Latest / In Moderation / Snooze-Worthy Strategies with Dr. Kansagra: Unraveling Sleep Science

Transcript

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

• 0:18
  Speaker 1: Hey everybody, welcome to the podcast, Episode 20.
• 0:21
  Speaker 1: Something doesn't really matter.
• 0:22
  Speaker 1: And as an introduction first digit right, it's 20 something.
• 0:26
  Speaker 1: I know it's 20 something as an introduction that we didn't plan at all.
• 0:29
  Speaker 1: Hey Rob, how'd you sleep last night?
• 0:31
  Speaker 2: I didn't.
• 0:33
  Speaker 1: Hey, that's a good transition, because right now we have a guest where we're going to be talking about sleep.
• 0:38
  Speaker 1: So why don't you introduce yourself?
• 0:40
  Speaker 1: Because, again, we know we're terrible at it.
• 0:43
  Speaker 3: Sure Happy to do it.
• 0:44
  Speaker 3: I'm Sujay Kansagra.
• 0:46
  Speaker 3: I'm a child neurologist and a sleep medicine physician by trade.
• 0:49
  Speaker 3: Sleep is my life.
• 0:50
  Speaker 3: I treat kids that have a variety of sleep disorders and recently have been out on social media trying to educate folks about how great sleep is.
• 0:58
  Speaker 3: So it's good to be here.
• 1:01
  Speaker 1: Oh, yes, that's the thing that I always tell people about and they immediately roll their eyes I don't know what it is about sleep.
• 1:06
  Speaker 1: But as soon as you tell people sleep, they're like, yeah, I know, like I don't do it, like I don't know what it is.
• 1:12
  Speaker 1: What is it about sleep?
• 1:13
  Speaker 3: You know, I'll tell you what it is.
• 1:14
  Speaker 3: It's a cultural thing.
• 1:15
  Speaker 3: You know to be sleeping and we should wear sleep deprivation like a badge of honor, and the the less you sleep, the harder you're working.
• 1:23
  Speaker 3: And you know lots of misperceptions and, honestly, we just didn't know much about sleep science until like the last few decades, and it's taken a while to sink in.
• 1:31
  Speaker 1: So I think I think that's what it is, you're a hundred percent right with that, especially because, like I will listen to, like you know, the president will say something like I only sleep four hours a night and I get I'm like no, please, don't, please, please, don't tell me that.
• 1:44
  Speaker 2: Listen that means you have the missile codes, launch numbers.
• 1:48
  Speaker 1: Whatever it is like, don't tell me you're sleep deprived.
• 1:51
  Speaker 3: That's not good.
• 1:52
  Speaker 3: Please tell me you're sleeping more, more.
• 1:55
  Speaker 2: Am I supposed to press again?
• 1:56
  Speaker 2: I don't really remember.
• 1:58
  Speaker 2: I'm getting too much, surgeon you know, come on.
• 2:01
  Speaker 3: You don't want your surgeon saying they're not sleeping.
• 2:03
  Speaker 3: You don't want your pilot saying they're not sleeping.
• 2:04
  Speaker 1: Imagine you're going in for your surgery and they're like fuck, I did not sleep well last night, let's cut them open.
• 2:09
  Speaker 1: Like that's not good.
• 2:12
  Speaker 3: Healthcare and sleep deprivation is like a whole other topic we can talk about, but it's scary, it's kind of frightening.
• 2:17
  Speaker 3: You should probably have the right to ask these questions to your surgeon, like, did you sleep well last night?
• 2:22
  Speaker 3: Like how much did you sleep, how long have you been on call?
• 2:24
  Speaker 3: Because that probably affects your outcomes.
• 2:26
  Speaker 3: But at this, point we don't ask those questions.
• 2:33
  Speaker 1: It's a good thing, I'm not performing open heart surgery today.
• 2:36
  Speaker 1: Man, I just I don't even want to get down that rabbit hole, listen.
• 2:46
  Speaker 1: So I think a good place to start with sleep is what is sleep.
• 2:47
  Speaker 3: Now for the listeners who have never heard of sleep before, why don't you tell them a little bit about what it is?
• 2:51
  Speaker 3: Yeah, it's a fairly new thing.
• 2:51
  Speaker 3: You know some people are into it.
• 2:52
  Speaker 3: Well, yes, sleep the definition that I like.
• 2:54
  Speaker 3: It's a reversible state of perceptual disengagement from, and decreased responsiveness to, the environment.
• 3:02
  Speaker 3: That's my definition of sleep.
• 3:03
  Speaker 3: Wow, it's reversible, thankfully right, I mean it's reversible.
• 3:06
  Speaker 3: because you wake up in the morning.
• 3:07
  Speaker 3: You have a decreased level of responsiveness.
• 3:09
  Speaker 3: You're not unresponsive when you sleep.
• 3:11
  Speaker 3: That's why you know you might toss and turn on your bed all night.
• 3:13
  Speaker 3: You don't fall off your bed and you also have like some sense of how much time has passed while you're sleeping.
• 3:17
  Speaker 3: And if you've ever had a dream where the fire alarm is going off and it's actually your bedside alarm, you can incorporate some of that external sensory stimuli into your sleep state.
• 3:27
  Speaker 3: So that's the definition that I like.
• 3:33
  Speaker 2: Everybody has a slightly different definition.
• 3:34
  Speaker 1: That was like the sleep version of dihydrogen monoxide right there.
• 3:36
  Speaker 2: Dihydrogen Water, yeah it's the fancy term.
• 3:38
  Speaker 2: What do you?
• 3:39
  Speaker 1: want to sound smart, like I work as a sleep tech.
• 3:41
  Speaker 1: So for anybody listening, I didn't talk about this podcast before, but I work as a sleep tech, so I help people with sleeping disorders.
• 3:46
  Speaker 1: But when I want to set when, when I don't want to talk about people's dreams, I say I'm a polysomnography technologist, because if you say you work in sleep medicine out and about, they're always like you got to study me.
• 3:56
  Speaker 1: I'm like, yes, I know, everyone sucks at sleeping.
• 3:58
  Speaker 1: It's all terrible.
• 3:59
  Speaker 1: You want to talk about your dreams?
• 4:01
  Speaker 1: Yep, they really don't mean much, as really I'm sorry to break that news if you're first hearing this now, but dreams are kind of at least from what I've seen, pretty much mind garbage.
• 4:12
  Speaker 1: Yeah, yeah, that's, that's harsh, that's harshly.
• 4:16
  Speaker 3: And yeah, I mean I, we don't.
• 4:18
  Speaker 3: We really don't even know what dreams are you know?
• 4:20
  Speaker 3: Like are they just a byproduct, the fact that we get into these weird sleep stages?
• 4:23
  Speaker 3: You know, are we rehearsing?
• 4:24
  Speaker 3: You know new learned skills?
• 4:26
  Speaker 3: Nobody really knows.
• 4:27
  Speaker 3: Yeah, it could be mind garbage.
• 4:28
  Speaker 1: I don't want to get into it, but basically, like REM is when your brain starts to, like you know, move some of the memories around no-transcript, and that's how your mind copes.
• 4:46
  Speaker 1: But again, we don't really know, as far as I'm aware, yet really what dreams are, so they're just fun or terrible, depending on the night you're at.
• 4:54
  Speaker 3: That's right.
• 4:55
  Speaker 3: Yeah, I mean it can really bother people.
• 4:57
  Speaker 3: You know it can lead to a a lot of sleep disruption for folks that have recurrent nightmares.
• 5:00
  Speaker 3: It's a challenge, yeah absolutely.
• 5:02
  Speaker 1: So I mean, I guess just, kind of start with sleep.
• 5:04
  Speaker 1: Like you know, I guess you go through the basic questions right, like okay, how much I?
• 5:08
  Speaker 1: I don't really know anything about sleep.
• 5:10
  Speaker 1: How much sleep should I be getting per night?
• 5:13
  Speaker 3: yeah.
• 5:13
  Speaker 3: So the typical adult, the range of seven to nine hours is, is average.
• 5:17
  Speaker 3: Now, when it comes to the amount of sleep you need, people say, okay, well, I get seven every night but I'm still sleepy, and and it's funny because that range is not permission to sleep how much ever you want to within that range.
• 5:26
  Speaker 3: That range is what encapsulates what the sleep need is for the vast majority of adults, and so what your sleep need is is genetically determined, like you can't really change it.
• 5:34
  Speaker 3: So you might be an eight and a half hours.
• 5:36
  Speaker 3: I'm an eight and a half hour sleeper.
• 5:37
  Speaker 3: Some people are seven hour sleepers and they do just fine off seven.
• 5:40
  Speaker 3: I would die with just seven every single night.
• 5:42
  Speaker 3: I would not do well.
• 5:43
  Speaker 3: So seven to nine is average.
• 5:45
  Speaker 3: There are short sleepers and there are long sleepers, but it's the vast, vast, vast minority of the population.
• 5:51
  Speaker 3: And it's tough for the long sleepers because they are labeled as being lazy and not wanting to get out of bed and that's just the genetic hand they've been dealt.
• 5:58
  Speaker 3: And short sleepers are the envy of everybody, like you know in like healthcare and like you know in the corporate world, because they can just churn it out.
• 6:05
  Speaker 3: They tend to be high energy.
• 6:07
  Speaker 3: They tend to be very positive.
• 6:08
  Speaker 3: Folks tends to run into families, and so it's.
• 6:11
  Speaker 3: You know, that's just their genetic hand.
• 6:13
  Speaker 1: Do you know any associations between like I honestly I don't know.
• 6:16
  Speaker 1: I'm asking.
• 6:16
  Speaker 1: You might not know any, but like between like the short sleepers, do they have any other?
• 6:20
  Speaker 1: Like you know, is there any um risks that come with that increased risk for you know serious diseases or anything like that?
• 6:27
  Speaker 1: I mean, I don't know, it's a great question, none that we know of.
• 6:30
  Speaker 3: You know, we think their short sleep is actually a byproduct of a genetic change, a genetic polymorphism that we think lets them go through sleep cycles more efficiently.
• 6:38
  Speaker 3: So we're, but it's.
• 6:39
  Speaker 3: It's still an area of research that's needed.
• 6:42
  Speaker 3: But no, no, no negative consequences.
• 6:44
  Speaker 3: They seem to function great during the day.
• 6:45
  Speaker 3: Don't need caffeine, don't have that lull that a lot of us experience, as long as they're getting their so we all just collectively don't like them.
• 6:53
  Speaker 1: Basically is what you're saying.
• 6:55
  Speaker 3: That's probably true.
• 6:56
  Speaker 3: Yes, that's true.
• 6:58
  Speaker 1: I'm like man, I need nine hours.
• 7:01
  Speaker 2: I just need to conveniently leave the room.
• 7:04
  Speaker 2: I definitely not one of those short sleepers.
• 7:08
  Speaker 1: Yeah, I know, it's definitely more than eight to nine, like I try and get eight to nine every night.
• 7:11
  Speaker 1: That's how you know I feel best and I have a five month old right now.
• 7:14
  Speaker 1: So you know, you know you do what you can, but I, I mean, it's just yeah, so don't feel bad if you're like I need the eight to nine hours.
• 7:22
  Speaker 3: Yeah, absolutely not, because I think you're absolutely right with that.
• 7:25
  Speaker 1: They do get kind of labeled as like oh you, just, you know you need to buckle up a little bit more, right.
• 7:31
  Speaker 3: Yeah, and this is why I like to tell folks, especially in the corporate world, like don't compare yourself to your boss o'clock, I should be able to grind it out until 2 o'clock.
• 7:38
  Speaker 3: No, your boss is probably in that position for a reason.
• 7:40
  Speaker 3: They probably keep you behind very little sleep.
• 7:47
  Speaker 2: And that's probably not you, as the person that is working to 2 o'clock in the morning.
• 7:51
  Speaker 2: Please don't do that If you don't have to work overnight don't do it, I do it and it's terrible.
• 8:04
  Speaker 1: You really don't want it, you don't?
• 8:05
  Speaker 1: No, we could get into that later about like night shift and how shitty it is, but anyway, so let's.
• 8:07
  Speaker 1: I mean we don't want to be on here for hours and hours okay, so why do we?
• 8:09
  Speaker 1: Need sleep.
• 8:09
  Speaker 1: What's like.
• 8:10
  Speaker 1: What's the deal like?
• 8:11
  Speaker 1: We just decide to do it because it's fun, like what's what's going on.
• 8:15
  Speaker 3: Well, you know it's funny, it's becoming an increasingly hard question to answer because there's so many reasons why we sleep.
• 8:19
  Speaker 3: You know, it's kind like being like hey, why do we wake, why are we awake?
• 8:25
  Speaker 1: Why are we awake?
• 8:26
  Speaker 2: That's a much better question.
• 8:28
  Speaker 2: Why can't we just stay asleep?
• 8:29
  Speaker 1: I'm going to steal that when people ask me.
• 8:31
  Speaker 1: I'm actually going to steal that I like that.
• 8:34
  Speaker 3: So I'll tell you so some of the reasons.
• 8:35
  Speaker 3: We think it's good for energy conservation you don't need to be awake for 24 straight hours to meet the needs your body has to maintain hydration and nutrition, et cetera.
• 8:43
  Speaker 3: We think that it's good for memory consolidation, right?
• 8:45
  Speaker 3: We move a lot of our memories into long-term memory storage when we're in deep stages of sleep.
• 8:50
  Speaker 3: We know it's good for unforgetting, so you don't remember what you had for lunch five days ago because your brain forgot that while you slept, because you don't need that.
• 8:57
  Speaker 3: You know you want to have room, you want room for other information and we know that there's also active brain cleaning that goes on.
• 9:02
  Speaker 3: There's a fascinating paper that shows that the fluid that runs between your brain cells, it opens up and it washes away toxic proteins that build up throughout the day.
• 9:10
  Speaker 3: So you know tons and tons of reasons.
• 9:13
  Speaker 3: But it's really conserved nicely throughout evolution, like if there wasn't a great reason for it.
• 9:19
  Speaker 3: There's a famous evolutionary biologist.
• 9:21
  Speaker 3: He's like it's the worst mistake evolution has ever made.
• 9:23
  Speaker 3: Because what are you doing while you're asleep?
• 9:24
  Speaker 3: Nothing.
• 9:25
  Speaker 3: You're like a sitting duck for predators.
• 9:26
  Speaker 3: You're not mating, you're not feeding, you're not doing anything to promote your survival.
• 9:30
  Speaker 3: Why is it so conservative amongst animal species?
• 9:32
  Speaker 3: There's got to be a good reason for it.
• 9:33
  Speaker 3: It's probably because it maintains us at our top standards when it performance during the day so I don't need to drink lemon water in order to cleanse my brain.
• 9:44
  Speaker 2: My brain does it on its own it adds I'm not saying
• 9:46
  Speaker 3: the lemon water won't help but you know, your brain has been cleaning itself fine for eons without the lemon water.
• 9:52
  Speaker 1: Yeah, lemon, water so good.
• 9:53
  Speaker 1: So because I think that really shows you across animal species right.
• 9:56
  Speaker 1: Like we see, it's not just like a human thing.
• 9:58
  Speaker 1: So we know, like this is a part of life, like this is necessary, for, like all animals, we all do it.
• 10:04
  Speaker 1: It's important I do find it interesting that like um between, like I've looked at animals, like how much they sleep, and that can vary a lot.
• 10:11
  Speaker 1: And you know we're not.
• 10:12
  Speaker 1: I'm not an animal expert or anything like, but I know giraffes are like one of the ones that sleep the fewest number of hours a day, whereas, like koala bears, sleep like 27 hours they sleep pretty much.
• 10:21
  Speaker 2: He's not an expert.
• 10:22
  Speaker 3: He just knows all these random animal facts.
• 10:24
  Speaker 3: Yeah, Tell us all about the mating habits of the red panda.
• 10:27
  Speaker 1: Leah, I don't know.
• 10:28
  Speaker 3: I'll be right.
• 10:29
  Speaker 2: Shush Go ahead.
• 10:32
  Speaker 3: No, I mean, animal sleep is fascinating actually.
• 10:35
  Speaker 3: But yeah, you're right, you know koalas tend to be the biggest sleepers.
• 10:38
  Speaker 3: The bigger the animal usually, the more they sleep.
• 10:41
  Speaker 3: You know, the bigger the animal usually, the more they sleep.
• 10:42
  Speaker 3: You know that's.
• 10:42
  Speaker 3: That's the the trend amongst animal species and you know animals have adapted a myriad of ways to sleep, despite their environment.
• 11:20
  Speaker 3: You know, like dolphins, we talk about sleeping half their brain at a time.
• 11:23
  Speaker 3: You know we talk about other species that have like a kind of like a quiz in time where they're not really that active but they're kind of really, you know, quiet it looks like sleep.
• 11:31
  Speaker 3: It's weird, that's right yeah, a lot of these marine folks that actually have to come up for air.
• 11:36
  Speaker 3: You know they can't sleep, otherwise you'd you'd drown in the water, so, um, so yeah, sleep is fascinating.
• 11:42
  Speaker 3: Uh, and the other weird thing about animal sleep is that you know we talk about melatonin and how melatonin is, you know, is helping us.
• 11:48
  Speaker 3: It's a dark hormone.
• 11:49
  Speaker 3: Well, you know, nocturnal animals also secrete melatonin at night and for them, melatonin tells them to do the opposite, tells them actually it's time, time to be awake.
• 11:59
  Speaker 3: You know that is interesting yeah, so it's kind of a fun little you know, yeah, veterinary sleep stuff that's about all I know, though.
• 12:06
  Speaker 1: Animals, veterinary sleep.
• 12:07
  Speaker 1: Oh man, what are you getting into?
• 12:08
  Speaker 1: that's um okay, so I mean we, so we need sleep, for for a lot of different things you need sleep.
• 12:14
  Speaker 1: So if you didn't know that, now you do good.
• 12:17
  Speaker 1: Um, so if someone is now struggling with sleep, I think we should.
• 12:20
  Speaker 1: I definitely.
• 12:21
  Speaker 1: I'm sure one of the main reasons people like listen.
• 12:23
  Speaker 1: It's like okay, my sleep sucks, it's shitty, I want to sleep better.
• 12:27
  Speaker 1: So, like they want to know, like some things that they can do.
• 12:30
  Speaker 1: We could probably get into supplements and stuff, but let's get into like the tips of just like what you can do throughout your day
• 12:37
  Speaker 3: to make sleep easier yeah, well, I'll tell you, like the low-hanging fruit which everybody that has a true sleep disorder rolls their eyes at, because they're like we've tried all that basic stuff, you know.
• 12:46
  Speaker 3: But but I got, but I gotta start there.
• 12:48
  Speaker 3: You know, I gotta start with the foundation, which is sleep hygiene.
• 12:50
  Speaker 3: So if you're not practicing good sleep hygiene, you should try to practice good sleep hygiene.
• 12:54
  Speaker 3: You know, sleep hygiene is a cure for sleep disorders caused by poor sleep hygiene.
• 12:58
  Speaker 1: So five main kind of elements.
• 12:59
  Speaker 1: That's where I brush my eyes right, Brush my sleep, that's right.
• 13:02
  Speaker 1: If that's part of your routine, you go for it.
• 13:05
  Speaker 1: Now I'm just thinking of a toothbrush to the eyeballs and I hate everything about that.
• 13:09
  Speaker 1: So much.
• 13:09
  Speaker 3: That can't help.
• 13:10
  Speaker 3: That can't help.
• 13:12
  Speaker 3: Um, yeah, that's pretty nasty.
• 13:17
  Speaker 3: Well, routine is important.
• 13:19
  Speaker 3: So having you know three or four relaxing activities before bed, um, it's important to you know, when you're laying in bed.
• 13:25
  Speaker 3: You want to use your, your, your bed, ideally just for sleep and intimacy and not for, you know, your room for exercise, et cetera.
• 13:31
  Speaker 3: You want your room to be comfortable, quiet and cool.
• 13:34
  Speaker 3: 68 to 72 degrees is kind of what we usually tell folks on the cool side.
• 13:38
  Speaker 3: You want to avoid things that are going to disrupt your sleep.
• 13:40
  Speaker 3: So bright lights in your face at nighttime, nicotine, alcohol, caffeine, all of those are sleep disruptors.
• 13:46
  Speaker 3: And you want to try to keep your schedule the same weekdays and weekends as much as possible, because it's really easy, especially for night owls, to push your bedtime late.
• 13:54
  Speaker 3: Right, I mean Friday night, saturday night really easy to stay up and then sleep in, particularly for teenagers and young adults.
• 14:00
  Speaker 3: It's really hard to move your circadian timing earlier.
• 14:04
  Speaker 3: That's why it's hard to travel from west to east, much easier to travel east to west.
• 14:08
  Speaker 3: That's why spring daylight savings, which we just had, is a rough one, because you're asking your buy do everything one hour earlier, and that's just hard to do so.
• 14:15
  Speaker 3: You want to try to keep your timing and say that's the, the foundation on which we then build for other sleep related.
• 14:21
  Speaker 1: I need to just stress again.
• 14:23
  Speaker 1: I need to stress again because people always roll their eyes at me and I don't care, fuck you.
• 14:26
  Speaker 1: I'm gonna say it again you're going to bed at the same time is so important and you can.
• 14:32
  Speaker 1: You said on weekdays and weekends, because I think a lot of people on weekends I go to bed three, four hours later, Like your brain likes routine.
• 14:38
  Speaker 1: It really helps so much.
• 14:40
  Speaker 1: If there's one thing I would say, it's going to bed at the same time because your brain just wants to do the same thing and it just makes it so much easier for you.
• 14:48
  Speaker 1: So if you can try and go to bed at the same time every night, that's right.
• 14:54
  Speaker 3: Be a friend to your future self is what I tell people.
• 14:56
  Speaker 3: Like, be a friend to your Sunday night self, you know.
• 14:59
  Speaker 3: Like don't kick yourself in the foot Friday, saturday and then make your future self suffer.
• 15:04
  Speaker 2: Yeah.
• 15:04
  Speaker 2: So the one thing I shouldn't be doing, and that I probably shouldn't have done last night, is pulling out my phone and watching tick tocks that make me angry and anxious, that are slandering me, and so I sit there all night going oh, I can't wait to make the response.
• 15:25
  Speaker 1: That's the worst thing to do, but it's up.
• 15:27
  Speaker 1: I feel like it's pretty up there with some.
• 15:30
  Speaker 3: It's pretty bad you two are.
• 15:32
  Speaker 3: You two are kind of in the spotlight and you know in prime.
• 15:34
  Speaker 3: You know prime target for people that have different thoughts and feelings, etc.
• 15:38
  Speaker 3: Tiktok and all these platforms are really good at getting our mesolimbic cortex and our limbic systems activated and getting dopamine revving up and norepinephrine revving up and all the neurochemicals that are not ideal for for sleep.
• 15:55
  Speaker 3: You know those are the ones that you want to shut off the norepinephrine, the dopamine, etc.
• 15:58
  Speaker 3: Uh and so yes, I I purposely make sure I'm not looking at any of the comments if I'm scrolling and looking at social media because if I come across something that angers me, it's going to make it much harder to fall asleep.
• 16:11
  Speaker 1: So yeah, yeah, I especially just screens in general not great, not great for your sleep.
• 16:16
  Speaker 2: I say try like an hour before bed, but I know we're all there.
• 16:19
  Speaker 1: You know like you're scrolling before you go to sleep.
• 16:22
  Speaker 2: I think we've all been there um the single best thing I did for my sleep habits was making the room dark.
• 16:29
  Speaker 2: So no screens, no lights, no um, get putting a little bit of tape over the surge protector lights on my plug-ins so they're not glowing all across the room I yeah working in sleep medicine I've noticed a wide range of some people like I need a little bit of light too.
• 16:45
  Speaker 1: If I have any light it'll destroy.
• 16:47
  Speaker 1: You know, like I will just be waking up all the time.
• 16:50
  Speaker 1: So find kind of what works for you.
• 16:52
  Speaker 1: And you know I prefer, yeah, nice and dark, a nice dark room and cold.
• 16:55
  Speaker 1: I like in, like the 63, you know, degrees fahrenheit, like I like.
• 16:59
  Speaker 2: I have no idea what 63 is, but I like that's 147 fahrenheit or something, I don't know.
• 17:04
  Speaker 1: It doesn't matter, no one cares when it's america um so yeah, it's dry cool, dark.
• 17:10
  Speaker 1: Uh, what would you say?
• 17:11
  Speaker 1: Like you know, just for people, some pre-bed routines, like do you have anything?
• 17:15
  Speaker 1: I always say, like I like a shower, actually like before bed, like a nice warm shower, because actually if you take a warm shower after you get out, your body cools down Because you know you have that water on you and just kind of that cooling effect can kind of help facilitate, you know, relaxation, at least in my experience.
• 17:31
  Speaker 1: So that's something I like, but you know.
• 17:32
  Speaker 3: That's totally right.
• 17:33
  Speaker 3: Yeah, there's actually good science to support that.
• 17:35
  Speaker 3: Yeah, no, I like a warm shower.
• 17:40
  Speaker 3: It artificially raises your body temperature and that quick drop off can help you fall asleep.
• 17:42
  Speaker 3: The same reason why we don't recommend exercise too late if you're having trouble sleeping, because it raises your core body temperature and it stays high for longer.
• 17:48
  Speaker 3: It's harder for that to calm back down.
• 17:50
  Speaker 1: So so if you have trouble sleeping, exercise is not your friend late at night, but it's funny because earlier in the day, like if you exercise early in the day, it can help you sleep later, but if you exercise later in the day that can be so the timing you have to find that that's right now, that being said, some people exercise late and fall asleep is fine, and that's the time they can exercise.
• 18:07
  Speaker 3: Go for it.
• 18:08
  Speaker 3: I don't want to stop you from exercising, that's's the time that you have.
• 18:10
  Speaker 3: But you know, yeah, so the other things, you know, anything that you find relaxing and calming.
• 18:14
  Speaker 3: So you know, like your typical stuff brushing your teeth, getting you know, wash your face, getting your clothes ready brushing your eyes, if you want Brushing your eyes, as Rob likes to do, you know, whatever works for you, you know.
• 18:25
  Speaker 3: And avoids excessive stimulation, some mindfulness or meditation, whatever works for you.
• 18:31
  Speaker 3: There's no magic, you know.
• 18:32
  Speaker 3: There's no magic here, it's just fine.
• 18:34
  Speaker 2: Well, there is magic.
• 18:35
  Speaker 2: It's called playing with the kitten as you hold your kitten right now yeah animals
• 18:42
  Speaker 1: in the room too, you know and I did want to go back to, as you said, avoid alcohol, and I know I always get people like, oh, but alcohol helps me fall asleep.
• 18:49
  Speaker 1: Yes, it does, uh, reduce sleep onset, meaning it helps you fall asleep faster, but it kind of just fucks your sleep.
• 18:56
  Speaker 1: You know.
• 18:56
  Speaker 1: It fragments, it means you wake up more.
• 18:59
  Speaker 1: It, especially your REM sleep, your REM sleep, is super important, so it'll, it'll, it'll fuck that up like it's really trying to avoid alcohol before bed, especially large amounts of alcohol, because your body will be dealing, because alcohol is a is a toxin, it's a poison that your body has to deal with.
• 19:13
  Speaker 1: So you don't want to deal.
• 19:14
  Speaker 1: You're dealing with that as you're sleeping, which is, you know other things like, uh, eating large meals right before bed.
• 19:21
  Speaker 1: If, like I don't, I prefer to have like a small snack or something, just because otherwise I wake up hungry, I don't know fast, and I was, yeah whatever I wake up 3am like I'm starving, so if I have something small, a little bit of protein cottage cheese.
• 19:32
  Speaker 1: Yeah, I do like it mentioned a lot of episodes ago.
• 19:35
  Speaker 2: I like a little bit of popcorn some, just something like something small.
• 19:38
  Speaker 1: But if you have a large meal, that and then you I'll deal with gird gastric upset, you know, if you have a large meal, you're dealing with, you know, heartburn, that sort of thing.
• 19:45
  Speaker 3: So then try to avoid yeah and then and then we even you know we're talking about just our blood sugar.
• 19:49
  Speaker 3: You, the nice protective thing about sleep is when we fall asleep our blood sugar doesn't change all that much.
• 19:54
  Speaker 3: It's kind of protective, so you're not bottoming out your blood sugar at night.
• 19:56
  Speaker 3: Well, if you go to bed after a huge meal and your blood sugar is kind of staying high the whole night, that's not great for you either.
• 20:02
  Speaker 3: So, yeah, lots of reasons to avoid a big meal before bed.
• 20:07
  Speaker 1: Okay.
• 20:08
  Speaker 1: So yeah, is that pretty much seal it?
• 20:10
  Speaker 1: On the tips, I'm just trying to think if there's any other like tips for sleep Keep the room dark, cool, something to relax.
• 20:19
  Speaker 1: Oh, I did want to say like one thing that I do see a lot of people they wake up after like an hour or two and then they try and force themselves back to sleep.
• 20:26
  Speaker 1: It's something I see a lot Like.
• 20:28
  Speaker 1: They just lie there.
• 20:29
  Speaker 3: Let's talk about that, yeah yeah, so this no-transcript psychophysiological insomnia, but it all just falls into the bucket of insomnia.
• 21:15
  Speaker 3: So the core answer is cognitive behavioral therapy for insomnia and a lot of the things that people recommend as part of CBTI.
• 21:24
  Speaker 3: It sounds a bit counterintuitive to what you might think if you're suffering from insomnia.
• 21:28
  Speaker 3: So, for example and again I'm giving just general advice here and for anybody that's out there listening that truly has insomnia find a sleep specialist.
• 21:35
  Speaker 1: you know find a sleep psychologist or a sleep therapist.
• 21:39
  Speaker 3: They can do wonders for you.
• 21:40
  Speaker 3: And if you don't have access to one, there are some online resources that are that are, I think, fairly legit and you can probably access, but as long as it's CBT.
• 21:47
  Speaker 3: I base cognitive behavioral therapy for insomnia and the whole goal is to reverse that process of excessive arousal response when you're laying in bed.
• 21:54
  Speaker 3: You want the bed to be your friend and not your foe.
• 21:56
  Speaker 3: You want to bed to be your friend and not your foe.
• 21:58
  Speaker 1: You want to sleep, to be a welcome friend, not a foe.
• 22:00
  Speaker 1: Which I think brings back to what you said earlier, where you said, like the bed is for sleeping, so a lot of people just hang out in their bed and just watch TV or do other things.
• 22:06
  Speaker 3: Yeah.
• 22:07
  Speaker 1: If you can avoid that and just this.
• 22:08
  Speaker 1: Your bed is for sleeping, their couch and other things are for everything else.
• 22:12
  Speaker 1: Try and make your bed just where you sleep.
• 22:15
  Speaker 3: It's amazing how powerful your brain is and how quickly it links things together, like when you walk into like your your gym.
• 22:20
  Speaker 3: You know you're revved up, you're ready to go.
• 22:22
  Speaker 3: Your brain knows what happens in the gym.
• 22:24
  Speaker 3: You know you walk into your favorite restaurant, you're going to start salivating before you even see the menu, because your brain knows what happens there.
• 22:30
  Speaker 3: Right, and so that's what you want your bedroom to be the place your brain's like yeah, I know what happens here.
• 22:46
  Speaker 2: Let's let's start shutting things down, yeah, okay, so, yeah.
• 22:47
  Speaker 2: So for me, like, just step through, step, step by step through.
• 22:48
  Speaker 2: What goes on with me basically is starts getting late at night and I'm like, okay, time for bed, head to bed, turn all the lights off, lay down and then just pervasive thoughts, anxiety.
• 22:57
  Speaker 2: I basically bottle up all the anxiety from the day and then release it at night, and then you know I'm laying there An hour later.
• 23:03
  Speaker 2: It's like, okay, I can't sleep, turn on the TV, play a game or something, and then it's just, you know.
• 23:08
  Speaker 2: Next thing, you know it's 3 am.
• 23:10
  Speaker 3: Yeah, yeah.
• 23:11
  Speaker 3: Well, you know it's interesting.
• 23:13
  Speaker 3: The main question I often ask for a lot of the teenagers that I see in my clinic is when you're laying in bed, do you actually feel sleepy and tired and your brain just won't turn off, or do you feel wide awake, like you're just ready to go?
• 23:24
  Speaker 3: You know, and you know Taylor Swift said it best you know, midnight's become my afternoon, right?
• 23:28
  Speaker 3: This is like a delayed circadian rhythm, when your midnight feels like your afternoon because you're wide awake, you know, and you're going to bed like three or four o'clock.
• 23:36
  Speaker 3: And so some people have both night owl tendencies and insomnia, which makes it hard to fall asleep, and so the classic kind of cognitive behavioral therapy interventions oftentimes include sleep restriction, because most people think, well, I'm only going to sleep five hours, let me lay here for 10 and see if, hopefully, I can sneak out five hours tonight.
• 23:53
  Speaker 3: but the opposite is actually what you should be doing, which is restricting your time in bed to try to fill, you know, a good chunk of that with sleep.
• 23:59
  Speaker 3: It doesn't have to be perfect, and so we usually restrict down to the number of hours that somebody reports are actually sleeping each night, like I'm only sleeping five or six.
• 24:06
  Speaker 3: I'm like, okay, we're going to narrow your sleep window down to five or six hours, and then, once you're sleeping that time consistently, because you're chronically getting sleep deprived with that timing and you're sleeping more and more of that chunk, then we start to open up that window, and so that's, that's called sleep restriction, which is one of the most effective ways to, you know, help with classic insomnia.
• 24:24
  Speaker 2: So that's really interesting Cause.
• 24:26
  Speaker 2: Um, like, going back to what you said, what we were saying about how if people naturally sleep longer, they shouldn't feel bad for sleeping longer.
• 24:33
  Speaker 2: That also goes right into this where, if you need to take time to sleep shorter, don't feel bad about not going to bed and staying up and doing stuff and restricting that sleep window.
• 24:46
  Speaker 2: Don't feel bad about it.
• 24:48
  Speaker 3: Yeah.
• 24:48
  Speaker 3: So if it's part of your cognitive behavioral therapy plan, yes, you shouldn't feel bad about it and know that intentionally you're kind of sleep deprived of yourself.
• 24:57
  Speaker 3: But know that if you have a terrible night with a six-hour window, the next night is going to be easier to fall asleep.
• 25:02
  Speaker 3: And if the second night is terrible night, your brain is keeping track.
• 25:05
  Speaker 3: Your brain knows that you're supposed to be getting sleepier and sleepier.
• 25:08
  Speaker 3: Then it makes the third night that much easier.
• 25:10
  Speaker 3: So at some point you know your brain accumulates enough of a sleep drive that you're going to fall asleep and hopefully stay asleep for a good chunk of that window and then you start opening things up.
• 25:19
  Speaker 1: Okay, I like that I will say for for people that you know, if you wake up during the night cause a lot of people tell me they sleep for a couple hours, two, three hours they wake up and you know they're just, they're just awake and they try and force themselves back to sleep.
• 25:31
  Speaker 1: Now you do have kind of have your.
• 25:33
  Speaker 1: Your sleep does go in cycles.
• 25:35
  Speaker 1: I, I, we have so many things to get to.
• 25:36
  Speaker 1: I don't really want to get too into the nitty-gritty, but basically you go through these cycles and they'll happen every few.
• 25:42
  Speaker 1: You go into like rem sleep every 90 ish minutes give or take and then you'll kind of wake up from that and you'll go back into another cycle, so you'll have these throughout the night.
• 25:50
  Speaker 1: So after a rem cycle you might wake up and you might feel a little bit more awake, and trying to force yourself back to sleep can be really difficult and frustrating.
• 25:58
  Speaker 1: Anyone who's who's alive, I'm sure has had a time where you're lying in bed trying to fucking sleep and you're like I can't.
• 26:04
  Speaker 1: And it's so frustrating because you're like this is my body needs this or I die.
• 26:07
  Speaker 1: Why won't I sleep like this is so stupid.
• 26:10
  Speaker 1: So I I recommend personally, I think getting up out of bed, not trying to force your sleep, just going for a walk, listening to I love to listen to a podcast and go for a walk.
• 26:18
  Speaker 1: I find that relaxing.
• 26:19
  Speaker 1: But whatever works for you, something that is just away from screens.
• 26:23
  Speaker 2: Liam, what's a good podcast for people to listen to.
• 26:26
  Speaker 1: I like the dollop and sawbones and my brother, my brother and me.
• 26:30
  Speaker 1: Oh wait, we have wait a second.
• 26:33
  Speaker 1: Hold on, you were trying to get us.
• 26:39
  Speaker 3: So you've gotten to the core of, like, the next cbti technique, which is stimulus control, which is, you don't want to spend too much time awake in bed.
• 26:46
  Speaker 3: But the one important thing that I'll go back to, which is what you mentioned we all sleep in sleep cycles and it's a hundred percent normal to have multiple awakenings at night.
• 26:56
  Speaker 3: You should, every human being wakes up at night.
• 26:58
  Speaker 3: You know your infant is going to wake up.
• 27:01
  Speaker 3: You probably know this already, but your infant is going to wake up multiple times a night as your infant goes through sleep cycles.
• 27:05
  Speaker 3: It is normal and it's not a failure of your sleep.
• 27:08
  Speaker 3: So many people get into this kind of catastrophization where they're like ah, I'm awake now.
• 27:12
  Speaker 3: This is terrible, my sleep has failed me.
• 27:14
  Speaker 3: No, it hasn't.
• 27:15
  Speaker 3: You've done exactly what you're supposed to do, what your brain is supposed to do, so don't consider awakening a failure.
• 27:19
  Speaker 3: The second thing is, if you're in a situation where you're getting frustrated it's been more than like 20 minutes or so you're like I'm not sleepy.
• 27:26
  Speaker 3: Yes, the cognitive behavioral therapy technique number two is yeah, you can get out of bed for a little bit.
• 27:30
  Speaker 3: Do something boring, relaxing.
• 27:32
  Speaker 3: Usually don't recommend, you know, getting too active or getting into something that's too interesting, something that's really just kind of calms you and relaxes you.
• 27:39
  Speaker 3: You know, read the.
• 27:39
  Speaker 3: You know, if you have a copy of the yellow pages, read the yellow pages or something, and then get me Some of you probably know what the yellow pages are that are listening.
• 27:46
  Speaker 3: You know Rare, yes, but you know.
• 27:49
  Speaker 3: You know what I mean Like a magazine or something dull and boring.
• 27:54
  Speaker 3: But then the other part about this I love the technique called paradoxical intent, which is another CBTI technique, which is when you're laying in bed, instead of telling your brain, God, why can't you sleep, Just fall asleep, why You're failing me and revving yourself up, Instead you tell yourself you know what?
• 28:10
  Speaker 3: I'm awake and I'm totally fine with that and I'm going to try to lay here awake quietly.
• 28:15
  Speaker 3: I'm actually going to try to stay awake, just restfully, calmly, awake in my bed.
• 28:20
  Speaker 3: Oh, look, I'm still awake, but that's okay, that's what I'm trying to do, and that sometimes takes that pressure off of trying to fall asleep and paradoxically, you end up falling asleep.
• 28:29
  Speaker 3: So that's called paradoxical intent.
• 28:31
  Speaker 1: I love that because I see people like in the sleep lab, I can tell like, I can see thoughts like through the camera, just because they're so frustrated.
• 28:39
  Speaker 3: They're just like no, Don't tell them that no one will ever sleep in a lab.
• 28:42
  Speaker 3: Liam's got a superpower, but it's just because they're so frustrated right, and they can't sleep.
• 28:48
  Speaker 1: And I will tell you this.
• 28:49
  Speaker 1: I will tell people we are very poor at judging our own sleep.
• 28:53
  Speaker 1: I get people every single night in the sleep lab who swear to me they didn't slept.
• 28:57
  Speaker 1: They didn't sleep at all and I I've listened to them snore for hours.
• 29:00
  Speaker 1: I have all their brain waves.
• 29:01
  Speaker 1: They absolutely slept.
• 29:02
  Speaker 1: They were very poor.
• 29:04
  Speaker 1: If you are in bed for six hours and you were awake for an hour, lying there for an hour awake feels like six, so you feel like you were awake all night.
• 29:12
  Speaker 1: You will not remember the times you were sleeping.
• 29:13
  Speaker 1: So try not to be too hard on yourself.
• 29:15
  Speaker 1: I'm going to say that that over and over, because you get into this cycle where you get frustrated with yourself and the more frustrated you get with yourself, the more it's harder to fall back asleep.
• 29:23
  Speaker 1: So I love what you said Just lie there.
• 29:26
  Speaker 1: I'm just going to lie here, I'm just going to relax, it's fine.
• 29:29
  Speaker 3: It's not a big deal.
• 29:30
  Speaker 3: It's what it is.
• 29:31
  Speaker 1: I'm not going to get frustrated.
• 29:33
  Speaker 3: Yeah, we, you know, we, we call that it's.
• 29:35
  Speaker 3: It's fascinating, we call it sleep state and misperception, where it's all it's.
• 29:39
  Speaker 3: As you get older it's actually tends to become more of an issue, and caffeine will make that a lot worse.
• 29:43
  Speaker 3: And so, people that you know, oftentimes there's multiple awakenings where you have fragmented sleep and then your brain puts all those together, thinking you're awake the whole time, like I did.
• 29:51
  Speaker 3: I did a sleep study when I was a sleep fellow as part of my like my like you know it was a part of a study and I could have sworn.
• 30:03
  Speaker 3: I was awake for like 45 minutes straight and then I was scoring my own sleep study the next day and I'm like I was in like stage two non-rem sleep for like a good chunk of that time.
• 30:08
  Speaker 3: So I have pretty wicked sleep state misperception so I'm sure how often you fall asleep.
• 30:12
  Speaker 1: Yeah, I'm sure I would do the same thing as someone who works in sleep medicine.
• 30:15
  Speaker 1: I'm sure I would say I was awake during the night.
• 30:17
  Speaker 1: So, like I tell people it's not your fault, like the morning questionnaire will ask you how long it took you to fall asleep, you will get it wrong.
• 30:23
  Speaker 1: Literally everyone gets it wrong.
• 30:25
  Speaker 3: It's okay, just make your best guess like totally don't be too hard on yourself.
• 30:29
  Speaker 3: Geez, that's right, that's right yeah um.
• 30:33
  Speaker 1: So yeah, we got into some some of the sleep tips.
• 30:36
  Speaker 1: Um, is there any other thing else I guess you wanted to add towards, like just kind of?
• 30:42
  Speaker 3: Yeah, I mean CBTI kind of goes on and on.
• 30:43
  Speaker 3: But I'll tell you that other thing is, you know, we talked about decatastrophizing, so it's perception that everything is going to be terrible if you don't sleep, etc.
• 30:49
  Speaker 3: And my tagline here is, you know, as a sleep doc, I sometimes have to tell people, yeah, sleep is important, but let's take, let's not make it like our primary life focus, you know, like it's important but it's not that important, you know.
• 31:03
  Speaker 3: And and my tagline is uh, you know, uh, sleep is important, but not important enough to lose sleep over think about that for a little bit, you know it's just not important to lose sleep over, yeah um, well, I mean, I just want so.
• 31:16
  Speaker 1: If we're through there, I had so many people ask me like questions and stuff.
• 31:20
  Speaker 1: I'm like, listen, I'm gonna ask the, the doc when we get like the, the, when we start talking about sleep, because I've gotten so many questions from especially like people asking about any connection between adhd and sleep, like, do you know anything?
• 31:32
  Speaker 1: Um, like, I have so many things, anything that you have, people are just like, please, anything to do with adhd and sleep.
• 31:38
  Speaker 1: I'm struggling.
• 31:40
  Speaker 3: Yeah, I'm happy to talk about that yeah, yeah, I mean, I'll tell you anecdotally, I do see folks that have that, suffer from adhd, that certainly have a harder time going to sleep and turning their brains off, etc.
• 31:49
  Speaker 3: Right, and oftentimes, particularly for children, we see that if you have a sleep disorder like sleep apnea, it oftentimes mimics the symptoms of adhd, where you have hyperactivity, impulsivity, you, you know, hard to focus, etc.
• 32:01
  Speaker 3: And so you know the question of chicken egg, like what's causing what.
• 32:04
  Speaker 3: I always say that if you suffer from ADHD and you worry about your sleep quality, you really want to make sure you're finding somebody to help you with that sleep quality, because that might improve the ADHD symptoms as well.
• 32:13
  Speaker 3: So you're really kind of focusing on both.
• 32:16
  Speaker 3: Yeah, but they do have huge ties.
• 32:18
  Speaker 3: Yeah, okay, yeah.
• 32:19
  Speaker 1: Cause people ask me all the time and I'm like that's just, I'm honestly I don't know much about that field I will say, yeah, like sleep apnea.
• 32:25
  Speaker 1: You, uh, most people who I've had in the lab who have sleep apnea, most of them don't realize they have it.
• 32:31
  Speaker 1: There's every once, in main things, I check for, because you get people yes, it's more common with men.
• 32:45
  Speaker 1: Yes, it's more common if you have a larger neck circumference.
• 32:47
  Speaker 1: So if you ever see someone that, where it goes head shoulders and it just skips the neck, there's probably a good chance they have sleep apnea.
• 32:52
  Speaker 1: Um, so these are all things that are more common, but I have seen people who are 130 pounds and have terrible sleep apnea.
• 32:59
  Speaker 1: So you never really this is this is.
• 33:01
  Speaker 3: This is so important to hear.
• 33:03
  Speaker 3: You know, it can just be anatomical, you know, like we know some of our eastern asian population but they notoriously are very thin have horrendous sleep apnea.
• 33:12
  Speaker 3: You know, it's all and it's all anatomical.
• 33:14
  Speaker 3: You know um and so.
• 33:16
  Speaker 3: And then for post-menopausal women, their rate starts to, you know, become, you know, equivalent to the frequency in men, just because we think estrogen may have some level of protection against sleep apnea.
• 33:27
  Speaker 3: And then women's symptoms don't tend to be as prominent.
• 33:29
  Speaker 3: Sometimes the snoring doesn't tend to be as prominent, so it's often underdiagnosed.
• 33:32
  Speaker 3: But if you snore regularly, half of adults that snore regularly have sleep apnea, which is kind of frightening.
• 33:37
  Speaker 3: So if you have a bed partner and you both snore regularly, there's a 75 chance that at least one of you has sleep apnea.
• 33:44
  Speaker 3: You know, like, go get it check.
• 33:46
  Speaker 3: Go get it checked out.
• 33:47
  Speaker 3: Yeah, the numbers are not in your favor, you know.
• 33:51
  Speaker 1: So yeah, for anybody listening, you really do have to talk with your doctor, who will refer you typically to a sleep physician.
• 33:57
  Speaker 1: It's not something.
• 33:58
  Speaker 1: You generally just walk into a sleep lab.
• 33:59
  Speaker 1: I've had people show up at night like, hey, I want to sleep study.
• 34:02
  Speaker 3: I'm like that's not how this works unfortunately uh, no, you don't want that bill, you don't want that bill.
• 34:07
  Speaker 1: Yeah, that too so, yeah, just you know, talk with your doctor, get checked out.
• 34:11
  Speaker 1: If you snore, like they'll ask you some questions, and if you're basically like, if you have enough things like you snore, you feel tired during the day, even just being male, over a certain age, over a certain weight, these are things that, will you know, qualify you essentially to get to get a sleep study.
• 34:25
  Speaker 3: So get it checked out, if you're concerned and you can do it at home.
• 34:29
  Speaker 3: There's a lot of home sleep studies now and a lot of insurance are pushing folks to home sleep tests.
• 34:32
  Speaker 3: The technology is getting better, you know, so they're becoming more accurate.
• 34:36
  Speaker 1: Yeah so yeah, sleep ap, sleep apnea.
• 34:38
  Speaker 1: You might not know you have it, you might have it, Just get checked out.
• 34:41
  Speaker 1: I mean, I see it every night, so obviously.
• 34:44
  Speaker 2: I have to, and, on that note, perhaps we should talk about the stigma surrounding CPAP, cpap.
• 34:51
  Speaker 3: Oh yes.
• 34:52
  Speaker 2: CPAP.
• 34:52
  Speaker 1: Yeah.
• 34:53
  Speaker 3: I mean people.
• 34:54
  Speaker 3: No, go ahead, liam Sorry.
• 34:54
  Speaker 3: I I mean people know.
• 34:56
  Speaker 3: Go ahead, liam Sorry.
• 34:57
  Speaker 1: I just get a lot of people who don't want to get CPAP because of they have to wear it at night.
• 35:01
  Speaker 1: They have a bed partner or something like that.
• 35:03
  Speaker 1: They want to be seen with it.
• 35:04
  Speaker 1: They're single and they're like I don't want to have my date come over and I told on let me put on my Darth Vader mask.
• 35:08
  Speaker 1: I get that a lot.
• 35:13
  Speaker 3: So I understand, yeah, yeah, who is it?
• 35:14
  Speaker 3: Jennifer Garner, you know, wore CPAP in this movie.
• 35:16
  Speaker 3: She did recently, and I'm like that's what we need more of.
• 35:19
  Speaker 3: You know, like people that are showing that it doesn't have to be.
• 35:21
  Speaker 3: You know this terrible look to you.
• 35:24
  Speaker 3: You know, when you're wearing the CPAP you can look good and wear CPAP, but it's uncomfortable.
• 35:29
  Speaker 3: Many people that are prescribed CPAP don't end up wearing it because of discomfort.
• 35:33
  Speaker 3: It's important to know there are a lot of options.
• 35:36
  Speaker 3: Now you know when it comes to the type of mask, the fit of the mask, whether it covers your whole face, your, your nose and mouth just your nose sits under your nose and so keep working.
• 35:44
  Speaker 3: And also know that your brain is just is amazing in that if you do something consistently for like a week or two, even though it's so painful, magically your brain starts getting used to it and makes sleep much easier.
• 35:56
  Speaker 3: So, even if the first few days are horrendous, just push through it and you might be amazed at what comes out the other side.
• 36:01
  Speaker 1: So yeah, I see that all the time it's patient I've got.
• 36:03
  Speaker 1: I've had so many patients go from.
• 36:05
  Speaker 1: I will never wear this to.
• 36:06
  Speaker 1: I will never spend a night without it because that first couple weeks are very difficult and I'll tell you, there's a lot of yeah, like you said, a lot of different type of masks out there, some that I look.
• 36:14
  Speaker 1: I'm like actually that's not too bad, unfortunately, in like a lot of times in movies and tv shows you see them with the big full face masks which are the ones that cover the nose and the mouth, and it looks like darth vader and the machines are loud as shit like, and I'm like, what are you doing?
• 36:28
  Speaker 1: Like is this machine from 1995?
• 36:31
  Speaker 1: What?
• 36:31
  Speaker 3: is going on like the machines are like the size of alarm clocks now and they're quiet and like there's so much they're really they're not nearly as bad as they used to be.
• 36:39
  Speaker 3: I'll say yep, absolutely yeah, and super quiet and you might be your bed partner but also probably end up loving it because you're not going to be snoring and restless and and jerking around all the time.
• 36:49
  Speaker 1: You won't be an asshole during the day, because you'll actually be sleeping also a benefit of c-pap correct yes c-pap is anti-assholery.
• 36:57
  Speaker 2: Yeah, that's, that's it yeah, they should re-practice that their new tagline yeah forget treat sleep, apia treats assholery, are you?
• 37:06
  Speaker 1: tired of being an asshole or, more importantly, is everyone tired of you being an asshole?
• 37:12
  Speaker 2: there's a lot of people on the internet.
• 37:13
  Speaker 3: I want to send some, some c-paps to now, oh no, that's great, um yeah, so cpap talk with your doctor, get that checked out 100 uh and it.
• 37:24
  Speaker 1: But it's really true that there's a stigma behind all of it.
• 37:26
  Speaker 1: Narcolepsy has a huge stigma for people of narcolepsy.
• 37:29
  Speaker 1: You see it on tv where people just fall asleep just like just standing up and they're like that's that is like just the severest severe sleep apnea or sorry, I sleep, not sleep apnea narcolepsy ever.
• 37:40
  Speaker 1: So you know like it's common, it's you know you have to get.
• 37:45
  Speaker 1: If you feel like you have narcolepsy, you want to talk with your doctor.
• 37:48
  Speaker 1: A lot of times it can be tied with emotion.
• 37:50
  Speaker 1: So if you feel strong emotions you might feel tired which is terrible for people.
• 37:54
  Speaker 1: It's like you know, I just feel bad for people.
• 37:58
  Speaker 3: Yeah, I'll tell you any any.
• 37:59
  Speaker 3: Anyone that feels like they're sleeping, you know adequate time or even, you know, has a hard time staying asleep and feels really, really sleepy during the day, because a lot of our narcolepsy patients actually have very fragmented sleep.
• 38:08
  Speaker 3: Um, yeah, definitely talk to talk to your doctor.
• 38:10
  Speaker 3: You know narcolepsy is a moderate to really severe form of just sleepiness.
• 38:15
  Speaker 3: So whenever you're like quiet and relaxed and you're in a meeting or you're the pastor in the car and you're always falling asleep, you know that's the level of moderate to severe sleepiness.
• 38:24
  Speaker 3: And cataplexy, which is what you're describing, liam, is some people have this muscle atonia that takes over their bodies when they experience, typically, anger or laughter and that can be really subtle.
• 38:34
  Speaker 3: It can be just a little bit of difficulty with speaking.
• 38:37
  Speaker 3: It can be your head starts to drop a little bit, your shoulders start to drop.
• 38:40
  Speaker 3: We'll probably diagnose one or two people with narcolepsy.
• 38:42
  Speaker 3: Just listening to this podcast, I didn't know they had it, but about 60% of folks that have narcolepsy also have this cataplexy phenomenon and if you have this, where you suddenly start feeling weak in the setting of laughter or anger and you're really sleepy during the day, you almost certainly have narcolepsy.
• 39:03
  Speaker 1: So, anger, and you're really sleeping during the day, you almost certainly have narcolepsy, so you want to talk to your physician about that, so remove the stigma behind sleeping disorders.
• 39:07
  Speaker 1: Talk with your doctor, get it checked out.
• 39:07
  Speaker 1: Totally, um, so, yeah, um, you know?
• 39:08
  Speaker 1: Oh, that's the other thing people always ask me about.
• 39:10
  Speaker 1: So I think I think we got to talk about marijuana and sleep, because I get asked about it a lot, which, from what I have seen, there's not a ton of research on it because it's still sort of illegal, so it makes it studying down there anyway.
• 39:25
  Speaker 3: Yeah, true, Is it legal up there?
• 39:28
  Speaker 3: Yep, yeah, interesting.
• 39:31
  Speaker 3: Well, most of our studies for marijuana come from the 70s, you know, and you know it shows kind of a mixed picture.
• 39:35
  Speaker 3: One is that it does, you know, lower doses.
• 39:36
  Speaker 3: It shows kind of a mixed picture.
• 39:37
  Speaker 3: One is that it does at, you know lower doses.
• 39:40
  Speaker 3: It does help you fall asleep faster, and so it does take away some of that.
• 39:44
  Speaker 3: You know sleep latency similar to alcohol.
• 39:46
  Speaker 3: But it's also a potent rem suppressant, you know.
• 39:49
  Speaker 3: So it does keep you out of rem sleep.
• 39:50
  Speaker 3: And so the question is, you know, uh, what's you know?
• 39:53
  Speaker 3: Is it truly beneficial or a net negative?
• 39:57
  Speaker 2: the jury's still out on that, you know my personal anecdote on it, having tried it for sleep, is, especially if you dose it a little too high, it definitely is a sleep interrupter.
• 40:09
  Speaker 2: You get that kick of being high in the middle of the night.
• 40:12
  Speaker 2: You're just, and you get like that hazy wake up like yeah, I don't know if I'm asleep right now but you know, you're not asleep because you get up in the morning and you're like oh, I slept like crap right, anecdotally we need to do a sleep study on you yeah, apparently anecdotally from the people I talk to.
• 40:32
  Speaker 1: they always say, like when I'm, when I'm using it, my dreams are gone.
• 40:36
  Speaker 1: I don't have any dreams, which sort of makes sense because, as you said, it is sort of a REM suppressant, and REM is generally when you dream.
• 40:43
  Speaker 1: So you know, there's probably something that goes along with that connection.
• 40:47
  Speaker 1: I would tell people like you kind of just have to wait If you can't sleep without it, and it's the thing that helps you sleep.
• 40:51
  Speaker 1: A lot of people who have PTSD or other you know other things that make it difficult for them to sleep it's the thing that helps.
• 41:03
  Speaker 1: And I'm like well, you know, I think you've pros and cons, like if it's the thing that helps you, then you go with it.
• 41:05
  Speaker 1: I mean it's everybody's right.
• 41:06
  Speaker 3: Yeah, you know I, I certainly can't give that my seal of approval, you know, from the medical side.
• 41:10
  Speaker 3: But you know I, I hear what you're saying and sometimes's working.
• 41:16
  Speaker 3: But I still always encourage folks.
• 41:18
  Speaker 3: You know there there are great therapies that are effective, that you know a lot of people just haven't tried and and they feel like they they skip over the sleep hygiene in there.
• 41:26
  Speaker 3: Oh, we'll try the marijuana instead, right?
• 41:28
  Speaker 1: so yeah, I mean, if you've tried everything, sorry, I was just saying if you've tried everything else, I'm not going to tell you to not do something, because everybody's different and you have to.
• 41:53
  Speaker 2: We always say on this party you have to find what works for you, so I'm yeah, I'm not telling you to go out and buy weed, but I'm not gonna, I'm not gonna shame you, but at the very least do the basics first, first before you go out and buy weed, yeah yeah which I can say, because it's legal here.
• 42:07
  Speaker 2: So if you want to go buy weed, go buy weed getting the sleep car moving forward.
• 42:11
  Speaker 3: I kind of say if you have like multiple flat tires, you know you gotta, you gotta fix all of them, you know.
• 42:15
  Speaker 3: So hygiene, maybe one of your flat tires you may have insomnia.
• 42:18
  Speaker 3: There's another flat tire.
• 42:18
  Speaker 3: You got to fix them all to move things forward.
• 42:22
  Speaker 1: And that can be tricky to find that combo.
• 42:23
  Speaker 1: Well, what about?
• 42:24
  Speaker 1: Like you said, they go to supplements.
• 42:25
  Speaker 1: People will ask, I'm sure.
• 42:27
  Speaker 1: So I think I have to ask, like melatonin, you know what's your opinion on that?
• 42:32
  Speaker 3: Yeah, yeah, melatonin has become what I call a sleep candy.
• 42:35
  Speaker 3: It's just being handed out to everybody now and the tough thing is in the medical community it's also becoming really common for physicians to say, hey, try some melatonin as kind of like the initial knee-jerk response.
• 42:46
  Speaker 3: But the problem is we get almost zero training in sleep disorders in medical school and residency even in pediatrics residency, we've got almost zero lectures on how to handle sleep issues and so if you tell a doctor I don't sleep well, they may not know what to do with that information.
• 43:00
  Speaker 3: They'll might be like hey, this is not a I'm not a jab at other physicians.
• 43:04
  Speaker 3: I, you know same thing with my training.
• 43:06
  Speaker 3: I just didn't get a lot of sleep training until I did a sleep fellowship.
• 43:09
  Speaker 3: Melatonin you know it's a supplement.
• 43:10
  Speaker 3: It's not FDA regulated.
• 43:12
  Speaker 3: It's the dark hormone that our brain naturally makes, makes.
• 43:14
  Speaker 3: It has data to support its use.
• 43:16
  Speaker 3: When you want to adjust your circadian rhythm timing and when you want to do that well, when you have jet lag or when you have shift work, when you have delayed sleep-wake phase syndrome, which is, everything is pushed later, so your preferred sleep time is much later and your preferred wake time is later, but that doesn't jive with your work schedule or your school schedule.
• 43:34
  Speaker 3: Those are use cases where melatonin can be very helpful.
• 43:42
  Speaker 1: Turns out it's the timing as opposed to the dose, so we're talking like really low doses, like you know.
• 43:44
  Speaker 1: Half a milligram, one milligram yeah, take 10 like I take 10 every night.
• 43:45
  Speaker 1: I'm like I don't think you need that.
• 43:48
  Speaker 2: It's always on the shelf in five milligrams.
• 43:50
  Speaker 2: 10 milligrams, that's right.
• 43:51
  Speaker 2: It's so hard to find it in one yep, yep, absolutely, and you know it's just.
• 43:56
  Speaker 3: data shows that if you taking it early, like four to six hours prior to your current sleep onset time, that's good for shifting your circadian rhythms earlier.
• 44:03
  Speaker 3: Now there are other cases.
• 44:04
  Speaker 3: If you're otherwise healthy and you don't have a circadian rhythm issue, melatonin usually plays no role whatsoever.
• 44:09
  Speaker 3: But there are other situations Like, for example, I treat a lot of children that are on the autism spectrum.
• 44:13
  Speaker 3: We know melatonin can be helpful there as a sleep aid to actually help them with sleepiness.
• 44:17
  Speaker 3: So there are some cases, but usually under the guidance of, hopefully, a sleep doc or a neurologist or somebody else that's comfortable treating sleep issues in these nuanced kind of situations.
• 44:26
  Speaker 1: So yeah, I always say like I don't recommend it for like every night, not because I think it's going to kill you or anything like that, but generally that's just something else going on that you're trying to like treat with the melatonin.
• 44:46
  Speaker 3: So I'd rather try and get that figured out than take 10 milligrams every night, which is not necessary totally yep 100 agree and these bottles.
• 44:49
  Speaker 3: They can have whatever they.
• 44:49
  Speaker 3: You know they can put anything in them and they've done studies that show.
• 44:49
  Speaker 3: Like you know, a lot of these bottles have no melatonin in them.
• 44:51
  Speaker 3: Some of these melatonin gummies have, like serotonin, like cbd in them and it's, it's just a wild, wild west when it comes to melatonin bottling.
• 44:58
  Speaker 3: You know so, do you?
• 44:58
  Speaker 1: know anything about cbd.
• 44:59
  Speaker 1: I don't know jack about like cbd and sleep.
• 45:02
  Speaker 1: Basically, I'm gonna be honest, yeah there's.
• 45:04
  Speaker 3: I don't think there's much out there.
• 45:05
  Speaker 3: Honestly, you know a lot of the studies that were done back the day are really with with thc.
• 45:09
  Speaker 1: You know I'm not not much with yeah, with cbd as far as I know, there's like not a lot of research on that, so that's my response when people ask.
• 45:16
  Speaker 2: I think that's fair, I mean I can give my anecdote that cbd didn't do anything for me, for me, for some people, other people seems to help, all right.
• 45:26
  Speaker 1: So are there any other, like sleep supplements that like I don't know, I guess you get asked a lot about, or like, yeah, I mean magnesium everyone yeah, magnesium is like the new go-to, you know, and people like swear by it.
• 45:38
  Speaker 3: You know I'll say that the data just does not support kind of the hype that's around it right now.
• 45:42
  Speaker 3: There is some data in elderly with insomnia that magnesium can help, but they're also more likely to be magnesium deficient, Whereas the general population, despite what people are saying online about like oh, 80% of people are magnesium deficient.
• 45:56
  Speaker 3: Oh, and, by the way, here's a magnesium lotion that you can absorb through your eyeball when you brush it in.
• 46:01
  Speaker 3: You know like it's Magnesium lotion.
• 46:03
  Speaker 3: You know people just aren't magnesium deficient.
• 46:07
  Speaker 3: You know like it's really rare.
• 46:08
  Speaker 3: You know they've done studies in like the critical care population.
• 46:11
  Speaker 3: Yes, you might see some magnesium deficiency, but if you're just walking around, our diets are pretty magnesium fortified.
• 46:17
  Speaker 3: You know it's hard to be truly deficient in it.
• 46:21
  Speaker 1: So yeah, I mean, what's the other one?
• 46:23
  Speaker 3: People like Z-Quil, I can't remember the fucking name of it.
• 46:28
  Speaker 3: All of these things have just antihistamines in them, you know, like similar to Benadryl.
• 46:32
  Speaker 3: You know they all have different types of antihistaminergic that are available over the counter and they, you know they market it as like the ultimate, like sleep cure.
• 46:41
  Speaker 3: Well, you're just putting a Band-Aid on that sleep problem, you know.
• 46:46
  Speaker 3: And the antihistamines, especially Benadryl, studies show that, you know, it does help for a few days and then the improvement goes away after like day four or five.
• 46:52
  Speaker 3: But the side effects persist.
• 46:54
  Speaker 3: You know the cognitive slowing, some anti-ch, cholinergic stuff, dry mouth, etc.
• 47:03
  Speaker 1: All that persists, yet your sleep benefit goes away.
• 47:04
  Speaker 1: So that's a that's a big no for me.
• 47:05
  Speaker 1: Right for like a day like you have one day where it's like your, your sleep is a little messed up and you need to go to bed a little earlier, or something.
• 47:11
  Speaker 1: I'm like okay, I can see it, but taking these things every day I just don't think is the way to go.
• 47:16
  Speaker 1: That's basically my attitude towards all of them.
• 47:18
  Speaker 1: Yes, 100 agree um, oh, the other thing that I wanted to make sure I get to, because I'm fucked by it uh, sleep shift worker disorder, uh, just like do you, do you have any recommendations for people who work?
• 47:30
  Speaker 1: You know, the fucking 7 pm to 7 am the thing that I work uh, try not to you know.
• 47:36
  Speaker 3: Uh, pretty much, that's I highly recommend that.
• 47:38
  Speaker 3: That is my biggest recommendation for that yeah, well, I mean, I don't want to, we, I don't want to get too far into the science, but you know it has shown to have health consequences of always working the night shift, you know?
• 47:50
  Speaker 1: okay, sorry, can I just say I have to say this fucking little thing because I went to school for sleep medicine first day of like sleep classes.
• 47:57
  Speaker 1: They're like, okay, working nights, you are at increased risk for diabetes, hypertension.
• 48:01
  Speaker 1: And they're just going down this laundry list of things and eventually that she says cancer, one of the kids stands up, closes the book, walks out, never comes back.
• 48:09
  Speaker 1: I'm pretty sure he went into accounting like he heard that and he's like I'm done, I'm like you know what fair, like, if you're gonna do it, might as well do it day one.
• 48:15
  Speaker 1: Where you're like I'm not, no, thank you, which is 100%.
• 48:19
  Speaker 3: That's the right way to do it.
• 48:20
  Speaker 3: I mean, I think it's only fair to share that information with you up front, because otherwise it's I don't think it's ethical to, like you know, be like, oh yeah, everything's totally fine in this occupation, like, if you work with radiation, you should know that this could be harmful to your health.
• 48:32
  Speaker 3: Similarly, you should know that it could be harmful to your health.
• 48:35
  Speaker 1: I say my condolences.
• 48:36
  Speaker 1: That's my big last word.
• 48:38
  Speaker 3: That's right.
• 48:38
  Speaker 3: Yes, yes, totally.
• 48:40
  Speaker 3: Well, I will tell you that if you have to flip-flop, that's the hardest People oftentimes get this question.
• 48:45
  Speaker 3: Swing shift.
• 48:46
  Speaker 3: Yes, yes, if you're like day shift and night shift, you're working 12 hours.
• 48:49
  Speaker 3: That is just painful and brutal.
• 48:52
  Speaker 3: And so my goal here is, ideally, don't do it often.
• 48:55
  Speaker 3: If you can arrange your schedule such that you're not doing it often, and then if you have different shifts, like if you have, let's say, it's an eight-hour shift, it's much easier to go from a morning start to an afternoon start than to a night start, as opposed to the other way around, going from a morning start to a night start to an afternoon start.
• 49:12
  Speaker 3: So if you can delay, that can usually help you, because it's much easier to delay your start time.
• 49:17
  Speaker 3: And then that's the situation where melatonin may be helpful, after discussion with your physician, where, if you're trying to flip too quickly, melatonin can help you make that transition much faster.
• 49:27
  Speaker 1: Yeah, I will say it's tough, yeah people who work nights, like myself, staying on the same schedule is what's best, so like that's why shift work, swing shift is.
• 49:36
  Speaker 1: It destroys you, like you're going back and forth.
• 49:38
  Speaker 1: Your brain doesn't know what the fuck, which way is up.
• 49:39
  Speaker 1: Black is white, east is west, I don't know.
• 49:42
  Speaker 1: It's terrible, so working if you work overnights, trying to stay on the same schedule.
• 49:47
  Speaker 1: Even on your off days, like for me, I stay up with my daughter and I still go to bed at like 7 am every every day, so I try and stay on this which is hard because like shit isn't open at like 2 am, so like you
• 49:59
  Speaker 2: know, I understand it's a hundred.
• 50:01
  Speaker 1: It's so frustrating.
• 50:02
  Speaker 1: But if you can stay on that same schedule and make sure especially for my people who work nights make sure your room is dark, and quiet and like that is.
• 50:09
  Speaker 1: It's always important, but for the people who are sleeping during the day it's even more important because there's shits people are mowing their lawns and shit it's.
• 50:17
  Speaker 3: Listen I know it sucks it sucks.
• 50:19
  Speaker 3: Yeah, people are playing basketball and the pets are barking and there's telemarketers are calling.
• 50:24
  Speaker 3: You know, like it's just you can't get away from it.
• 50:26
  Speaker 3: Imagine if you were mowing your lawn at like 2 am.
• 50:28
  Speaker 1: People would be like what the fuck are you doing?
• 50:29
  Speaker 1: Stop doing that, that's you all the time.
• 50:31
  Speaker 2: This is you, because people are mowing their lawn at the fucking normal times and you're like god damn it I'm just trying to get some fucking sleep here, so I love.
• 50:38
  Speaker 3: You know, I'll tell you, I love like a good pair of earplugs for folks.
• 50:41
  Speaker 3: You know like I get these foam ones from, like like these purple ones, and then my trick here is I don't, I don't put like the rounded edge inside, I put the flat edge inside, I squeeze it down and that actually creates like the tighter seal.
• 50:52
  Speaker 3: And then my trip, my, my test is if you rub your fingers next to it, you shouldn't feel, you shouldn't hear your fingers rubbing.
• 50:57
  Speaker 3: That's a good seal for your, for your plug and that can interest eliminate a lot of noise.
• 51:01
  Speaker 3: And then white noise.
• 51:02
  Speaker 3: In that situation, white noise may also be helpful for folks that are really trying to sleep during the day and drowning out somebody as long as it's not too loud, drown out that can I ask who the there's got to be someone out there who's listening, because I need, I need answers.
• 51:15
  Speaker 1: Okay, I have a white noise app.
• 51:16
  Speaker 1: Okay, and there are options for water dripping what that's the question.
• 51:23
  Speaker 1: Yeah, where it's just like drip, drip, drip, or or the clock ticking, tick, talk, tick you you need to be you need a psychiatric evaluation.
• 51:33
  Speaker 3: I'm sorry, you need to be checked out by all the doctors if you listen to that sort of stuff to go to sleep you're like having music that's going all night and you're like, yeah, I can fall asleep for that is happening.
• 51:45
  Speaker 1: The wind chimes.
• 51:46
  Speaker 1: There's wind chimes to go to sleep.
• 51:48
  Speaker 1: What?
• 51:49
  Speaker 3: the.
• 51:49
  Speaker 3: My goal is always if you're gonna have a noise, you want the noise to be steady and consistent, no fluctuations.
• 51:56
  Speaker 3: I don't like even music.
• 51:57
  Speaker 3: I like like white noise, consistent rain.
• 52:00
  Speaker 3: You know, I don't even like oceans because it's like up and down, up and down.
• 52:03
  Speaker 3: I mean just find like a pink noise, brown noise, white noise, uh rain, you know a river rumbling.
• 52:09
  Speaker 1: You know that's, that's all fine yeah, it's like they took the whole point of white noise and said fuck that, we're going the opposite way.
• 52:16
  Speaker 1: I'm just mad.
• 52:17
  Speaker 1: I'm just mad at whoever decided city streets that's an option.
• 52:21
  Speaker 1: People are just like chatting and talking.
• 52:23
  Speaker 1: Cars are going by like all right, I'm done.
• 52:25
  Speaker 2: I'm done with the white noise fine, whatever well, everyone.
• 52:29
  Speaker 3: You know everyone's different here.
• 52:31
  Speaker 2: Liam and some people may have gotten used to it lived in a big city and then they moved to like a rural, you know yeah, we are people that move from the city to rural areas and they want that city so they might need it.
• 52:43
  Speaker 1: They might need it, that's right a little bit ambulances and police cars rolling by, they might appreciate it works for you great, but you should also get checked out.
• 52:50
  Speaker 1: That's all I'm saying um.
• 52:52
  Speaker 2: So do you have an opinion on uh saraquil getting prescribed for a sleep aid, since uh siraquil is usually prescribed as a sleep aid because of a side effect rather than as a?
• 53:08
  Speaker 2: Um yeah, on label I would.
• 53:13
  Speaker 3: I have huge reservations about using it solely as a sleep aid.
• 53:17
  Speaker 3: Uh, huge reservations.
• 53:19
  Speaker 3: If you're using it as part of an underlying psychiatric condition, that merits using siraeroquel and you can benefit from the side effect of the sleepiness fantastic.
• 53:29
  Speaker 3: But by itself it's a pretty harsh way to get just sleep and it comes along with its own fair share of side effects and labs you have to monitor, etc.
• 53:41
  Speaker 3: So I would give that a big no.
• 53:43
  Speaker 1: What do you feel about going back to the michael jackson sleeping aid?
• 53:48
  Speaker 2: what do you think about?
• 53:49
  Speaker 2: How do you?
• 53:49
  Speaker 1: feel about putting yourself in a coma every time you go to sleep.
• 53:52
  Speaker 1: By the way, people coma is not sleep.
• 53:54
  Speaker 1: There's a difference between comas are are.
• 53:58
  Speaker 1: Sleep is still an active process for anybody listening.
• 54:02
  Speaker 1: Sleep is not just as, like nothing happens.
• 54:04
  Speaker 1: There's a ton of shit happening while you're sleeping.
• 54:05
  Speaker 1: You can't just be like hit them over the head and they'll sleep.
• 54:08
  Speaker 1: That's right.
• 54:09
  Speaker 1: That is different than sleep.
• 54:11
  Speaker 3: Sedation is not sleep, anesthesia is not sleep and this is.
• 54:14
  Speaker 3: This is another interesting thing that I could share, which is I think VIPs get like the worst health care.
• 54:19
  Speaker 3: You know, like the people out in like california thinking they have access all this new and amazing newfangled stuff and they're seeking like these magic cures and people are like cting their whole bodies.
• 54:27
  Speaker 3: I'm like y'all are getting like the worst health care.
• 54:30
  Speaker 3: You know like vips get the worst treatment because they think they've like stumbled on some and they're and they're like charlatans that will be like oh, you know, come with me and I'm.
• 54:39
  Speaker 3: You know you guys are.
• 54:40
  Speaker 3: You guys are uncovering a lot of these guys and I know what you do, I know what you do.
• 54:43
  Speaker 3: You you call them out, but these vips out there, you know they get and there's some data to support that vips.
• 54:49
  Speaker 3: You know you don't ask them those questions that we typically ask that might be a little personal but that are important.
• 54:55
  Speaker 3: We cater to what they want and they end up getting worse care.
• 54:58
  Speaker 3: You know.
• 54:58
  Speaker 3: So any hollywood celebrity is listening.
• 55:00
  Speaker 3: Just go see like a legitimate doc and stop talking to dr doolittle from the.
• 55:04
  Speaker 1: You know who's offering you like you know, it's so true like if you look at we talk about like the blue zones a lot, where people like live the longest, they're like they're eating like beans and rice and they just like exercise and move they don't have fancy, they don't sit around a lot.
• 55:20
  Speaker 3: Yeah, I mean we.
• 55:20
  Speaker 3: It's an amazing thing about health is like we know what works.
• 55:23
  Speaker 3: You know, we actually know what works.
• 55:25
  Speaker 3: And people are looking to do all sorts of other things that are like no, they want the fountain.
• 55:29
  Speaker 1: They want the fountain of youth.
• 55:30
  Speaker 1: They want that, that fancy supplement, secret pill that they can get.
• 55:35
  Speaker 1: Do what works do it.
• 55:36
  Speaker 2: Do what's already been shown to work, you know, but that's kind of why I was asking about the Seroquel is because I know that, going back to the doctors don't really know what to do in regards to sleep and they give you the melatonin and I see with a lot of people they end up.
• 55:52
  Speaker 2: The next step from that is doctors prescribe them Seroquel.
• 55:58
  Speaker 3: That's interesting practice and I don't know if this is more Canada, more canada specific, you know, but there are definitely in down down here from what I've seen.
• 56:06
  Speaker 3: There are some other kind of go-tos before we get to the serocles of the world and and that can include things like you know, antihistamines.
• 56:13
  Speaker 3: It can include things like gabapentin, for example, or trazodone, or amitriptyline.
• 56:18
  Speaker 3: These are things that can work double as sleep aids that are usually used for other indications.
• 56:22
  Speaker 3: Clonidine is another one that's usually a blood pressure medicine by trade that can help with sleepiness.
• 56:27
  Speaker 3: So Seroquel tends to be much further down the list in my experience here.
• 56:31
  Speaker 1: Interesting.
• 56:33
  Speaker 1: Yeah that's why I take Viagra is for my blood pressure.
• 56:36
  Speaker 2: Yeah, is that it?
• 56:38
  Speaker 1: It's just for blood pressure, it's just for blood pressure okay, it's a medical condition and I prefer you not make fun of it.
• 56:48
  Speaker 1: Um, but yeah, no, I I just love what you said about the the whole.
• 56:50
  Speaker 1: Like there's the one guy that's trying to like make himself 30 years younger or whatever by taking like every supplement.
• 56:55
  Speaker 1: It's it's 100 people, people that there is no magicness, it's it's all.
• 57:01
  Speaker 1: We know that.
• 57:02
  Speaker 1: I know the normal shit is boring.
• 57:04
  Speaker 1: I know we know hey, get enough sleep and move around more and eat vegetables is boring, but we're gonna fucking keep telling you that shit because that's the stuff that works and there is no fucking fancy, super crazy pill.
• 57:17
  Speaker 1: You're gonna get here's.
• 57:19
  Speaker 3: Here's another one of my what I've discovered which is when I look online and social media, people that are usually like harping all these.
• 57:24
  Speaker 3: Like you know, our solutions are usually, you know, men that are at the age where they realize they're not going to live forever, right, and they're trying to find this magic solution to help themselves live longer.
• 57:34
  Speaker 3: And, you know, when you're 80, you're probably not going to want to live another 20 years.
• 57:39
  Speaker 3: To be honest, you know, like, yeah, I don't meet any 80 year olds.
• 57:46
  Speaker 3: They're like let me just knock out another 20 and let me just, you know, take all these supplements to get my get myself another 20.
• 57:49
  Speaker 3: It's the quality of your life that's super important, and in in quantity, although we emphasize that you really got to think more about the, about the quality of the years that you have and you're not going to be worrying about, you know, eking out extra time when you're that old honestly, yeah, completely agree.
• 58:03
  Speaker 1: Oh, oh, before we go, okay, so before we go I gotta run through some like very quick, like sleep things that are fun, okay, um so because this is my way to talk about sleep.
• 58:11
  Speaker 3: Yeah, before you do your sleep thing, fine fine, what do you gotta do?
• 58:15
  Speaker 2: we did have one question that I don't know if you're gonna be able to answer or anything, but we did have a viewer question, um, and if you don't know what to do with it, I will just cut this part.
• 58:26
  Speaker 2: Sounds good.
• 58:28
  Speaker 2: So anyway, I've got uh lola here who wrote in uh, I have a disorder where I don't produce cortisol, thyroid estrogen, testosterone, growth hormone.
• 58:39
  Speaker 2: She supplements all these things to get normal levels as possible, but she notices that she doesn't seem to need as much sleep as the guidelines generally say that you should get.
• 58:49
  Speaker 2: And if I try to force myself to sleep more, I sometimes struggle to fall asleep the next day and I I think that instantly goes back to where you start at the beginning, where you don't have to force yourself to feel like you need to sleep the guidelines.
• 59:05
  Speaker 3: Maybe you just don't do that, yeah, I mean it sounds like she has what we call panhypopit, which is where your pituitary is just not making all the stuff that it needs to make.
• 59:12
  Speaker 3: It sometimes comes along with other sleep-related issues or brain-related issues which could also then cause sleep-related issues.
• 59:19
  Speaker 3: So, without knowing her detailed medical history, I agree If she feels well, offers lower amounts of sleep.
• 59:27
  Speaker 3: You've got to listen to what your body is telling you.
• 59:29
  Speaker 3: And if you're okay, as long as you're not like over-treating with Synthroid, for example, for the thyroid issue, or you're not taking too much hydrocortisone and that's keeping giving you extra alertness as long as your levels are balanced and your endocrinologist is following along and you feel like you're sleeping well, you could be a short sleeper.
• 59:45
  Speaker 3: I don't know if it's because of that underlying disorder or in spite of it.
• 59:48
  Speaker 3: That's just how her brain was formed.
• 59:53
  Speaker 2: Okay, and what about pets in bed?
• 59:54
  Speaker 2: Do I have to cover Pippin's ears?
• 59:58
  Speaker 3: No pets in bed.
• 1:00:00
  Speaker 3: Yes, you know this is yeah, I feel you know, and this is tough because there are some people that say well, listen, I have anxiety and I love having my pet there and if that's helping you with sleep again.
• 1:00:10
  Speaker 2: I'm not going to argue with success.
• 1:00:11
  Speaker 2: Yeah, that's me.
• 1:00:12
  Speaker 2: It's like my animal is an emotional support animal.
• 1:00:15
  Speaker 2: I love having him curled up beside me.
• 1:00:18
  Speaker 3: And that's your situation.
• 1:00:19
  Speaker 3: By all means, do what works for you.
• 1:00:21
  Speaker 3: If you have a choice, though, you know and you're not in that situation ideally out of the out of the room, both from an allergen standpoint.
• 1:00:27
  Speaker 1: I was going to say, from allergies.
• 1:00:28
  Speaker 1: What I'm thinking, too, is yeah.
• 1:00:30
  Speaker 3: Yes, yes, absolutely Allergies.
• 1:00:32
  Speaker 3: And then your pets.
• 1:00:33
  Speaker 3: You know, they they wrestled any small sound.
• 1:00:35
  Speaker 3: They have super hearing, they have a super smell, you know, like an ice cream, like a pizza truck walks by.
• 1:00:39
  Speaker 3: They're probably gonna get up and be like, hey, what's going on?
• 1:00:41
  Speaker 3: And you don't need to, you don't need to, you know, bear the brunt of that.
• 1:00:43
  Speaker 3: So, um, so yeah, pets out of the room, ideally okay, all yours, liam.
• 1:00:48
  Speaker 1: I need to run through some fun things about sleep.
• 1:00:50
  Speaker 1: Okay, we've got through the the things, but we need to go through the fun things, okay.
• 1:00:53
  Speaker 1: So first off, do you know the record for most times?
• 1:00:55
  Speaker 1: Uh, awake, without any sleep was that 11?
• 1:00:59
  Speaker 3: 11 days just over?
• 1:01:01
  Speaker 1: 11 days without sleep, which that is fucking nutso bananas.
• 1:01:04
  Speaker 3: That's bonkers.
• 1:01:05
  Speaker 3: That's bonkers.
• 1:01:06
  Speaker 1: There was one radio DJ who broke the record.
• 1:01:08
  Speaker 1: At the time it was like six or seven days right, and he was like going to do it for charity.
• 1:01:12
  Speaker 1: They kept him awake.
• 1:01:13
  Speaker 1: At like day three he started seeing like spiders in his shoe, started hallucinating, which is normal because it's your brain going like what the fuck is happening?
• 1:01:20
  Speaker 1: Basically, like when you're a POW, the first thing they do is keep you awake because it just breaks your ass.
• 1:01:24
  Speaker 1: So he did it for like six days.
• 1:01:26
  Speaker 1: They kept him awake.
• 1:01:27
  Speaker 1: He slept for 24 hours after that and he never fully left his state of psychosis.
• 1:01:31
  Speaker 1: He still saw things.
• 1:01:33
  Speaker 1: He still had hallucinations.
• 1:01:34
  Speaker 2: His wife left him he lost his job.
• 1:01:48
  Speaker 1: So like that goes to show you that they're thinking there's probably some underlying mental disorder.
• 1:01:50
  Speaker 1: That lack of sleep is what brought it out.
• 1:01:51
  Speaker 1: Now the person who did it for 11 days was totally fine after, so like you never really know.
• 1:01:52
  Speaker 1: So just don't.
• 1:01:52
  Speaker 1: The guinness book of world records, as far as I know, doesn't keep track of most time awake anymore, because people were getting fucking injured basically doing it.
• 1:01:56
  Speaker 1: So don't do that by the way not smart.
• 1:01:58
  Speaker 1: Don't keep the record for the fattest cat.
• 1:02:00
  Speaker 3: I think because, yeah, people also, don't make your cats fat.
• 1:02:04
  Speaker 3: Yes, yes, yes, yeah.
• 1:02:07
  Speaker 3: The the biggest skydive without a parachute probably is not a record that they're keeping either, you know I wouldn't do it I would tell you that anecdotally.
• 1:02:14
  Speaker 3: If they say that you die quicker of sleep deprivation than food deprivation, you know you can go longer than you can without sleep, you know.
• 1:02:22
  Speaker 3: So yeah, I would 100 agree% agree with that.
• 1:02:24
  Speaker 1: So, get some sleep REM behavior disorder is a fascinating one, that's one of my favorite disorders when it comes to sleep.
• 1:02:29
  Speaker 1: So, basically, you have REM sleep.
• 1:02:30
  Speaker 1: That's kind of when you dream.
• 1:02:31
  Speaker 1: Mostly, as I stated before, your body kind of, though, paralyzes you when you sleep because you know you don't want to get up and move around, of act out your dreams.
• 1:02:41
  Speaker 1: Now, normally it just involves you moving your arms and legs and stuff I had.
• 1:02:45
  Speaker 1: There was one patient who sat up in the middle of the night and started dealing poker cards in his sleep.
• 1:02:50
  Speaker 1: So that can happen.
• 1:02:51
  Speaker 1: Super dangerous there was one case of not homicide because he was acquitted, but one guy did kill someone else in his sleep because he was having a nightmare or something like that, and so they brought him in for a sleep study.
• 1:03:04
  Speaker 1: Afterwards, of course, he got up, walked around.
• 1:03:05
  Speaker 1: So if you have rem behavior disorder, you get one free.
• 1:03:08
  Speaker 1: Kill one.
• 1:03:09
  Speaker 3: Hum, look at that, you did not just say that you did not, just don't kill anybody is that where you get your your lungs and your nose to try eating liam?
• 1:03:22
  Speaker 3: listen, I'm saying go ahead, go ahead.
• 1:03:25
  Speaker 3: I would say it's funny, because you know it's.
• 1:03:28
  Speaker 3: It's actually not funny, but the legal implications of some of our parasomnia is like the one you just mentioned these interesting things that happen at night.
• 1:03:35
  Speaker 3: You know, it's an area.
• 1:03:36
  Speaker 3: There's another one that's a non-rem parasomnia called sexsomnia, in which and this is likely very underdiagnosed, but similar to sleepwalk walking you start initiating like sexual type behaviors while you're sleeping and, of course, for a bed partner that can be.
• 1:03:49
  Speaker 1: That's what the very concerning I don't need that during my sex somnia time, absolutely.
• 1:03:56
  Speaker 1: You're 100 right.
• 1:03:57
  Speaker 3: yeah, so rent behavior disorder, I'll tell you that.
• 1:03:59
  Speaker 3: You know it can be medication related.
• 1:04:01
  Speaker 3: But if you have it out of the blue, where you're actually acting out your dreams and usually you have really vivid dream recollection and your bed partner who witnesses it was like yeah, you were punching, and he's like, yeah, I was dreaming about being in a boxing ring, you know, if you have that you actually should go see a neurologist, because a lot of these patients will end up developing a neurodegenerative condition, typically in.
• 1:04:25
  Speaker 3: Typically this is kind of nuanced but in the synucleinopathy family, which is Parkinson's etc.
• 1:04:28
  Speaker 3: And so it's a fascinating disorder and it's also why I think, of all the neurodegenerative conditions, we're probably going to be able to cure things like Parkinson's earliest because we have a canary in a coal mine.
• 1:04:42
  Speaker 3: Like we know, it's going to happen for a good chunk of the population that has idiopathic REM behavior disorder, where it comes out of the blue.
• 1:04:49
  Speaker 2: So see your doctor.
• 1:04:49
  Speaker 2: It can be super dangerous.
• 1:04:51
  Speaker 2: I have to send somebody.
• 1:04:52
  Speaker 2: I already know somebody that I'm going to be sending this podcast to, because he does do that.
• 1:04:57
  Speaker 3: Yeah, very interesting, and again it can be med related.
• 1:05:07
  Speaker 1: You know the SSRIs and SNRIris can sometimes also cause this type of stuff but because it's so dangerous, you definitely want to talk to your physician about it.
• 1:05:09
  Speaker 1: What about um so I'm blanking on the name of what it's called basically where your mind wakes up before your body.
• 1:05:11
  Speaker 1: So you kind of wake up but you can't move yeah, sleep paralysis, sleep paralysis yeah, so what do you?
• 1:05:17
  Speaker 1: so like it's I know it's kind of it can happen to people, like once in a very blue moon, but like typically it happens more with people of narcolepsy correct or like yes, that's right, very common if you have narcolepsy.
• 1:05:29
  Speaker 3: But in the folks that don't have narcolepsy it's often associated with sleep deprivation.
• 1:05:32
  Speaker 3: So yeah, I've experienced this once or twice during, you know, late night studying during medical school.
• 1:05:37
  Speaker 1: But yeah, sleep deprivation is usually the culprit for folks that don't have narcolepsy so you basically wake up but you can't move, and sometimes it comes with auditory or visual hallucinations, so you can see things that aren't real, hear things that aren't real, so like that is right.
• 1:05:49
  Speaker 1: So if that happens to you the first time, I experienced it.
• 1:05:52
  Speaker 2: I was like, uh, early teens, and of course I didn't know what sleep paralysis even was, and so I was like freaking the fuck out.
• 1:06:01
  Speaker 2: No, yeah, no, it's freaky shit.
• 1:06:02
  Speaker 1: So if that happens to you regularly, see, see a physician like if it's once every, like years and years, like you know, sleep it might be sleep deprivation, something like that.
• 1:06:11
  Speaker 1: But if that's happening to you, people tell me like oh yeah, that happens all the time.
• 1:06:14
  Speaker 1: Like, oh, go talk to someone yeah you need to talk.
• 1:06:17
  Speaker 1: Yes, absolutely for sure.
• 1:06:18
  Speaker 1: Okay, um so yeah, that one's interesting.
• 1:06:20
  Speaker 1: Uh, I, if anybody asks me like what's the worst disorder to have, one of them up there for me is Klein-Levin syndrome.
• 1:06:26
  Speaker 1: It sounds absolutely awful, so.
• 1:06:30
  Speaker 2: Klein-Levin were two doctors.
• 1:06:32
  Speaker 1: They were the answer, so basically.
• 1:06:33
  Speaker 1: So correct me if I'm wrong, like I don't.
• 1:06:35
  Speaker 1: I'm not an expert on Klein-Levin syndrome, but basically you sleep less and less over time.
• 1:06:47
  Speaker 3: You're able to.
• 1:06:47
  Speaker 3: Just you're not able to sleep um as much as you need and slowly it gets more difficult to sleep and you just kind of sleep less and less until you die, essentially like ah so you're, you're.
• 1:06:50
  Speaker 3: You're actually talking about a disease known as familial fatal insomnia okay, so yeah klein levin, is much more benign than familial fatal insomnia, um, but it's still.
• 1:07:00
  Speaker 3: It's still a tough disorder, yeah, if, um.
• 1:07:02
  Speaker 3: So familial insomnia, we think, is a, I believe it's a pre-mediated disorder in which over time you have just no generation, you can't tell sleep versus awake states and you it is.
• 1:07:14
  Speaker 1: So, klein-levin, is it has to do with having difficulty sleeping right Like is, or am I wrong?
• 1:07:21
  Speaker 3: Well, it's actually, it's intermittent periods of excessive sleepiness, and so it's periodic hypersomnia in which you're sleeping, for you know, it can be like 20 plus hours in a day.
• 1:07:30
  Speaker 3: It can last for like a day or multiple days when, when you're awake, during those episodes, you tend to be not yourself there, you can be confused, you can be altered, the sense of like kind of like derealization.
• 1:07:41
  Speaker 3: You're just not yourself during these episodes and you tend to eat a lot and you can also have hypersexuality type type presentation as well during the times that you are awake.
• 1:07:49
  Speaker 3: And it occurs periodically and we have no idea why it happens.
• 1:07:53
  Speaker 1: We have no, yeah, that's just one of those rare ones, like I know.
• 1:07:55
  Speaker 1: It's super rare, super rare, super rare.
• 1:07:57
  Speaker 1: That's right, okay, yeah, oh, what about, um, the sleeping sickness of the west african sleeping sickness by the tsetse fly?
• 1:08:03
  Speaker 3: yeah, yeah, I can't say that I've you know, I've never I haven't seen any have you never seen anybody?
• 1:08:07
  Speaker 3: With that I was gonna ask no, no, it's um, but it's yeah.
• 1:08:11
  Speaker 3: A lot of these, unfortunately, like infectious inflammatory conditions, can come along with excessive sleep, and it's because you know that inflammatory mediators can also make your brain just feel sleepier, you know so it's yeah, because yeah, if you don't like, so yeah, there's a, there's a tsetse fly in africa like it bites you and then, yeah, you become.
• 1:08:28
  Speaker 1: It's called the sleeping sickness, because you sleep more and more and I'm like I don't really know why, and I don't even know we know exactly why.
• 1:08:33
  Speaker 1: But yeah, it's just fascinating yeah, it's so weird.
• 1:08:35
  Speaker 3: I'll have to look into that.
• 1:08:36
  Speaker 3: I don't know why.
• 1:08:37
  Speaker 1: Yeah, yeah, yeah, it's never come across my desk, but yeah yeah, if you ever get a West African sleeping sickness case, I need to know about it.
• 1:08:47
  Speaker 3: For sure, for sure, I'll come back and chat with you all about it.
• 1:08:52
  Speaker 1: So yeah, that's.
• 1:08:53
  Speaker 1: I just wanted to go through some weird things with, with, with sleep.
• 1:08:56
  Speaker 1: Sleep is strange, that's fine Sleep is strange.
• 1:08:59
  Speaker 3: It's a, it's a fascinating world, you know, and there's something new every day, which is the amazing thing about sleep yeah, liam's over there thinking hey, I'm just thinking about, yeah, so a lot of rare disorders, but mostly, um, get your sleep hygiene checked.
• 1:09:14
  Speaker 1: Okay, so get that.
• 1:09:14
  Speaker 1: You know, figure that shit out.
• 1:09:16
  Speaker 1: You know all the things, the simple things.
• 1:09:17
  Speaker 1: We said uh, if that's not working, go see your doctor, who will refer you to a sleep doctor.
• 1:09:21
  Speaker 1: Then they're gonna check you for things, for things like sleep apnea, narcolepsy, all those things that are a bit more common.
• 1:09:26
  Speaker 1: Get that fucking treated, because see what is it?
• 1:09:28
  Speaker 1: Cpap compliance is like what?
• 1:09:30
  Speaker 1: Fifty percent like it's not.
• 1:09:32
  Speaker 2: I don't know the exact numbers, but it's not very good.
• 1:09:34
  Speaker 1: Most people who are prescribed CPAP don't use it, so that's not great.
• 1:09:38
  Speaker 1: So if you have an issue, get it treated.
• 1:09:40
  Speaker 1: There are other options besides c-pap.
• 1:09:42
  Speaker 1: If anybody was curious, talk with your doctor.
• 1:09:44
  Speaker 1: Honestly, from my experience, they're not really that great.
• 1:09:47
  Speaker 1: C-pap is definitely the gold standard for a reason it works the the most effective and the fewest number of side effects.
• 1:09:51
  Speaker 1: So you, if you can't do it, try other things, but definitely try that first and uh yeah, uh, sleep well and don't be your worst anti-acid.
• 1:10:02
  Speaker 2: That's our goal, yes, and brush your eyes, that's right.
• 1:10:06
  Speaker 3: And brush your eyes, sleep.
• 1:10:08
  Speaker 1: The anti-asshole treatment yes, we're gonna talk about, like you know, your coffee, like the coffee mugs are like, don't talk to me till I have my coffee.
• 1:10:17
  Speaker 1: Like well, definitely sleep first.
• 1:10:18
  Speaker 3: Definitely sleep well first and then the coffee, sure is important, but without the sleep, the coffee ain't doing shit yep agreed and avoid caffeine before bed.
• 1:10:26
  Speaker 1: I think we said that.
• 1:10:27
  Speaker 1: But also, yeah, limit caffeine later in the day next, some people say oh, I can drink.
• 1:10:31
  Speaker 1: It's all the coffee I want to be fine.
• 1:10:33
  Speaker 1: Like, no, that doesn't work.
• 1:10:34
  Speaker 1: Oh, people always say, like with adhd they're like oh, caffeine has the opposite effect on me.
• 1:10:38
  Speaker 1: I'm like, I still don't think you should be drinking a bunch of caffeine before bed, even if you don't feel like it does anything if you'll invite me back, we'll talk about the caffeine bad sleep caffeine cycle that's made starbucks, like you know, incredibly rich.
• 1:10:49
  Speaker 3: But, um, but that's that's the story for the day yeah, that's smart.
• 1:10:54
  Speaker 2: Yes, we need to do that, okay, but uh, next merch, we should, we should make like pillowcases that are like sleep the anti-assholery.
• 1:11:03
  Speaker 3: I love it.
• 1:11:04
  Speaker 3: I love it.
• 1:11:06
  Speaker 1: There's definitely some options we could do with, like sleeping stuff.
• 1:11:09
  Speaker 1: I like it.
• 1:11:12
  Speaker 1: I like it.
• 1:11:13
  Speaker 1: Well, yeah, you got to tell me where to find you.
• 1:11:16
  Speaker 3: It comes with some magnesium.
• 1:11:17
  Speaker 3: Oh yeah, hey you can find me anywhere that social media is consumed.
• 1:11:20
  Speaker 3: I'm that sleep doc.
• 1:11:23
  Speaker 1: That sleep doc, all the good places that social media is consumed I'm that sleep doc, that sleep doc.
• 1:11:25
  Speaker 3: All the good places that social media is that sleep doc.
• 1:11:26
  Speaker 2: All the good places.
• 1:11:27
  Speaker 2: There are no good places on social media.
• 1:11:29
  Speaker 2: You can find them on all the bad places in social media all the bad places that are keeping us awake and and angering us.
• 1:11:38
  Speaker 1: Yes, uh yeah, find me on the places where you can't be before bed or your sleep will be shit.
• 1:11:43
  Speaker 1: Don't watch me.
• 1:11:46
  Speaker 3: I'll shame you into going to sleep on those.
• 1:11:49
  Speaker 1: I'll be like are you still watching me Every night?
• 1:11:51
  Speaker 1: You'll be the.
• 1:11:52
  Speaker 2: Papa Swoleo of sleep.
• 1:11:54
  Speaker 1: Yes, but you could use it for good.
• 1:11:56
  Speaker 1: Every 9.30, release a video, Be like go to sleep.
• 1:12:00
  Speaker 2: Go to sleep right now.
• 1:12:00
  Speaker 2: Turn your phone off.
• 1:12:01
  Speaker 2: Oh I love that to sleep.
• 1:12:03
  Speaker 2: Go to sleep right now.
• 1:12:04
  Speaker 3: Turn your phone off.
• 1:12:05
  Speaker 3: I actually did.
• 1:12:05
  Speaker 3: I did like an adult bedtime story.
• 1:12:07
  Speaker 3: You know I did that.
• 1:12:07
  Speaker 3: I'd be like, hey, here's a bedtime story for adults, because I think adults could use a bedtime story from time to time.
• 1:12:12
  Speaker 3: But um, yeah, yeah, have you?
• 1:12:14
  Speaker 2: have you seen paul julio's stuff?
• 1:12:16
  Speaker 1: I haven't, no no, jim bro, just yells at yeah, he just yells at the camera.
• 1:12:21
  Speaker 2: All his, all his videos are literally a video.
• 1:12:23
  Speaker 2: Go to the gym.
• 1:12:24
  Speaker 2: I don't care that you go to the gym.
• 1:12:26
  Speaker 3: Yeah, I'm sure you just like shut up you need to go to sleep or I'm gonna put you to sleep I think he did a video, actually go to sleep and I was like actually I don't mind this.
• 1:12:37
  Speaker 3: This is the one video I don't mind where he's like go to sleep, turn your phone off, right.
• 1:12:40
  Speaker 1: I'm like you know what know what.
• 1:12:41
  Speaker 1: That's fair, that one.
• 1:12:43
  Speaker 3: I can do.
• 1:12:43
  Speaker 3: I don't have that same physical presence to be able to pull that off, I think.
• 1:12:48
  Speaker 1: You should just follow a pillow at the camera.
• 1:12:50
  Speaker 2: Just like go to sleep.
• 1:12:51
  Speaker 2: That's a good one too, but I think you should just put on a nice smoking jacket, get a pipe sit in your chair and the camera just comes around and you're just like, I guess it should go to sleep I should be taking notes.
• 1:13:05
  Speaker 3: I should be taking notes on that.
• 1:13:06
  Speaker 3: I like it.
• 1:13:06
  Speaker 3: I like it absolutely.
• 1:13:08
  Speaker 3: Let me tell you the reasons why you should be sleeping based on the data you know.
• 1:13:13
  Speaker 3: A more sophisticated plea for sleep?
• 1:13:16
  Speaker 1: yes and relaxing, and then the last and the last like minute or whatever of the video is just like white noise or something, just like go to, and then you just let it fly.
• 1:13:25
  Speaker 2: There's something that's brilliant, we'll figure it out.
• 1:13:26
  Speaker 2: There's something here.
• 1:13:26
  Speaker 2: There's something here.
• 1:13:27
  Speaker 2: There's something there.
• 1:13:28
  Speaker 2: For sure, for sure, don't be your worst.
• 1:13:32
  Speaker 1: Don't be your worst.
• 1:13:33
  Speaker 1: That's our tagline.
• 1:13:34
  Speaker 3: Don't be your worst.
• 1:13:34
  Speaker 3: The theme for today.