you know.
Also, you know a veteran thathas been separated for from the
military within the past fiveyears, because I know a lot of
folks end up getting out and goright into that dod, civilian
and contractor.
Scott McLean (33:27):
So it's hard to say no to people too.
Lindsey Hildebrand (33:31):
It is and like I promise you, it is not
anything against youspecifically, it's just when it
comes to research we have itcomes to safety Right.
So, there's when we screen forinclusion and exclusion, it's to
make sure that you know one,we're targeting the right
population, you know one we'retargeting the right population
(33:54):
right and that you know we'refollowing things ethically
according to our institutionalreview board and the safety
standards we have set up.
And then, just like I said, itcomes down to a safety
standpoint, like like if you'renot included, just please know
not everybody makes it into thestudy, right and stuff.
Like we, it's a clinical trial,so we have like pretty strict,
you know, inclusion, exclusioncriteria.
(34:14):
But you know, like, once again,anybody can go through the
screener and stuff and see ifyou, if you make it in, it
(34:44):
really isn't.
Like I said, I would love, likeonce we get to a phase three
clinical trial.
You know, especially when itcomes to research, you know
we're very strategic about likeyou know how this gets out in
the population how we test it.
To research, right, you have topilot test it.
So there was an initial trialof this where we were like hey,
does this even work?
Like, does this concept evenwork?
Scott McLean (34:57):
in a very small population.
Lindsey Hildebrand (34:58):
Then we usually move on to, like, you
know, a second trial where we'retesting it in like a
generalized population, and thenthere's usually like a phase
three and a phase four, likephase three being, like, hey,
you're going to test it, youknow, in the actual population
it's intended for.
In phase four, in the actualsetting and population it's
intended for.
(35:22):
So, you know, it's verystrategic in the way that we do
things so that we can, one, makesure that we're interpreting
the results correctly and thenalso understanding, once again,
who this works for why does itwork for them?
And stuff in like how they canget the most out of this
treatment, which I all think arereally important things to
consider when it comes todifferent types of treatment
modalities.
Right Is, like you, for thefolks who are going to be, like,
(35:43):
implementing this right, it'simportant for them to know, like
, hey, who is going to be a goodmatch for this type of therapy
and stuff, because sometimesit's not one going to be a good
match for this type of therapyand stuff, cause sometimes it's
not one, or treatment like it'snot a one size fits all solution
.
And so, you know, making surethat we develop those guidelines
just makes it more likely thatwhoever does receive that
treatment, it's going to beefficacious for them, it's going
(36:06):
to be something that actuallyhelps them at the end of the day
and stuff.
Scott McLean (36:09):
So Is an ongoing or is there a time frame or we?
Lindsey Hildebrand (36:13):
would love to close this out as soon as
possible.
So, like you know, search inthe masses, right.
Scott McLean (36:18):
Do you have a number that you have to reach to
get your sample?
Lindsey Hildebrand (36:21):
400 nationwide.
Scott McLean (36:23):
How many?
Lindsey Hildebrand (36:23):
400, nationwide 400, okay, yeah, so
we still have a prettysignificant way to go.
I wouldn't say significant like, because we're at the point
where you know we're gettingabout like halfway through our
goal and so so you know, I mindyou 400 folks for any any trial
is like that's a lot.
This is the biggest light studythat is currently being done in
(36:46):
the DOD.
So like it is not an easytarget, but obviously like the
sooner we get done right, thesooner we can unblind and
publish those results, becausewe would love to, you know, we
would love to get this out therelike, make it, you know,
publish these results, likepresent on them and stuff.
And you know, the sooner we cando that, the sooner we could
(37:06):
kind of churn through kind ofthe next phase, the next type of
testing.
Scott McLean (37:11):
Yeah, then make it mainstream right.
Lindsey Hildebrand (37:13):
And give those deliverables right,
because that process is, youknow, it's very strategic but
it's also very slow.
Right, research moves a little,both quickly and slowly.
It's a really big dichotomy.
Scott McLean (37:26):
I've learned a lot about research from my wife.
She loves, loves, loves,research, loves it's that phd
life.
Lindsey Hildebrand (37:39):
It's absolutely loves research.
Scott McLean (37:40):
Yes, yes, yeah um, yeah, we do too.
Yeah, well, evidently you dotoo yeah, I'll say that amongst
I.
Lindsey Hildebrand (37:48):
I feel like I could make that that statement
for the entire lab.
Scott McLean (37:51):
It's like we do love the research Research nerds
.
I love research nerds.
Lindsey Hildebrand (37:57):
Yeah, we 100% are.
Scott McLean (37:59):
The world needs research nerds, and I say that
without joking, all kiddingaside.
The world needs people like you, lindsay, and the people in
your lab and the people that doresearch to make this stuff
happen.
It's it's kind of one of thoseuh, just like in the shadows
(38:19):
type thing.
They never get the credit,never get the recognition.
You know those researches.
It always goes to the companies, corporations you know.
Lindsey Hildebrand (38:28):
Well, I guess I'll give a shout to make
sure at least I'm not the onlyone that's highlighted and stuff
like scott kilgore, who's thepi for the study brilliant, I
have to thank him because he,you know, this is his brainchild
, like and he's done work for 20plus years and in the dod and
like continues to just keep on,keep on contributing, you know,
(38:50):
for our study coordinators Ihave worked so hard on the study
gabriella franca, lana lollyand and devin ermis, amazing,
amazing folks.
And so please, like, definitely, if you're in the study and
stuff, give them props.
And then obviously, I'd bewithout my postdocs, uh, elisa,
elisa husky, who has helpedimmensely with those projects,
(39:12):
and then also David Nagelstock,and so they're all still there
at the lab still doing reallyamazing work for this particular
study.
So I would be remiss if Ididn't give them a shout out,
because they're the ones thatmake it turn day by day, by day.
Scott McLean (39:27):
Yes, love that, love that Selfless is the way to
be.
Let everybody know whoeverybody is, very important
people in this.
Well, did we miss anything?
I?
Lindsey Hildebrand (39:41):
don't think so you.
Let me drone on for so long Iwas asleep and magnetic
stimulation and light therapyand all this stuff we're doing.
So, like I said, likeabsolutely grateful for the fact
that you let me pop on to hearas many of times and let me
ramble on my nerd platform.
Scott McLean (40:00):
So, not only are you my favorite guest for the
number of times you've come onin this future episodes that
we've talked about, but you area podcaster's dream.
It's autopilot, Like I can justsit back and just let let it go
.
The information flies, it comesacross clean and the podcast
(40:21):
and just I just need to sit hereand just okay, keep going, Keep
going.
Lindsey Hildebrand (40:26):
I love it.
Being like you can't stop mefrom going on specific nerd
rants.
I feel, like that's more of thecase.
Scott McLean (40:35):
That's perfect.
Well, lindsay, again, thank youso much for coming on.
I appreciate you.
I appreciate all you do forveterans, and just stick around.
I'm going to do my outro.
That I haven't done in a monthbecause I took about three weeks
to a month off.
So if I blow this, I'm not evengoing to edit it, it just is
what it is.
I want to thank you forlistening.
(40:55):
I appreciate you, yourlisteners, the engine that runs
this machine and the machine isrunning pretty well now.
Thanks to you, and if you likedit, share it.
If you didn't like it.
Well, thanks for listening for47 minutes.
Yeah, and stick around.
There is a public serviceannouncement at the end of this.
That's pretty informative forveterans and family of veterans
(41:17):
and anybody that's in maybecrisis.
Take a listen and, yep, webuilt another bridge today and
this was a research bridge.
I like research bridges.
I want to thank LindsayHildebrand again for coming on.
You'll be hearing her again andyou'll be hearing me again next
week.
Welcome to the podcast.
I'm Scott McLean.
My guest today once again isLindsay Hildebrand.
Now, lindsay was on here before.
She's been on the podcast acouple of times.
She did an episode for FloridaLeads, she did an episode for
the Veteran Yoga Project and nowshe's on again.
(00:24):
Lindsay is an amazing youngwoman.
She's on here to promote andtalk about well, I'm going to
let her give you the name, butshe's a research scientist for
scan labs.
This is how we kind of talkedabout it before the episode.
I didn't want to blow it, soI'm going to let Lindsay explain
(00:44):
how you doing Lindsay.
Lindsey Hildebrand (00:46):
I'm good Thanks for having me back on yet
again.
Scott McLean (00:51):
We still have another one in the future
sometime.
Lindsey Hildebrand (00:53):
I know you keep letting me come back time
and time again.
Scott McLean (00:57):
I love it Because every time you come back, you
come back with somethingabsolutely different than before
, which, again, in my opinionand I'm sure I'm not alone in
saying this you're an amazingyoung woman for everything you
do and all the help that youbring to the veterans, which is
what this is all about.
So, research scientist at ScanLab, let's give us a whole
(01:18):
breakdown.
We're all ears.
Lindsey Hildebrand (01:20):
Lindsay, we're all ears.
Oh geez, We'll be here for awhile Well that's fine.
Yes.
So I, before I kind of movedinto the realm of social work,
I'm still involved with the SCAMlab.
So we are the social, cognitiveand effective neuroscience lab.
So what we primarily do is welook into social, cognitive and
(01:42):
effective neuroscience factors,primarily towards, you know,
military and veterans.
So we've done a lot of studies.
It's headed by a primaryinvestigator who is Dr Scott
Kilgore really wonderful, youknow, dod researcher, very well
known in the field.
But one of the primary kind ofareas that we look into is how
(02:06):
sleep or lack of sleep kind ofaffects all of those domains.
So that's kind of, I would say,our specialty.
We're pretty wide, kind of awide swath, because we're really
folks of like anything thatreally interests us and stuff we
usually come up with studiesfor.
But it's really orientedtowards looking at, you know,
(02:28):
non-pharmacological treatments,for you know specific disorders
that we know military servicemembers and veterans kind of
deal with in higher proportioncompared to the general
population.
So a lot of the things that welook at are like insomnia, you
(02:50):
know.
Circadian misalignment, youknow we looked at, you know
we've done a lot of studies onlike post traumatic stress,
traumatic brain injury.
So I would say kind of morecommon or like higher proportion
that of disorders that veteransand, you know, military service
members as a result of theirservice kind of experience and a
little bit more commonly thanyou would typically see within a
normal population.
So that's what we kind of do so.
(03:12):
Like I said, we kind of rangeacross the board for a lot of
things.
Scott McLean (03:17):
So you mentioned there's no pharmaceuticals
involved, right?
So we tend which I'm sorry,which has always been a bone of
contention for a lot of veteransthat medication.
(03:37):
They always just give me pillsand I'm talking about the va and
I I will never disparage the vain any way, shape or form.
They've helped me immensely andI will never disparage the VA
in any way, shape or form.
They've helped me immensely.
But people I talk to have saidthat, oh, all they want to do is
give me pills.
All they want to do is give mepills and I know that snowballs
sometimes and maybe it soundsworse than it really is, but it
(03:59):
is a thing with veterans.
I know that for a fact.
So you guys avoid that.
Lindsey Hildebrand (04:06):
Yeah, we really try to look at kind of
advancing technologies.
So some of the stuff we've usedpreviously are kind of light
therapy.
That's the one that this studykind of concerns and is the
treatment and then for it.
But we've also used differentthings.
Like you know, transcranialmagnetic stimulation is one of
(04:27):
our other big tools.
It's something that is gettingkind of a little bit more common
in the VA, especially at largerVA centers like San Diego.
Scott McLean (04:36):
You know, minneapolis, like Explain more
about what that is.
Lindsey Hildebrand (04:40):
Transcranial magnetic stimulation depends on
kind of.
Scott McLean (04:43):
I'll try not to get too nerdy into the science
oh, get as nerdy as you want,lindsay, all right.
Lindsey Hildebrand (04:48):
Well, that's the best that I do so what we,
you know what transcranialmagnetic stimulation essentially
sends out specific types ofpulses towards the brain.
So there's specific areas thatwe localize to target.
So what you tend to seetranscranial magnetic
stimulation being used for a lotof the times is either to
inhibit activity or to increasecertain activity by kind of
(05:12):
shooting these types of specificwavelength frequencies towards
specific areas of the brain.
So a lot of the times, I thinkat the VA, we tend to see them
using it for treatment of kindof like major depressive
disorder and anxiety.
They tend to use it towards,like, the dorsolateral
prefrontal cortex, becausethat's one of the common areas
(05:34):
that tends to either be likejust kind of misaligned in terms
of, you know, in terms of likeneurobiology and it's linked to
those specific types of mooddisorders.
So that's where you'll see itkind of used.
But it's a really it's likethis huge machine and if we, you
know, we use MRI to basicallymap like where we want to target
(05:56):
the stimulation.
We used it very specificallywithin a clinical trial.
We actually have a secondclinical trial coming up that's
going to be even larger andlonger is using transcranial
magnetic stimulation fortreatment of insomnia, and so we
used it on, we use it on aspecific brain network called
(06:16):
the default mode network.
So that's associated with a lotof like rumination, mind
wandering, so kind of that.
You know, when you get into bedand say you do have like
insomnia, right, it's kind ofhard to turn down the noise,
right, you're kind of sittingthere, your mind's kind of going
on overdrive, like you're kindof left to your own devices.
(06:36):
So a lot of that, a lot of thatlike pre-bedtime anxiety we
tend to find kind of preventsone sleep onset.
You're spending more time inbed than time asleep.
When it comes to sleep, whatwe're looking at is really
efficiency.
So the time that you know youspend in bed we want you to
sleep right.
People who have insomnia a lotof the time spend a really
(06:58):
prolonged time in bed but not alot of time asleep, and not a
lot of time asleep at thespecific stages that they kind
of need in order to feel a lotof those like restorative
effects and stuff.
So we use this particularmachine, you know the
transcranial magneticstimulation, to kind of suppress
the default mode network, tokind of tune down a lot of those
(07:22):
ruminating thoughts and stuff.
And what we found in our studyis that you know it was
effective, for you know, duringour pilot, like for the 20 folks
that came through for ourrandomized control trial and
stuff at the time, that they gotlike the actual, active, real
transcranial magneticstimulation versus when they got
like the placebo stimulation,and so, as we saw, you know,
(07:44):
better total sleep time, bettersleep efficiency and better what
we would call wake sleep onsetor WASO, and so, essentially,
like you know, people who youknow woke up in the middle of
the night, they wouldn't, youknow, spend as much time like
awake during that, during thoseperiods of kind of awakenings,
during the actual like sleepperiod before what we would call
(08:07):
your final awakening, like thefinal time that you wake up.
So so pretty cool.
We got a second phase comingdown the pipeline.
So if anybody's in Arizonathat's listening to this, it's
available for you.
So, yeah, so it's a pretty cool, pretty cool study.
But we also use, like I said,the focusing on a lot more of
the circadian component, becausewhen it comes to sleep, there's
(08:30):
really two different processes.
So this is called like the twostep process of sleep.
So there's the natural kind ofhomeostatic drive, what we call
like sleep drive or sleeppressure, and then there's the
circadian aspect of it.
So those two kind of work inconjunction and in tandem with
each other but they can both getmisaligned and what we tend to
(08:51):
find is that's what really kindof propels or perpetuates a lot
of insomnia, particularly forfolks that have like irregular.
You know sleep-wake cycles likethat might get interrupted by,
you know, being on CQ whilethey're in service, like staff
duty.
You know sleep-wake cycles likethat might get interrupted by,
you know being on CQ whilethey're in service, like staff
duty, you know trainingexercises yeah different things
(09:11):
like that.
But even like on the outsidewith civilian work like if
you're on like a shift workschedule and stuff, it
interrupts kind of both of thoseprocesses.
So we use kind of light therapymodalities to kind of help with
that circadian aspect, becausetheoretically you kind of want
both of those things aligned atthe same time so that way you
can optimize your sleep.
Scott McLean (09:32):
So I have a couple of things to say.
I understand the shift work.
When I first went into USCustoms back in 1997 and I got I
was working at the MiamiInternational Airport behind the
scenes stuff, we changed ourshifts every two weeks.
We went midnight to eight andfour to midnight and then 12 to
eight and eight to four everytwo weeks.
(09:54):
I didn't even do that in themilitary.
Talk about getting just totallyout of alignment.
So I understand all of thatfirsthand.
I totally get that.
Lindsey Hildebrand (10:10):
The magnetic stimulation is that how long?
Yeah, you can call it TMS,because you know, everything has
to be an acronym.
We can call it TMS.
Scott McLean (10:17):
TMS.
There you go, TMS.
How long does each session lastand how many sessions before
results start to show up?
Lindsey Hildebrand (10:26):
So in our initial trial we only did a
stimulation for 40 seconds.
40 seconds like that, that wasfor both the active and the
placebo.
Where you know you can do,there are longer kind of
transcranial magneticstimulation protocols out there,
depending on what you'retargeting.
But for this initial trial wewere like we were like 40
(10:49):
seconds, like 40 seconds of whatwe would call a continuous
theta burst, so that's a veryspecific wavelength of the
transcranial magneticstimulation.
There's also something calledITBS, so that kind of increases
activity, ctbs suppresses andstuff are like quiets down.
So which is what we were goingfor when we were targeting the
(11:09):
default mode networkspecifically.
So yeah, like it's, it doesn'ttake much, like we, you know,
think about it, 40 seconds isnot a long time period at all
and stuff.
And we saw, you know,statistically significant
improvements in total sleep time, sleep efficiency and something
that short, which is, you know,really great.
(11:30):
Hopefully for, you know, thisnext round of piloting and stuff
, we're going to be doingmultiple iterations of TMS and
stuff.
So not just because once againwe only did one single actual
stimulation for 40 seconds.
This time our folks are goingto be coming in week to week to
week and suffer an extendedprotocol and receiving multiple
(11:51):
transcranial magneticstimulation sessions in order to
see, kind of one, the thresholdof when we start to see those
changes and then also how longthose changes last after
receiving transcranial magneticstimulation.
Scott McLean (12:04):
So a veteran goes in.
Lindsey Hildebrand (12:06):
This is just so, unfortunately, this study
will not be open to veterans.
This one is only for those thatare on active duty but it's
going to be, you said eventuallyactually no, you know I might
have misspoke.
It'll be open to because it'san in-person study at the
university of arizona, which isin tucson, not to be mixed up
(12:28):
with asu, which is in phoenix.
Scott McLean (12:29):
I always have to make that distinction because
otherwise people will be like Idon't know where this is and so
we are recruiting folks thathave like active insomnia, but
like veterans, theoreticallycould go in.
Lindsey Hildebrand (12:42):
it's just we're not specifically
recruiting for veterans, or?
Scott McLean (12:45):
Okay.
Lindsey Hildebrand (12:46):
So misspoke on that.
My apologies.
Scott McLean (12:48):
That's fine, that's fine, that's fine.
So they go in the, the, the,the participant goes in and 40
seconds.
They get set up in 40 seconds.
And is that like boom like, ordo they come in like every other
day, or is it a continuous it?
Lindsey Hildebrand (13:06):
depends on the protocol, like there's like
a certain number of sessionsthat will be done per week and
stuff for about a 12 to 14 weektreatment period, once we get
the brain maps and stuff.
So we have folks that need togo into the MRI because we need
to know the location of specificcenters of the brain that we
would be targeting fortranscranial magnetic
(13:27):
stimulation.
So so, yeah, like very exciting, exciting trial and it really
is a cool non-pharmacologicaldevice that we're seeing a lot
of efficacy with a bunch ofdifferent disorders.
So so, really, really coolstuff and right now we, like I
said, said we kind of focus onthat and then also our light
(13:48):
therapy very specifically, andso, once again, another
non-pharmacological device.
So, but it's really fun becauseit's like it's a randomized
control trial and so you know,we're testing to see like, hey,
(14:27):
is this actually helping, youknow, as people sleep and mood
regulation, and it's a studythat, like I said, with this one
we're really trying to targetthat circadian aspects of sleep.
We tend to find a lot of folksgetting out of the military a
lot of their circadian ismisaligned and so because, like
you know, your your circadiancycles, how it typically works
is it runs on a 24-hour clock,right, and we have a bunch of
different types of circadianrhythms want to dispel that myth
(14:48):
.
There's certain peak you knowkind of peak times that hormones
are released and stuff.
That's a circadian rhythm,different types of functioning
like throughout the body, likekind of falls in that 24 hour
cycle.
Same thing happens with sleep,right.
I think that's the one thatmost people think about when we
talk about circadian rhythm,like.
That's like the first one.
(15:08):
And so there's this really coolpart of your brain called the
suprachiasmatic nucleus or yourSCN.
So it is the thing that kind ofgives you the wakefulness and
alerting that is cued by, youknow, daylight and nighttime,
right, neurobiologicallyspeaking, that's the way we
evolved, right.
We evolved to like do stuffduring the day and then at night
(15:30):
to reduce risk, you know,falling asleep and getting that
restfulness.
You know, especially with a lotof like military folks right,
that that circadian cycle canreally get thrown off.
One, you know, if you'reworking in a skiff or something
like that, where you're notgetting a lot of, you know,
sunlight, you know you'reworking weird shifts where your
(15:53):
you know your body clock's kindof getting thrown off because
you're awake at night and thenyou know you're going to sleep
during the day and stuff.
A lot of those have verylong-term implications.
But we know, especially aboutsleep and kind of coming through
the threshold and you know,connecting this to a lot of the
work that I do withneurodegenerative disorders and
(16:14):
stuff is that sleep is like oneof the crucial processes that we
see, kind of predicting, Iwould say, earlier onset of
neurodegenerative disorders butalso the likelihood that folks
get neurodegenerative disorders.
But also the likelihood thatfolks get neurodegenerative
disorders.
These are things, like you know, alzheimer's, parkinson's, lewy
body dementia and stuff likesleep is like one of the most
(16:36):
critical kind of healthcomponents that we see having
that predictive value,especially for folks that aren't
getting like good, consistentsleep, like I could probably
list off all of thecomorbidities that sleep is tied
to, and so it's tied to almostevery single one of them.
And so then, by all means, thatthat relationship gets very
complicated, right, because it'sreally this.
(16:59):
It's really like this criticalfactor, and the easiest one that
I can think about throwing outis like anxiety, right, a lot of
our folks that have insomniaand stuff also tend to have like
anxiety.
So, and it's this really awfulperpetual cycle where it's like
you know you're anxious duringthe day, so you come into bed
(17:20):
wired right and then you can'tget enough sleep and but then
because you don't get enoughsleep, right like your your
mood's thrown off, you have alot of like emotional
dysregulation, right, and itfeeds into that anxiety because
you're worried about going intobed and you're not going to get
enough sleep and that cycle justkind of continues over and over
and over again.
So what we're really trying to,you know, promote because
(17:42):
sometimes it's easier to changevery specific behaviors, like
thinking about sleep anddifferent things.
Sometimes it's easier to changethat initially than it is to,
you know, thinking about, youknow kind of mood disorders,
like, you know, depression,anxiety, like even
post-traumatic stress, right,getting to the root of those
things is really important.
(18:02):
But it's also like thosebaseline kind of behaviors, like
like sleep and stuff, can kindof help that process as well, to
help that treatment process.
So you know, we're reallytrying to take a look at what
can we do to help improvepeople's sleep and so so that
way, you know, when it comes tonot just insomnia but all of
these other kind of comorbiddisorders and stuff, is this a
(18:25):
way that could also help forpeople that have a lot of
emotional dysregulation, or like, can it also help with mood
regulation and stuff, just as aresult of getting better sleep
at night Because you have moreresources during the day.
Scott McLean (18:41):
It's that anticipation like am I going to
sleep, and you go to bedthinking that and then, when
you're not sleeping, turns intofrustration, and frustration and
anxiety mixed together is not agood feeling yeah, it's really
not a good feeling, which justsnowballs every.
Definitely so.
(19:02):
The light therapy is that redlight therapy, or is it white
light or is it?
Lindsey Hildebrand (19:07):
We use different types of variable
wavelength light.
We take a look across a bunchof different ones.
So we look at, you know, white,blue, red, there's even like
purple and green, because thisis a double-blinded randomized
control trial.
I was like I can't say whichones you'll be receiving, for
you know, for this specifically,but we are looking at the
(19:29):
effects of bright light, sobright light wavelengths, on,
you know, on specific types offactors like sleep, and when we
look at sleep we're looking at abunch of different bunch of
different kind of variables.
So, like I said, I'll take thisin a glance over of the nerdy
process of sleep, but there andtalk about sleep architecture,
like a like a good, like a goodsleep person.
(19:51):
So we'll, I'm sure my, my PI,will be proud if I can explain
this well.
So, you know, when it comes tosleep, there there's a lot of
different variables that we kindof specifically look at sleep
apnea, right, you had to like goto an actual sleep clinic and
probably do something called apolysomnography.
What that polysomnography doesis does sleep stage grading.
(20:13):
So there's very specific kindof electrical signals,
respiratory signals and heartrate signals, that kind of point
to when you drop into specificstages of sleep, and so the way
it kind of breaks down is youhave your non REM stages.
So your REM or rapid eyemovement stage is what we would
associate with the dreamingstate, right.
(20:35):
So very early on, when you firstfall into sleep, right, you go
into N1.
So that's kind of like your, Iwould say, the most like when
you're awake, right, so it'slike that very light level of
sleep.
Your N2 is where you get alittle bit deeper into the sleep
but there's still kind of likespikes of activity.
And then your N3 is really thatreally important kind of
(20:59):
non-REM stage.
That's what we call like yourslow wave, your slow wave sleep,
it's your deep sleep.
That's like the sleep where itreally like.
Your slow wave, your slow wavesleep, it's your deep sleep,
that's like the sleep where itreally like you slow down.
And a lot of that deep wavesleep has really high
implications, especially when itcomes to restoration.
So we know in particular thatslow wave sleep has a lot to do
(21:21):
with the glymphatic system.
So that's your brain's kind oflike wasting process.
That's the time when, likepruning happens, a lot of the, a
lot of the gunk in your brainkind of gets washed out during
that time as a result of thatslow wave sleep and so so that
happens really during the firsthalf of the night in more
proportion, so you're not reallyin as much dream state during
(21:43):
that time and then kind ofduring the last half of your
sleep it flips where you'respending a lot more time in that
REM stage, in that dreamingstage, where it's mind really
active, it almost looks likeit's awake, but your body's, you
know, catatonic, it's likeyou're not moving and stuff.
So it's it's a little bitdifferent.
So those are kind of the stagesthat you know we're looking at
(22:06):
is like, you know, as a resultof kind of getting more of your
circadian aligned right, are youspending more time in very
specific stages and especiallysome of those helpful stages
like N3?
And is that helping with likedifferent processes, especially
as it relates to mood regulation, right?
(22:27):
And so you know we're kind oftaking a look at, you know the
percentage of time we're lookingat basic things.
Like you know how much time areyou just in total spending
asleep?
How many times are you wakingup?
How long are you spending?
You know spending when you areawake and like you have those
awakenings like is it reallyshort or are you spending like
(22:48):
15 plus minutes like up duringyour awakenings and stuff Like
how long is it taking you tolike go to sleep from the time
you get into bed versus like thetime that?
you actually like fall asleepand stuff.
So you know we're grading thatthrough a couple different
measures.
So we used to have like thisreally cool five channel EEG
headband.
We did our sub study with that.
(23:09):
But our folks that are in thisstudy are just going to wear a
Fitbit at night Really awesomelike sleep stage grader.
And so we, you know we kind oftrack your metrics through that
and the nice thing is you get,as long as you're compliant with
the study and you go through,you get to keep that Fitbit at
the end.
You don't want it back so yeah.
Scott McLean (23:27):
So like so that way.
So they do this at home, theydo this.
Lindsey Hildebrand (23:30):
Yep, this is 100%.
I guess I'll talk a little bitabout the protocol.
Scott McLean (23:33):
I was going to ask you that, like what's the
process, is it?
Lindsey Hildebrand (23:39):
Yeah, so what we're looking at, like I
said, is the effect of this, ofthis light therapy treatment, on
different sleep and moodregulation measures and stuff.
So what we have people do it isa hundred percent remote study.
It can be, done anywhere in theUnited States.
So it doesn't matter where youlive and stuff.
We ship you your equipment aslong as you meet the criteria
(24:01):
for entering our study.
Scott McLean (24:02):
And I'm going to ask you about that after this.
Lindsey Hildebrand (24:04):
Yeah, don't worry, we'll go through that.
So what we'll do is like,essentially, we, you know, we
send out equipment, so you'llget two pairs of light therapy
glasses.
It's really cool.
You just like flick them on for30 minutes in the morning,
anytime from 6 am to 11 am.
Flick them on, wear them, youcan do, you know dishes, read
(24:27):
the paper, like, do, do whatever, and so they're only set for
that time, so like as, whereveryou're at, it's synced up to
Bluetooth, so it's synced up to,like, your, your time zone and
your clock, and so during thattime, you know, we, you know, we
just have you wear them.
It's a very passive device andstuff, so pretty easy to wear.
I would say it's like one ofthe easiest devices that you
know we're not, you know,dragging a clunky machine.
(24:47):
We all have to scan your brain.
You literally just got to flickthem on and wear them for 30
minutes.
So it's pretty like, like Isaid, pretty low impact.
And so during that time we alsosend you some questionnaires
during that period for you to tokind of, you know report like
you know how did you sleep lastnight and stuff like what's your
level of fatigue?
You know waking up, you knowwhat, you know how's your mood
(25:10):
today, like different thingslike that.
So we asked a bunch ofdifferent questionnaires that
you fill out.
The questionnaires take like 10minutes.
We, on the beginning, before youstart kind of wearing the
glasses, we have you go throughmore of like a 30 minute battery
to kind of get a better idea oflike your baseline.
Have you go through more of likea 30 minute battery to kind of
get a better idea of like yourbaseline, kind of like mood and
just different like demographiccharacteristics and like your
(25:31):
experiences like the military,different things like that.
And then you actually go intothe treatment period so where
you'll wear one set of glassesfor two weeks for 30 minutes a
day, and then we just ask thatyou wear your Fitbit at night
and stuff to track your sleepmetrics, so you just do that.
Then we have a we call it likea two week washout period where
you're not wearing any glasses,you're still wearing your Fitbit
(25:53):
, you're still, you know, takingyour daily surveys, but you
don't, you don't have to wearthe glasses or anything like
that.
Then the the following twoweeks, so it's a six week.
Uh yeah, six week protocol.
The following two weeks, soit's a six-week protocol.
The following two weeks, youwear the other set of glasses,
do the same exact thing, wearyour Fitbit at night, do your
questionnaires during the dayand then that's end of treatment
(26:15):
.
We do our end of treatment orend of protocol surveys.
You ship back the glasses, youget to keep the Fitbit and if
you're 100% compliant with thestudy, you also get a nice $500
gift card.
So not a bad day not a bad dayand stuff.
Scott McLean (26:31):
I'll sign up 10 times a year.
Lindsey Hildebran (26:35):
Unfortunately , you can only complete it once.
Scott McLean (26:38):
There's people I was saying that jokingly with
this people that Ooh.
Lindsey Hildebrand (26:43):
I will say Christmas is coming.
Scott McLean (26:45):
I need some sleep study stuff.
Yeah, I need some sleep studymoney.
Lindsey Hildebrand (26:50):
Yes, so I do want to get into the inclusion
criteria, since you did you didmention that.
So we are looking for anyonewho is actively serving.
So what that means is it youknow any branch, any components,
so you, you can be reserve, youcan be national guard, you can
be active duty and stuff welcometo everybody.
And so we can ship within thedomestic united states.
(27:14):
So so, like we can also doalaska, hawaii and like the, the
continental 48.
Unfortunately we know there's alot of folks that are okonis
and stuff.
We just don't have the capacity, um, to do to do that.
So, sorry, folks that areposted overseas.
We're hoping to change that.
But now we also have an arm ofthe study that's opened up to
veterans.
So in total it's the largestlight therapy trial that will
(27:39):
ever be done with the DOD thusfar, and so it is 400 service
members and or veterans that weneed to recruit for this study.
If you're a veteran, as long asyou've separated within the
past five years and stuff,you're allowed to enter into
this study as well.
And so you know, for folks whohave questions about like hey,
(28:00):
how do you know, like that thisperson isn't like is who they
say they are, we vet folkscoming into the study.
So we look at active duty folksthrough the global list
directory and then for veteranswe ask that you provide a
redacted portion of a DD-214.
And so that's really.
(28:21):
It so pretty much like that.
There's also kind of specificinclusion exclusion criteria as
it relates to sleep and mood.
But the easiest way to figureout whether you're eligible for
the study is to go through ourscreener.
So Scott provided you the flyerwith the QR code and also the
URL with the link and stuff.
So feel free, you can gothrough the screener, see if you
(28:44):
make it.
If at that point you areeligible, you'll be contacted by
a study coordinator for ourbright light glasses study to
start coordinating shipment andtraining and getting you
onboarded into the actual study.
So we try and make it prettyseamless and pretty easy.
Thus far we've had 150 plusfolks already go through the
(29:05):
protocol from all differentbranches, from all different
types of MOSs and stuff.
But, like I said, this veteranspecific, this veteran specific
kind of arm just opened up.
We just got approved for it andwe would love to hear very
specifically about you knowveterans in particular, because
we know there's a lot of folksthat you know still struggle
(29:26):
with insomnia, especially afterthey leave, or struggle with,
you know, mood dysregulation,but also just struggle with
sleep in general, even afterleaving the service.
So we were really wanting tocapture that arm.
But also taking a look at youknow their experiences with
getting things like sleep, likesleep treatment, like you know,
have you been treated for?
(29:48):
You know any any of your sleepconcerns, like, have they been
addressed and stuff.
So we're also looking at it fromin terms of, like, a resource
gap, but also in terms of youknow how easily this could be
implemented at the DOD but alsoat, you know, the VA, to be
hopefully offered as a treatmentprotocol in the future once we
kind of do a little bit more, alittle bit more research and a
(30:10):
little bit more phasing with our, with our research.
But right now it's looking, youknow, pretty promising thus far.
That you know promising thatyou know we're going to
accomplish our, you know ourtreatment goal and then
hopefully assess the efficacy ofthis treatment.
Like I said, don't know becauseit's blinded until the study
closes, can't say, like, exactlywhat we're going to find and
(30:33):
stuff, but you know we're we'rejust really trying to assess,
like whether this is somethingthat you know is feasible or
implementation Right.
I think it's that's reallyimportant, really important
right, because it's not a goodtreatment if people don't want
to use it right and don't anddon't find it easy to use right.
But also to to make sure thatit that it's efficacious amongst
(30:55):
a bunch of differentpopulations, right that and that
is generalizable enough to tomake it effective across the
board so the tms, the magneticstimulation, yeah, you got it.
Scott McLean (31:11):
Yeah, so that is for active duty.
Lindsey Hildebrand (31:14):
It's open to anybody that's in and around
the.
Scott McLean (31:17):
Arizona area.
Lindsey Hildebrand (31:20):
It hasn't opened up yet.
I don't know when it's going toopen up.
It's a very lengthy protocol.
But so if you're in Arizona andyou're interested, just keep
your eyes peeled.
You can find us on Google.
You can just type in you know,scan, just keep your eyes peeled
.
You can find us on Google.
You can just type in you know,scan Lab University of Arizona.
As soon as the study opens up,we usually post it.
There's usually a link to thescreener at that point.
(31:41):
So just you know, kind of keepif you're interested in that.
If you're also interested insome of the results that we
published, there's a couple ofpapers out if you want to read
about the treatment protocol.
I wrote a publication on how wedid essentially that first
pilot round.
My colleague, elisa Husky,posted this amazing paper on the
neuroscientific aspects of whythe transcranial magnetic
(32:06):
stimulation really helped withcertain sleep aspects.
So yeah, take a look at thosepapers if you really are feeling
nerdy and wanna take a look atsome scientific publications.
But we, yeah, and then you know,just keep your eyes peeled for
that coming up.
Hopefully we'll be launchingsometime in the next year.
So, like I said, just feel freeto kind of take a look if
(32:28):
you're in and around the Arizonaarea.
Like I said, it's an in-personstudy.
So look, if you're in andaround the the arizona area.
Like I said, it's an in-personstudy.
So obviously, if you're willingto travel in by all means and
stuff, you won't get reimbursedfor it and stuff.
Maybe there, maybe there'speople who want to, but so I'll
leave it open.
But and the light therapy yeahis national is national so yeah,
(32:51):
and it's anytime it like, sorry, not anytime any like anywhere
right.
So that's for veterans andactive duty yeah, very
specifically so, and I've gottensome questions before about
whether, if you're a dodcivilian, if you're a contractor
, you know if you're a spouse,and stuff unfortunately is not
(33:13):
opened up to y'all unless youwere you know.
Also, you know a veteran thathas been separated for from the
military within the past fiveyears, because I know a lot of
folks end up getting out and goright into that dod, civilian
and contractor.
Scott McLean (33:27):
So it's hard to say no to people too.
Lindsey Hildebrand (33:31):
It is and like I promise you, it is not
anything against youspecifically, it's just when it
comes to research we have itcomes to safety Right.
So, there's when we screen forinclusion and exclusion, it's to
make sure that you know one,we're targeting the right
population, you know one we'retargeting the right population
(33:54):
right and that you know we'refollowing things ethically
according to our institutionalreview board and the safety
standards we have set up.
And then, just like I said, itcomes down to a safety
standpoint, like like if you'renot included, just please know
not everybody makes it into thestudy, right and stuff.
Like we, it's a clinical trial,so we have like pretty strict,
you know, inclusion, exclusioncriteria.
(34:14):
But you know, like, once again,anybody can go through the
screener and stuff and see ifyou, if you make it in, it
(34:44):
really isn't.
Like I said, I would love, likeonce we get to a phase three
clinical trial.
You know, especially when itcomes to research, you know
we're very strategic about likeyou know how this gets out in
the population how we test it.
To research, right, you have topilot test it.
So there was an initial trialof this where we were like hey,
does this even work?
Like, does this concept evenwork?
Scott McLean (34:57):
in a very small population.
Lindsey Hildebrand (34:58):
Then we usually move on to, like, you
know, a second trial where we'retesting it in like a
generalized population, and thenthere's usually like a phase
three and a phase four, likephase three being, like, hey,
you're going to test it, youknow, in the actual population
it's intended for.
In phase four, in the actualsetting and population it's
intended for.
(35:22):
So, you know, it's verystrategic in the way that we do
things so that we can, one, makesure that we're interpreting
the results correctly and thenalso understanding, once again,
who this works for why does itwork for them?
And stuff in like how they canget the most out of this
treatment, which I all think arereally important things to
consider when it comes todifferent types of treatment
modalities.
Right Is, like you, for thefolks who are going to be, like,
(35:43):
implementing this right, it'simportant for them to know, like
, hey, who is going to be a goodmatch for this type of therapy
and stuff, because sometimesit's not one going to be a good
match for this type of therapyand stuff, cause sometimes it's
not one, or treatment like it'snot a one size fits all solution
.
And so, you know, making surethat we develop those guidelines
just makes it more likely thatwhoever does receive that
treatment, it's going to beefficacious for them, it's going
(36:06):
to be something that actuallyhelps them at the end of the day
and stuff.
Scott McLean (36:09):
So Is an ongoing or is there a time frame or we?
Lindsey Hildebrand (36:13):
would love to close this out as soon as
possible.
So, like you know, search inthe masses, right.
Scott McLean (36:18):
Do you have a number that you have to reach to
get your sample?
Lindsey Hildebrand (36:21):
400 nationwide.
Scott McLean (36:23):
How many?
Lindsey Hildebrand (36:23):
400, nationwide 400, okay, yeah, so
we still have a prettysignificant way to go.
I wouldn't say significant like, because we're at the point
where you know we're gettingabout like halfway through our
goal and so so you know, I mindyou 400 folks for any any trial
is like that's a lot.
This is the biggest light studythat is currently being done in
(36:46):
the DOD.
So like it is not an easytarget, but obviously like the
sooner we get done right, thesooner we can unblind and
publish those results, becausewe would love to, you know, we
would love to get this out therelike, make it, you know,
publish these results, likepresent on them and stuff.
And you know, the sooner we cando that, the sooner we could
(37:06):
kind of churn through kind ofthe next phase, the next type of
testing.
Scott McLean (37:11):
Yeah, then make it mainstream right.
Lindsey Hildebrand (37:13):
And give those deliverables right,
because that process is, youknow, it's very strategic but
it's also very slow.
Right, research moves a little,both quickly and slowly.
It's a really big dichotomy.
Scott McLean (37:26):
I've learned a lot about research from my wife.
She loves, loves, loves,research, loves it's that phd
life.
Lindsey Hildebrand (37:39):
It's absolutely loves research.
Scott McLean (37:40):
Yes, yes, yeah um, yeah, we do too.
Yeah, well, evidently you dotoo yeah, I'll say that amongst
I.
Lindsey Hildebrand (37:48):
I feel like I could make that that statement
for the entire lab.
Scott McLean (37:51):
It's like we do love the research Research nerds
.
I love research nerds.
Lindsey Hildebrand (37:57):
Yeah, we 100% are.
Scott McLean (37:59):
The world needs research nerds, and I say that
without joking, all kiddingaside.
The world needs people like you, lindsay, and the people in
your lab and the people that doresearch to make this stuff
happen.
It's it's kind of one of thoseuh, just like in the shadows
(38:19):
type thing.
They never get the credit,never get the recognition.
You know those researches.
It always goes to the companies, corporations you know.
Lindsey Hildebrand (38:28):
Well, I guess I'll give a shout to make
sure at least I'm not the onlyone that's highlighted and stuff
like scott kilgore, who's thepi for the study brilliant, I
have to thank him because he,you know, this is his brainchild
, like and he's done work for 20plus years and in the dod and
like continues to just keep on,keep on contributing, you know,
(38:50):
for our study coordinators Ihave worked so hard on the study
gabriella franca, lana lollyand and devin ermis, amazing,
amazing folks.
And so please, like, definitely, if you're in the study and
stuff, give them props.
And then obviously, I'd bewithout my postdocs, uh, elisa,
elisa husky, who has helpedimmensely with those projects,
(39:12):
and then also David Nagelstock,and so they're all still there
at the lab still doing reallyamazing work for this particular
study.
So I would be remiss if Ididn't give them a shout out,
because they're the ones thatmake it turn day by day, by day.
Scott McLean (39:27):
Yes, love that, love that Selfless is the way to
be.
Let everybody know whoeverybody is, very important
people in this.
Well, did we miss anything?
I?
Lindsey Hildebrand (39:41):
don't think so you.
Let me drone on for so long Iwas asleep and magnetic
stimulation and light therapyand all this stuff we're doing.
So, like I said, likeabsolutely grateful for the fact
that you let me pop on to hearas many of times and let me
ramble on my nerd platform.
Scott McLean (40:00):
So, not only are you my favorite guest for the
number of times you've come onin this future episodes that
we've talked about, but you area podcaster's dream.
It's autopilot, Like I can justsit back and just let let it go
.
The information flies, it comesacross clean and the podcast
(40:21):
and just I just need to sit hereand just okay, keep going, Keep
going.
Lindsey Hildebrand (40:26):
I love it.
Being like you can't stop mefrom going on specific nerd
rants.
I feel, like that's more of thecase.
Scott McLean (40:35):
That's perfect.
Well, lindsay, again, thank youso much for coming on.
I appreciate you.
I appreciate all you do forveterans, and just stick around.
I'm going to do my outro.
That I haven't done in a monthbecause I took about three weeks
to a month off.
So if I blow this, I'm not evengoing to edit it, it just is
what it is.
I want to thank you forlistening.
(40:55):
I appreciate you, yourlisteners, the engine that runs
this machine and the machine isrunning pretty well now.
Thanks to you, and if you likedit, share it.
If you didn't like it.
Well, thanks for listening for47 minutes.
Yeah, and stick around.
There is a public serviceannouncement at the end of this.
That's pretty informative forveterans and family of veterans
(41:17):
and anybody that's in maybecrisis.
Take a listen and, yep, webuilt another bridge today and
this was a research bridge.
I like research bridges.
I want to thank LindsayHildebrand again for coming on.
You'll be hearing her again andyou'll be hearing me again next
week.
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