74: We’ve Been Getting Sleep Wrong! – The Shocking Truth About Rest, Recovery & Longevity with Dr. Christian Jenski

It's basically how do you feel after you've allegedly slept well, you know, you go to bed, you maybe fall asleep fine. You think you slept fine. But do you wake up feeling invigorated, rested and recharged? Or do you drag your butt through every single day and require lots of caffeine in the morning? Do you have low mood, do you have apathy or these things that kind of go along with this inefficiency of yours? It's obvious if you can't fall asleep and you just laid there all night awake, that you know you're not having efficiency. But what if you do fall asleep fine, but your sleep maintenance is not good, then clearly that's gonn lead into poor sleep efficiency.

Welcome back once again everybody. We were actually gotten a conversation about some fun things about sleep this episode we're going to talk about sleep, but specifically what can you do about it? Last time we talked about all the things about sleep, why it's so important, why you got to make sure you get adequate sleep. And today's the so what? What can you actually do about it? If this information is useful or helpful for you, please like share. Subscribe below. That's how we get this information out. Also, we'll be doing a question and answer session at the end of this. After this goes out on our social media channels, we'll collect those and do a Q and A session. And if you subscribe, you'll get notified when that happens as well. The other thing is about this, we cannot diagnose or treat anything. In this time together, you should have always discussed anything you learn with your primary healthcare provider and not institute any treatment or medical thing without discussing with them is first. Because this is for educational purposes only.

Yes. All right, so logistics aside, now let's get into it.

So we're talking about today. We've already talked about sleep, why it's important, what it is last time. Today we're going to talk about sleep initiation, sleep maintenance and sleep efficiency, which are how we look at functionally at sleep disorders. And then we'll talk about what you do for each one of those. I'll talk about medications. Yeah, medications and herbs and things. I feel like this will be really helpful for people and we can take a couple deep dives into naltrexone and trazodone, all kinds of stuff.

So I think this is where the rubber meets the road and this is what people have probably been waiting for with regards to at least the sleep topic and potentially stress. If their stress is derived from sleep or their sleep is jacked because of their stress? I mean, it's again, it's always loops.

So what is sleep initiation?

Simplest way to describe sleep initiation would be the falling to sleep. Right. How do I, how well do I fall asleep along the same lens of that, I would say sleep initiation involves what I call sleep hygiene. So what's the process building up to that? Do I go from falling asleep on the couch while a TV is on with a bunch of artificial light to just like getting into my bed barely and falling Right. Asleep, or do I have a process where, you know, I'm dimming the light as the day gets darker, I'm turning off the WI fi at night, I'm not staring at a blue screen. Maybe I'm using some blue blockers. I'm not eating within two to three hours of bedtime, I'm not taking any caffeine. And you're working up to the point where you're going to be, you're trying to set the stage for being successful as when I hit the pillow, I am going to fall asleep shortly thereafter. Room has got to be climate controlled to what you prefer. Bed's got to be comfortable, pillows got to be appropriate. Hopefully you're brushing your teeth and flossing. Go to the bathroom, empty that bladder and then get in bed. Do I fall asleep? To me, all of that is initiation.

Yes.

What do you think?

100% agree. Initiation actually starts when you wake up that morning. And you mentioned caffeine. Yeah. The half life of caffeine is six hours, which means if you do four cups of coffee at 8:00 in the morning, you know, six hours later, which will be 2:00 clock in the afternoon, you've got two cups of coffee in your body. Six hours later at 8:00', clock, you've got the equivalent of a cup of caffeine in your body. So if you have a big. Even if you stop your caffeine by 12, but you're drinking too much in the morning, that caffeine exposure in the morning stacks up, can stack up. Yeah, that's something important. And to think about the other thing about it is the temperature in the room, you know, ideally about 65 degrees. I like it not quite that cold, but that's a huge factor. If you keep it hot, that will impact things, you know, things like core body temperature. Having your feet like a little cool actually affects your core body temperature, can improve sleep. That's the reason that you have these things like these sleep mats that people Mats and my wife got pads. Yeah, that actually helps with that. Probably just cheaper to have your room cool than it is to buy a $2,000 chili, especially this time of year. Yeah. The other thing about those things is that I worry about molding them build up. Cause they're just basically contained water and a thing. And if they leak, then you have issues with that. Yeah.

We set our thermostat to 65 to 66 every night.

Save some money too. Yeah. And then the food thing is important that you mentioned. If your gut is working on digesting food you ate an hour or two ago, that's going to impact your nervous system, which is the primary regulator, instigator, maintainer and awakener of your whole sleep cycle. And so if you're digesting a lot of food, you might fall asleep. But you. You know, again, looking at your heart rate variability, I've learned personally, if I eat within an hour or two, I can actually watch my heart rate be a little high and watch it slowly go down and my variability slowly go up. Yeah. Correlating with I just ate four, went to bed versus if I go to bed three hours after eating, it'll pop up really super quick. So those are again, sleep initiation. It's that whole prep time.

100% on the random nights that I eat anything after dinner and we eat dinner early, we eat dinner at like 5:00'. Clock. Maybe that's not early, but we think compared to the general population, that's early. So we eat dinner at five o'. Clock. If. And I'm in bed by nine. If I eat anything in between, I don't dream that night. And I've correlated that in myself already. And I check my sleep scores over a Fitbit and it. My sleep gets jacked. So I know that to be true for me. Now, is that true for everybody? Probably. But the timing of which, the general rule of thumb, about two hours before bed, you shouldn't be eating anything. And the caffeine thing is absolutely true. I think there are layers. It depends on some of your cytochromes. If you're a rabbit or a slow metabolizer, some of us can drink caffeine and churn through it pretty quickly and not have that negative effect. Others, it's in your system forever and ever.

But didn't you say your heart rate variability is not.

It's not great. That's for other reasons. Like my boss. No, I'm just kidding.

He's. He's a hard. He's a hard guy. Yeah.

All right. So that's sleep initiation. Next stage is sleep maintenance. Why don't you talk about sleep maintenance?

So sleep maintenance is just the time from when you go to sleep to the time you wake up. Do you stay asleep the entire night? Now, the interesting thing is you will awaken, and I can measure it. I wear my aura ring, and I see every time I wake up. But you don't remember those, because if you have a short awakening and you get back to sleep within 30, 40 seconds, you won't actually remember that awakening. If you're up for more than two minutes, you actually will remember that awakening. And so sometimes the maintenance, you might feel like you're sleeping all night long, but you actually, if you track it, you'll see no, you're waking up a ton. It's just that it's not long enough for you to remember. So that's something interesting to remember as well. Which. Which is important if you have sleep problems. I think tracking it helps you figure stuff like that out. You might be, I sleep all night long, I'm still tired. When you track it, you're like, well, there's no rim, there's no deep.

And I was tossed in journey. But you didn't even realize it.

Or what you'll see is like, you have movement and these big jumps and you, like. Then you can look, your oxygen levels kind of go down. Like, wait, you got some sleep apnea.

Right.

So it's really useful to track that. But maintenance is basically that phase most people, when they will complain of, like, waking up, like at 2 or 3 in the morning, I can't get back to sleep. That's definitely part of that. But maintenance is also that asymptomatic part where you are waking up a lot but you don't realize it.

Yeah.

And that really requires some kind of tracking. Yeah. To figure that out.

What leads to dysfunctional maintenance.

So that could be a lot of things. If you have restless legs, for example, which is a movement disorder that can be driven by low iron levels. You know, my ferritin is kind of low, and if I have sugar before I go to bed, or drinking alcohol, which I don't drink anymore, I would have some restless legs. Other things that can affect your maintenance is actually when you eat, because, again, you're activating your GI tract, you're digesting food, you're not going to. You're more prone to have issues with maintenance cortisol spikes. Something we had actually talked about before is if you have a sugar drop, if you're a carboholic and you can't go without four or six hours without eating, or you get, get, get hangry. You get kind of irritable, and you have a sugar drop in the middle of your sleep. You know, you will have a adrenal. Actually, you'll have a cortisol. Insulin will start. You have a cortisol spike. It'll drive your sugar up, which.

Drive insulin.

Yeah. Which then drives also a norepinephrine and epinephrine spike. And you might wake up. And so all of a sudden that, you know, if you can't go without eating for six or eight hours, you. Because you have metabolic issues. That's how your diet and your gut can play in with this maintenance.

Yeah. And it's not even just eating before bed, but what your nutrition is and what your glycogen stores in your liver are and what your, Your metabolic flexibility is. All of that plays an absolute role.

Yeah. That's where some of nutrients come into play. Because if you have magnesium deficiency or chromium or selenium or other things, your.

Insulin receptors aren't working.

Yeah. So you have more prone to have issues with that.

And then you'd mentioned autonomic instability.

Oh, yeah, that's. Yeah, totally figured out that one.

Yeah.

So one things we see a lot of is dysautonomia. And the more common, the more popular thing people see is pots, which is basically you kind of pass out, feel lighthead and dizzy. But unfortunately, that's really common in our chronic fatigue, Fibro mold, Lyme patients, mast cell patients, hypermobile patients, autoimmune patients, patients with GI tract issues. Like, that's CIRS. That's 90% of what we see.

Oh, God.

Yeah. And so there's people. If you look at, if you have hypermobility and MCAs, about 60% of those people will actually have a correlating dysautonomic thing. So that's. I can't assume people have that. And what that is, is, is basically you have a surge in your sympathetic nervous system while you're sleeping. And sometimes that looks like people. Like if you're sitting on the couch, kind of relaxing, all of a sudden your heart rate just starts to go up. You get like a sudden panic hits you for some unknown reason, just when you're doing whatever. But when you're sleeping, you might wake up suddenly kind of in a startled state. And some people, that looks like night terrors, when people have these horrible dreams that they literally waking up, wake up from frightened or horrible nightmares. Those are all things where. And again, these are regulated in your hypothalamus, which we talked about earlier on those expressions of dysautonomia can affect that maintenance, but also affect deep and REM sleep in that if you don't get in a really safe place, so you're more parasympathetic than sympathetic than that dysautonomia, that irregulation irregularity in your all nervous system will affect that maintenance phase which you want to be optimal to get your REM non REM light sleep. So, so that, that plays into efficiency, which is when you wake up, you feel well rested. So why don't you touch on efficiency?

Yeah, efficiency, as you just mentioned. I mean, it's basically how do you feel after you've allegedly slept well, right? Well, you know, you, you go to bed, you maybe fall asleep fine, you think you slept fine. But do you wake feeling invigorated, rested and recharged, or do you drag your butt through every single day and require lots of caffeine in the morning? Do you have low mood? Do you have apathy or these things that kind of go along with this inefficiency of your sleep? And it's obvious if you can't fall asleep and you just laid there all night awake, that you know you're not having efficient sleep. But what if you do fall asleep, fine, but your sleep maintenance is not good, then clearly that's going to lead into poor sleep efficiency. And at that point in time, it's what's the underlying mechanism? Is this obstructive sleep apnea that we had a lengthy conversation about and you know, in the last podcast talked about how to diagnosis and what it looks like and how it shouldn't be the stereotypical person that you think it might be, and then again how to treat it. But then in the previous podcast prior to that, we talked about the importance of mitochondria and these patients with chronic illness and mitochondrial issues, their sleep efficiency isn't great and so they wake up feeling unrested and sometimes they're the ones that are getting the appropriate amount of sleep or more. I'm sleeping 10 hours, I'm sleeping 12 hours, and they still feel tired or worse. So what would you say to that with regards to the sleep efficiency? I mean, what are your thoughts on that?

So some people, I kind of go back to some of the older literature that's over a hundred years old with that thing we mentioned before, the neurasthenia, where it's a weak nervous system, yeah. And so you know, you know, some animals need to hibernate. And so it's, it's really interesting. If you look at sleep curves, there's this U shaped curve for sleep. And so if you get the inflection points are 6 hours of sleep at night between 6 and 7 and then 9 to 10. So optimal longevity all cause mortality. We talked about before, you know, dying for any reason whatsoever. The, the lowest all cause mortality is that seven and a half plus or minus spot. Once you get, start going to less and you get that six and a half to seven, that's when you start seeing a going down. Sorry that, that six or seven, that's when you start seeing the all cause mortality. Mortality like skyrocket up. When you get involved nine or ten, you start to see it skyrocket up. So when people have like sleep like long periods of time, there's a concern of, there's something underlying that's increasing your risk for dying for under cause. There's that aspect of it, but there's also the aspect of it that when you have hypothalamic pituitary dysregulation, when your autonomic nervous system is dysfunctional and when you get sick, when you have flu, whatever you need to sleep, you might sleep 12, 16 hours a day. There is a component of people who just need to get that deep. You just need to sleep for maybe 10 or 12 hours a day and just. It's like almost going to yoga ville we talked about before getting away for like a month because you're not getting adequate deep in rim. The kind of way you make out for it is getting, getting enough of the light sleep to make up the difference. That's not the same thing as saying I've been like that for the last three years. Because then you may have a parasomnia, maybe you have narcolepsy. And those are totally different things where you actually need to get evaluated with a sleep. A sleep test. Yeah. And that needs to be in a sleep center. For a lot of my people with like fatiguing illness issues, I encourage them to sleep after we get a sleep apnea evaluation. If I think they might have narcolepsy, which is an issue where you, it's an autoimmune issue where your body's not making this thing called Orexin. And so you, you actually aren't getting into quality sleep, then that requires an actual polysomnogram to be done. And some people will have different parasomnias or fancy ways of saying sleep disorders. Where they, they, they have cataplexy or catalepsy where they either like you just basically aren't getting the quality sleep. And it's actually a brain based issue. You have to actually diagnose that with a, a sleep study.

You have a brand new patient with idiopathic hypersomnia is her diagnosis.

She has sleep like a polymer.

Multiple sleep studies and initially it was not caught. They were, she was told normal, normal, not narcolepsy, not this. And then she had a couple of pregnancies, it got progressively worse and ultimately she went and had another test done and it was positive for, for idiopathic hypersomnia. So they're treating it at this point in time, but I think she's getting a reevaluation for narcolepsy. But I'm working with her right now and I think I know what else is going on and so we're going to work on that. And I'll tell you, it ties to the mitochondria.

Really?

Yeah.

So ultimately if you have a sleep dysfunction, you have a mitochondrial dysfunction, so you gotta like get down those things. Yeah. Sleep can be difficult because there's so many things that play into it. So. Yeah. So what do we do about it? Great. So I think we're playing good cop, bad cop here for a bit. Just of our brief conversation before. So lots of things we can do about sleep, we're start with medications, you know, probably the place people don't expect functional medicine. People just start. But this is where I cut my teeth in primary care for 15 to 20 years. So I've been working this for a while. And then it's funny how a lot of this has translated into the functional medicine world.

Yeah.

So this might be, I want you to talk about each one of these first because you're going to come from it from a purely functional perspective. And like benzos, for example, benzodiazepines, you know.

Yeah.

Don't love them. Don't love them. So what are the problems with benzos?

Dependency. Dependency. Long term ramifications associated with things like dementia. I think there's correlation with Parkinson's as well with chronic benzo use.

If, if, if you. Ambien particularly, and this is, this data is insane. If you take ambien more than 15 times in a year, you have an increased risk for all cause mortality.

That's crazy.

So how many of our patients have been on them daily for years? Yeah, you mix it with a little bit of alcohol and all of a sudden you have these episodes where People can walk and do things they don't remember. It's almost like a roofie. Yeah, this actually happened to my wife and I. We were going on a honeymoon on the plane, you know, we just got married, all excited, and you get your free, you know, glass of wine on international flight. And yeah, took our little ambient because you want to sleep. And then, you know, and she didn't remember the next six or eight hours. Yeah, spilled stuff in her lap, woke up, freaked out. She's like, someone could have done something to me. I'm like, you're here. But it was. That was the first time I actually experienced, like, wow, you do not mix these things. That's.

No. And I. I've seen with Ambien these kind of hyper, acute anxiety and panic episodes as this, like, rebound phenomenon. Almost like, you know, Benadryl is supposed to be sedative, but when you give certain kids, they actually get wild. I've seen this happen in acute anxiety reaction. And then also the sleepwalking stuff, benzos. I mean, look, if you're having a severe panic attack and you require an emergent treatment, and this is what I did for 20 years. I mean, I gave my fair share of Valium and Ativan in the ER iv, a couple milligrams. We used it for sedation in procedural situations. But I think chronic use is concerning to me, and I think that's problematic. And a lot of people are relying on these just to get a good night's sleep. And over time, that becomes an issue other than Ambien benzos. I know there are others that were going to talk about, but let's. I'll let you kind of touch on this one because I know you utilize this one no matter what hat, medical hat you're wearing. And I think it's because you know enough about it and it's efficacy, but also safety. And that would be Trazodone. You want to speak to Trazodone a little?

Sure. Trazodone. Well, sure, I'll talk to Trazodone. Go back to the benzos. Actually use them a fair amount with certain types of patients. Yeah, sure, go ahead.

Go do that one.

So benzos. I remember early on my career because benzos are bad, they're addictive. I got that later. Learned about how bad Ambien. Ambien was. But, you know, there's certain patients I'd see that who. They needed just a small amount of clonidine. I'm sorry, Klonopin. That's another thing. Like 0.25 milligrams. It was almost like they would just lick it and that was enough. They'd sleep, they felt it calm them down. And what I've learned now with all the mast cell stuff. Yeah. Is that benzos actually are mast cell stabilizers. And in some patients with mast cell issues, sleep disturbances. I have a young child I'm working with and this, you know, is kind of insane. Dysautonomic young kid with mitochondrial issues was dysfunctional for the first. He's. He's 15 or 16 now. Was dysfunctional for like six years of his life. Not in school. Did a bunch of things with one of the things I actually did that helped improve his sleep quality. Now he's actually thinking about going to college at 16. When I first saw him, he literally would just lay down on the exam table and couldn't. Wasn't hardly functional. Was. I started using a slow, low, low dose of a benzo or clonazepam. And had a massive impact on not only his sleep, but he also had issues with. He couldn't drive anywhere more than half. So they couldn't go to the beach because driving to the beach would make him so crazy dizzy. And the touch of the benzo eradicated that vestibular dysfunction related to driving. And so it's a unique situation where that had a profound impact on him. And I use it with my mast cell patients with sleep disturbances. But that's a more nuanced use of it in general, the answer is no, don't use it. But in the mast cell world, which also includes POTS and dysautonomia and chronic fatigue. And it does have some utility to it.

It does. Well recorded and it's in my last ditch Hail Mary effort for my mast cell patients. I'm using everything else before. I will do that, but I can't say that I haven't done that.

Yeah. And I think it's also like practice styles. Cause you know where you're at, you were probably used to the seekers and users coming to get. Oh yeah. And when in my. And I cut my teeth where it's like people coming in. I remember when I was in the military, people taking Klomp and 12 milligrams four times a day. It was just like you're on the.

Front lines where you're seeing these individuals over and over again for the same complaint and you're trying these things and it's not getting better. And inevitably something makes it better. Why not? I'm on the other side of that spectrum where I'm seeing all of the downsides and complications that we're talking about of abuse and overuse and sometimes intentional over ingestion. So, you know, it's like we said, bad cop, good cop, good.

Yeah. So I mean, you make. If the kid gets a hold of the bottle of stuff, it. Yeah. Kills them. You mix it with alcohol and then you can stop breathing. Yeah. Trazodone is interesting. It is. Was originally FDA approved as an antidepressant. It's kind of one of those older dirty medications. It's got some serotonin, some norepinephrine, a little bit of anti tricyclic activity to it. Very sedating. So it never really made it in the depression world because it made people too depressed to use it. It made them too tired. Yeah. But it actually is now one as the most highly recommended medication for sleep in the elderly because it's so safe. You know, one of the things with benzos, benzos and elderly for sleep increases the risk for fall, increases the risk for hip fractures. Ambien, I mean, actually, that's where some of the dementia stuff comes into. Older individuals on Ambien. Yeah. So trazism's kind of risen to the pack with that. But interesting enough, it actually improves deep sleep. So if someone's having a problem with sleep maintenance and efficiency because they're not getting that deep sleep track and they're not getting that deep sleep, a little bit of Trazodone actually can be pretty potent. I've had multiple patients who. It's been like a godsend for them. It's a simple thing, pretty basic, easy to try.

Yeah, yeah, I have no issue with that one. I have a couple patients on it. They need it, so.

Yeah, so gabapentin.

Yeah, gabapentin. Gabapentin. In the world that I previously existed and currently exist. I see this more. So for neuropathy, chronic pain, diabetic neuropathy, small fiber neuropathy, sometimes musculoskeletal muscle spasm, that kind of thing. I do not use it for sleep, although I have some patients that have used it for sleep. What's your experience with it?

Well, restless legs. Yeah, it's one of the many medications used for restless legs. And how many of our patients with dysautonomia have small fiber neuropathy?

A lot.

Neuropathic. Yeah. POTS is like one of the secondary forms of dysautonomia and you can use it for that as well. How many are patients I have, and I put Pain actually at the very bottom. But how many people have sleep disturbances from pain? Yeah, they have some weird neurological. They're a post Lyme patient. They're a COVID patient who's got horrible pain after Covid.

Yeah.

Or. Or a TBI patient. You know, Gal pain can be really helpful in those patients with their sleep. It's fairly safe medication. It actually was originally FDA approved as a seizure medication in the primary care world. We started using it for migraines. People got used a lot.

Yeah. It was used for trigeminal neuralgia as well.

Yeah, we cover. Mesopeam is used a little more of that. Yeah. Which has more negative metabolic consequences. But you can use it for that as well. And it's interesting to try genital neurologies when these weird neurologies I had. I've had one or two patients have it related to their Lyme disease, you know, which is interesting. But so it has some utility. It's not my number one thing, but maybe let's skip the pain. Because if you have pain, whether it's arthritis, in our world, we have a lot of people weird neurological pains. The hypermobile world, people have fascial pain, just have weird joint pains. Cervical pain, they'll get occipital pain from nerve tension from the fascial stuff. These things called myodural bridges, which are in your arachnoid space, get stretched out and cause weird spinal kind of issues. Pain can become a big issue with sleep. I've had some patients who've had sleep disturbances. I've done trials, different pain medications and had NSAIDs. Actually. Ibuprofen lower the inflammation up so they sleep well. So the thing about, with some of these medications, you have to keep in mind is that if you don't sleep, it's just as bad for your health as smoking. That's a big deal, you know. So you also have to balance, you know, risk, benefit. You know, is what I'm doing gonna be helpful or hurtful? This individual. I think we're starting with these. Cause these are where in the functional medicine world people usually don't do any of this stuff. Yeah, they usually hop right to like the herbs and. Yeah. Which we're going to talk about.

But. And we have to some extent. But it's. It's nice to provide information for all demographics for individuals that are looking for any medicine that's going to help them get better. And from a pain standpoint, I love Lotus naltrexone. I mean, LDN as we call it. It's to me it's a panacea at this point in time. Studied in the late 90s for chronic pain patients determined that in a very, very low dose, it paradoxically would block the opiate receptor and then wear off, thus resulting in a paradoxical upregulation of those opiate receptors and more endorphins. So in English, by using something that blocks pain receptors, the body responded by making more of its own pain medicine and more docking sites. And so patients pain would get better and they were like, well this is interesting, let's study it some more. We now know that it's anti neuroinflammatory, it's promotility for the gut. It's got immune regulatory properties in particular th17 so these autoimmune phenomenon that we see. So I'm using it in chronic pain patients. I'm using it sometimes for sleep or mood, I use it for chronic fatigue, I use it for autoimmunity, I use it for chronic Lyme, I use it for sirs, I use it for long Covid. I sprinkle it in the water a little bit. I just think it's just so impactful and beneficial that this is one of these ones that I'm thinking of a patient again, like I know you do this too. Like as we talk about these things and we're discussing the global nature of these concepts, I'm just thinking about people that I've treated. And so I'm thinking about this one guy used to come in here, he's still a patient and he would come in and would just be a little bit rough with everybody and, but always nice with me. But just everyone else just kind of rubbed him the wrong way. And it got to the point where people were a little bit unhappy about that. But I said, you know, he's in pain, let's just give him the benefit of the doubt. I got this guy's inflammation down and put him on some ldn, did a couple other things. Comes in the next time. He's as polite as can be, he's happy, he's treating everybody with respect now. He comes in all the time, he gets IVs, he's here. It's just you took the guy's pain away. He became a completely different person. And I just saw that in real time. It speaks volumes about what was happening to him physiologically that he didn't want to be that person. It's just how he felt, right? Like that's the reality of getting someone's pain under control. So what are Your thoughts on ldn?

Well, pain is the other sixth vital sign besides sleep, right?

Seven.

Seventh guy's the seventh. Yeah, let's keep on making more violence. Yeah, let's do it.

Have you ever lost trust in your own body or in the doctors who were supposed to help you heal? It happens to millions of people who are stuck in the cycle of prescriptions, tests, and more questions than answers. That's why Dr. Aaron Hartman wrote his new book Uncurable. As a physician and a parent, he's lived through the pain of being told there's nothing more we can do. But instead of accepting that, he built a new path, one that combines traditional and functional medicine to uncover what's really driving illness. Uncurable is more than a book. It's a roadmap to help you find the root causes your doctor might have missed, reactivate your body's natural healing systems, and finally believe in what's possible again. If you've lost hope or trust in the system, this book will help you take back control. Go to UncurableBook.com and grab your copy along with Dr. Hartman's free resources to help you start your healing journey today.

LDN is awesome. That young kid I mentioned before with the dysautonomia, one of the things I put him on as well is ln my autistic kids typically get. It's one of the first things they get on. You know, it's helps with pcos. If you have a young female with PCOS endometriosis that can act with fertility issues, this can actually help them abate those and help with fertility issues. And it helps maintain the placenta during the first trimester. So it's. It's really. There's a Dr. News. He's a like a functional fertility guy in Beverly Hills, kind of old dude with cool glasses and wears all the cool. The flame bowing kind of clothing. And everybody around, from around the world comes, sees a guy and he uses this a bunch and his fertility patients. And that's kind of turned me onto that. LDN is lirasal. Trexone is pretty amazing. I have a few patients that actually is amazing for their sleep. Typically, it can disrupt it, but some people, it can be amazing. One thing I want to talk about, though, is, like, in our local community, we do have some physicians who see naltrexone. They're like, you know, the narcotic abuse. Yeah. Drug abuse. These radars. And they kind of get like, what these functional people doing.

Yeah.

At the same time, I'm having The neurosurgeon from across the street call me about a pain on his patient asking about naltrexone because he's read in his literature it can be helpful for spinal cord injury patients. And I'm talking to him. So it's one of those things that is lots of data. It's not. There's no. No one is advertising for it in our medical journals. You're not going to see an advertisement for it.

Yeah.

So unless someone goes looking for the information, they're not going to learn how useful it is. They're only going to think this is for opiate abuse, drug abuse. Yeah. Fentanyl crisis and other.

Which is insane. And I mean, that being said, like, I'll play devil's advocate. I came from that world. I worked in the er. That's all I saw. We would use Narcan to bring people back from the dead. But I didn't come into this assuming that that was going to be something bad. You know, you do your research, you see what the data shows, you talk to patients about it. They're willing to try it. I've personally been on it. And it can be an absolute game changer. And then you use that anecdotal data to just continue to build your case for using it. And the reality is, is that this is something that I think is. It is overlooked. I remember that patient that reached out to you just because of something she saw write or post. She had long Covid. She convinced her primary care doctor based on something you wrote or said to get her a smldn. And it completely changed her life. And she reached out to you to thank you for that. You never even treated her. Never even matter.

Yeah.

And it was just because you provided some information like that to me. That's a game changer.

That was so cool. I was actually a TV interview during COVID Yeah. During what was going on. And that was.

She saw it and talked to her primary. Who did the right thing.

Yeah.

Did his or her research and then prescribed it.

Right.

That's awesome.

That's the way that's the practice of medicine.

All right, well, let's talk. I'm gonna let you talk about these others. So talk about.

I wanna say one extra thing about daltrexone. So this is where I think with the kind of medicine we do is like deep medicine.

Right.

So we talked about naltrexone, all the cool things with it. In one of the groups I'm in, there was someone who heard about naltrexone for Pain and for all these things and gave the patient a 50 milligram naltrexone didn't help them at all. If you look at the literature, which is interesting about how opioids work, the 50 milligram naltrexone long term is associated with and increased risk for certain cancers. Lotus Naltrexone is used in the integrative cancer world all the time as an adjunct to cancer therapy. So this is one of those things that is so nuanced and it's so cool. But the dose, the details are in the dose. You know the FDA has a drug called Contrave, FDA approved for weight loss. It's 8 to 16 milligrams of naltrexone twice a day. Some people can't tolerate. So we microdose them now. And that's more the practice, that's anodical practice. But I had one young lady who had breast implant illness, horrible dysautonomy, pot, all that kind of stuff. Pots got her implants removed, made it, she got 80% better, still had some symptoms. We talked about naltrexone. She could not tolerate it. I used it topically on her scars for breast explant to minimize scarring and she could tolerate that and it helped her so much. So for her the topical 1% was all she could tolerate.

I gave someone topical naltrexone for psoriasis. Made it go away. I gave someone topical naltrexone for rosacea. Made it go away.

Yeah.

That's awesome.

Yeah.

And talk about the holiday because I was not aware of.

So this is something I'm working on a currently working on a fellowship in personalized medicine through usf. And one of the lectures, the main ladies who's drawing, Dr. Pam Smith. She's like a 20 some thousand books on hormones and all kinds of stuff. She's incredibly been doing this for 40 years. She actually started out as an ER doc, so she's your people but. But she's actually the head of like the LDN Trust which is a consortium of professionals and experts that kind of are showing information out there. One of the things she was sharing is that one of the newer things is actually doing a holiday, like a three day holiday every month to help prevent this, the tachyphylaxis or like a tolerance to the effects of the low dose naltrexone. So I haven't implemented that quite yet but that's something like half the press.

Yeah, like literally I just, it makes so much sense. I mean we Know that receptors get downregulated or upregulated or become resistant. So this is a way to prevent that from happening and increase the efficacy of this drug.

Right.

Like, it just makes sense to me.

But I feel like, like. And this is one of the things I want just we can leave from here is like, in functional medicine, this is what we do. We take one thing we can do this whole podcast about. Thanks. Great. And yeah, I mean, if you have questions about LDN trust out there, it's. It's not hard for anybody to find. And it's just surprising me. It's within today's information world that we still get pushback on something that's so safe. One of the. I'm in this group, this called Genius Genius Network. And one of the things they're doing is helping with addiction recovery. And they're do. They're helping support trainings across the country, cvs, Kroger, where they're giving out Narcan spray, people. Just. Because if someone gets a fentanyl overdose, you can save their life.

Yeah.

It's so safe that they're giving out training people to get.

It used to be just first responders, and now it's general public now.

Fentanyl's so bad, it's not been giving out to everybody. But the point is, like, that's how safe it is.

Yeah.

So. And we're talking about low doses.

Anyway, let's dive into.

I want you to talk about cloning, cloning, guafacin.

So what are they doing? And what population are you typically?

So these are. Yeah, these are Alpha 2 blockers. And what they do is they. They affect. They block the effects, the release basically, of adrenaline and noradrenaline. Okay. Which is a part of your sympathetic nervous system. Noradrenaline is more in your central nervous system, and adrenaline is more in your peripheral nervous system. So when you do your neuronatomy, you'll see. And this is not 100% the case, but usually the noradrenaline is how your. How your sympathetic nervous system is. That's how your nervous neurons are connecting in your central nervous system. Epinephrine, adrenaline is how the peripheral. Hence, epinephrine. You know, when someone xenophylaxis. Yeah, yeah. But then you'll do like a nordine or norepinephrine to, like, for maintain blood pressure in the icu. So we have different uses. These are actually blocking the release of that. And so what happens with dysautonomia, one of the types of dysautonomia is actually an adrenergic Dyson where people release this stuff and you'll see it with people having panic issues, panic attacks, anxiety, they get sleep disruption so they might wake up panicked. If you have ptsd, we've known for since Vietnam that you'll have night terrors, which are guys in, you know, Vietnam, other wars and gals wake up in cold sweats. Crazy we know about. People just get old fashioned nightmares. This is a part of dysautonomia that's impacted by your bacteria hypothalamus. And you can actually block that impact by these kind of medications. Prazosin has a lot of research behind, specifically behind night terrors. Now to put this in perspective, these drugs were originally produced as blood pressure medications. So people are familiar with doxtazosin. Prazosin was another one, Clinine, methyl dope or guanfacine. Here. Methyl dope is one of the approved medications to use in pregnancy because it's that safe. Right. So what we do is we repurpose these, which is one of the things that happens. And you use them specifically for people with sleep disturbances related to dysautonomia and the chronic illness. So these are medications like, if you have someone who's like, I'll wake up panic palpitations who, you know has dysautonomia. Right. If you have someone who's night terrors, you know, night terrors are more common in kids. Some kids get night terrors. Right. You can actually use these to help improve their sleep. But. And you do a therapeutic trial like anything. You do a therapeutic trial. If a diabetic patient comes in, your sugars are high, Try metformin. It gives me diarrhea. You try, you know. Yeah. Whatever it is.

And so the clinical correlation.

Yeah. And you see is clonidine.

Clonidine also has some efficacy on the MU receptors, the API receptors.

It does a little bit, yes.

Because we used to use that in the emergency department for withdrawal. So it has some activity there as well. I guess my question is, can you use clonidine and ldn or would they Again.

Yeah. You're not. It's not. There's not.

There's no antagonism.

Yeah.

Awesome.

The one. This is anecdotal about the ldn. The patients I've had on LDN who are also a narcotic for their chronic pain. It actually worked better.

Well, that's suboxone, isn't it?

That's.

Well, Suboxone is, is like an opiate agonist antagonist. So it's a similar form philosophy.

Well, the philosophy of that is it's to try to prevent abuse.

Right.

So you can't crush it. Snort. If you do that, you basically won't get the effect. You can only do it orally. The naloxone is not. Was not absorbed by mouth. Naltrexone is.

Yeah.

So it's. It's oral naloxone. So if you crush up and snort it, guess what, you don't get the hit. Right. Take it by mouth. Only the narcotic is absorbed. So that's the reason that's done like that. But yeah, I was wondering just partly because the whole effect of naltrexone, because it does downregulate before it up regulates the opioid receptor. It feels like enhancing the impact of the. This one lady was taking Percocet for fibromyalgia.

She needed less than that.

She got her off of it. I used naltrexone to get off of that. But when she would have some flares, she would take her Percocet and said, oh my gosh, it works so much better now. I never recommend her do that.

Yeah.

It's contraindicated. But it was just kind of interesting how in her situation, beyond the nurse, naltrexone enabled her to get off of the opioid pain. Caveat to that. If you're on chronic narcotic, I'm not going to give you naltrexone.

Yeah.

Because withdrawals too. But those are just an anecdotal case of someone who went.

Yeah, but I think that's just more proof that the opiate receptors are upregulated. The same dose of medicine was working better.

What's interesting, chronic opioid use is associated with increased risk for infections.

Yeah.

It suppresses your count. Yeah. It also causes, over time, actually upregulates, you get increased centralized pain. Yeah. So it does the exact opposite of what it's supposed to do.

Yeah. And exposure got down, which affects your. Your immune system.

And you know what the opioids also do? They also release mast cells. Right.

Bad news.

Yeah.

So they're all just bad news.

And then on pain medications, the main thing, you know, when people have sleep disturbances. I did mention tricyclics here.

Yeah.

One interesting about the tricyclics is they also. Many of them have antihistamine effects. With some patients with some mast cell issues. Yeah. With some neuropathy, with some migraines, you can use like a Nortriptyline, amitriptyline on these individuals and get some nice effects from them. Again, I cut my teeth using these. I used to use them all the time, migraine patients, and they work so well. And the question now, in hindsight, how many migraine patients had mast cells?

You were having a cholestyramine moment, right?

Yeah, yeah, exactly. Yeah. It's like, I did this, but there's so many things I've done treating this.

And all these other things got better.

There's so many things I've done, I did early on my career that I just, you know, that's what a good clinician does. You recognize things. I'm like, huh. I just kind of hung them up.

Yeah.

And then, you know, 10 years later, I'm like, huh. Maybe this was what was going.

That's awesome. That, that retrospective kind of look back and, and. And then, I mean. But that speaks to the curiosity, right? That's, to me, what's rooted in functional medicine. It's. You were talking about it earlier, like, we can take this one thing and drill down on it. It's like, there are no shallow pools anymore. Everything is deep.

You drown everything.

Everything is deep. You just go deep on everything. Like, that's how it becomes like, I don't know how to just be superficial with my thought process anymore when it comes to these types of things, because you just want to know. You want to know more and more and more. But you've said so many pearls with regards to just, like, each of these drugs. We know what they're for, we know the one or two things they're for. But did you know the three or four or five other things that they might be for?

Right.

Like, and I would imagine that there's going to be more repurposing and more discovered as we move on. But that's.

So let's talk about. So we talk about some medications. I think when people. Most people listening to this are probably more interested in herbs, supplements, other things to help with sleep initiation. Yeah. Sleep maintenance, sleep efficiency.

Yeah.

So I'm going to briefly talk about the breath work. Just.

Yeah.

Real quick. And then I want you to talk, because we talked a lot about theanine, and I want you to kind of take that rabbit hole.

Sure.

I like looking at my sleep. You know, breath work is really interesting because it calms your nervous system down, activates your vagal nervous system. Personally, I will do about 15 to 20 minutes before I sleep at night. And it's interesting when I do holotropic Breathwork specifically. And I practice some breath holding. So I'll hyperventilate and you can look people, most people can look on YouTube and find out holotropic breath work and find this out. But I'll do that and then do slow breath work afterwards. So I'm basically increasing my CO2 levels, which is improving vasodilation. And then I'll have like five minutes of slow breath work maintaining that elevated CO2 levels. It's interesting. I get better deep in REM sleep actually. I've actually had times where I've actually been breath holding and falling asleep while. And I wake up and I start breathing again. And so it's really interesting how calming that can be in the right situation. Now this will look stream. But just doing box breathing something can be a powerful tool. And it's interesting. Like, just like the you mentioned, the sleep preparation starts, you know, hours before. If you do something routinely, you'll train your brain. The room's cold. I'm sleeping on my back where you're sleeping. Have my chamomile tea. I do my breath work and just these things stack to train your brain. Now I go to sleep. And so breath work is a super simple thing. Cost you nothing.

It's free, it's portable.

Yeah. And the thing I tell people, if breath work is good enough to train your box breathing is good enough to train Navy SEALs. And they're trained to do this to keep their head in the game in combat, so it can keep you from freaking out when people are shooting at you and you're shooting at them. Then it actually works, right? Yeah, so it actually works. So that's. Plus we've been using it in traditional Chinese nearby.

Yes.

And for millennia.

It's great for kids too. I mean, like, you don't want to just pump anything into kids right off the bat with regards to like supplements or medications or any of these things. Like working some breath work and add by subtracting, remove, remove the stimuli all the way up to bedtime. Don't let them snack all the way up into bedtime. Make sure their room is, is comfortable and appropriate for them and work on some breathing. My son and I do breath work every night. And it's because he started out of nowhere coming out and coming out of the bedroom and in an unexplained fashion, saying that he just didn't feel right. I don't feel right. I don't feel right. I feel scared. If you're scared all of a sudden he got, he got scared of the dark. And so when I go and say goodnight to him now to good night to him now, I put my hand on his chest. He says, here we go. And we do breath work and we take long inhalations and then prolonged exhalations and we only do a couple of them. And he is yet to come out since we started doing that. And it's our ritual and it. My daughter eavesdrops now she wants me to do it with her, so I do it with her too. So I get my breath work in before I even hit my bed. I'm doing it with my kids. But like so cool. I think it's transformed to sleep. And I don't. I haven't identified why he was scared. Maybe it was just phase or something. But this is now what he relies upon. And he. I see him doing his own breathing, like when he's getting. His sister's making him mad and he's getting worked up. So I think that's profound and impactful and we could probably have an entire podcast on breath work. Yeah, I know it was transformative for Becky. So I mean there's a lot there. All right, so supplement wise or nutrition wise or nutraceutical wise initiation. I like L Theanine. It's calming. It is one of these things that I just think is so benign. It hits GABA receptors, it hits dopamine receptors. So you get focus and mental clarity. But you're not hyper focused, you get calm. It's also an adaptogen. So as an amino acid, it's one of the few adaptogens. Cause most are typically herbs. And what it does is basically if cortisol is high, just kind of nudging it down a little bit and then it hits those GABA receptors, like I mentioned, there's not a lot of toxicity. I haven't seen any. And there's no, really no real side effects that I'm aware of. I think this is why green tea, especially matcha tea, tends to be calming as well because it's high in O. I also like relora. We didn't talk about that yet. Relora comes from philodendron and comes from magnolia and it's a really nice calming herb. But it's also for perseveration. So if someone has that kind of. They get stuck on a thought and they just keep hammering in on that thought. It helps break that. It actually can also help with stress induced eating patterns. So if you're someone who. You're sitting in front of TV and you're not even hungry. But you're just eating because you're watching TV or because you're stressed. You're eating your feelings, so to speak. Relora is really great for those people. So that can help with the initiation. So there's some combination products that I like that have for Laura and L Theanine and holy basil in it. That's a nice one. I like phosphatidylserine. I know you do as well. I sometimes give just PS phosphatidylserine. Sometimes I give activated phosphatidylserine. It really depends on the individual. The body has to activate it. If you give it preactivated sometimes that's calming right off the bat. But I've had some people that that's actually paradoxically made them feel too wired. Magnesium is my go to as well. Everybody when they write me and say I can't fall asleep, it's mag first followed by L theanine or a combination product that has L theine in it. I might add some PS and then the next step would be leading into maintenance, which would be melatonin. And we can talk on that a little bit. What else do you like to use for initiation?

Well, I like meltering from initiation as well. Yeah, it's great antioxidant. So I'd like to get a little closer here and then I really like lots of magnet first myself. I'll use like four to six capsules of mag glycinate. Yeah. With the glycinate. Because glycine turns into gaba, I prefer mag bis glycinate, which sometimes is a little harder to find based on supply issues. But because you're for every magnesium you're getting two glycine versus one glycine.

Yeah, that's intake.

Because you can use just glycine by itself in high doses. One to three grams. Yeah. To help bump gab up, to help us sleep as well.

And to make bile.

Yeah, well, that too. Yeah. Well, also with us making glutathione too, so. But it's not rate limiting in glutathione production. So it's not super. I mean it's, it's good regardless. It's also one of the amino acids. It helps with liver detoxification, which goes.

To your, your bile point.

Yeah. So those are all great points about the initiation.

So for maintenance, let's talk about melatonin real quick. Do you vacillate between immediate release and sustained release? Do you muck around with that or do you just give Them the same. Is it more about the dosing and timing of when they take it? And what are your thoughts on melatonin that you traditionally get versus plant based melatonin like Erbatonin. If you use any of that.

As far as the melatonin immediate versus delay, it depends on if the patient like wakes up at you know, five or some enforcement that if so they do they, you know, you can use a extended release melatonin. Sometimes I'll just use like there's a quicksilver product, the sublingual liposomal glutathione. I'm sorry, liposomal melatonin. Yeah. And just have them do like that if they wake up as well in the middle of night. So it depends on, you know, pick which one you want to use. Yeah. Either way, I tend to like, if someone wakes up, I tend to like the liposomal sublingual because it's going to be a quick on.

Yeah.

Versus take it by mouth. It takes 45 minutes to really get in your system. If you're waking up at, you know, three or four, maybe it might be a little groggy at six. Yeah. So I tend to do that over the ER stuff just because I've had enough patience who get groggy from it. Yeah. Which seems again kind of weird but that I more prone to like doing it from 5 to 10, 1 to 3, 5 to 10, depending on what other issues they have on the front end. And if you wake up, do like a one to three sublingual milligrams. Yeah, yeah, yeah, yeah. You know, I've not really gotten to that. So I don't really have a.

So I have a patient who told me that every time she takes melatonin she reacts negatively to it and almost describe melatonin. Like her body repulses it. And I'm like, but you make melatonin every night. Like you need it, your body makes it. So maybe it's the formulary and I had seen and read something about plant based melatonin or foods that are high in melatonin and ultimately going that route in these like sensitive individuals to melatonin where like either have this paradoxical effect or they're super groggy. And there's a product called Erbatone and that's a plant based one. Um, and I don't recall what the sourcing is, but she tolerated it. And so I think there's some insight there too of the type that you're getting because theoretically we're only making about.05 milligrams of melatonin a night at maybe less. And we're giving these big doses, but the big doses aren't because we're trying to cause harm, but rather maybe just supersede the dysfunction and get that person to a point of sleeping to then reverse titrate and deescalate. That's what I tend to do. I'll use like sustained release. Take it about an hour or two before bed, unless you find that you're absorbing it quickly and it's making you sleepy. I'll start about 2 milligrams and I'll work my way up, which is right in your one to three spot. And I'll work my way up. If they're popping up three to four in the morning, then that's probably a melatonin or cortisol or autonomic or whatever issue. And if they do need melatonin, then in my opinion, it's gotta be immediate release. Otherwise you're asking for them to be tired the next morning. But the key is, is that there's, there's just a lot of wiggle room here. People are just assume I can take melatonin or I can't. That' not necessarily true. It's dosing, it's timing release, it's the, the combination formularies that sometimes there's, there's probably some synergy with some other things. So I think it's something that should be considered for anybody that's having a sleep problem.

And for kids or adults, the higher doses I think are more helpful if someone has a brain based inflammatory disorder.

Sure.

The caveat to a lot of the over the counter melatonin things with kids is the American Pediatric association put out a warning on this because many of the random melatonins you buy over the counter can have 10 to 20 times more melatonin than that's on the container. So we'll say 1 or 2 milligrams is 20 or 30. Yeah. And the kids can actually. For kid, for young kids, you can actually get melatonin toxicity.

Yeah.

So the caveat to everything we've said, if you're giving it to a young kid, make sure you're getting it from a high grade nutraceutical or pharmaceutical grade product. If you just get something on Amazon, you could potentially cause harm. So that's one of those things.

Any of those products.

And there was. Yeah, it's just, that's a general thing and this is actually such a big deal that the American Pediatrics association actually put out like a, a Warning about it. So just FYI listening. Yeah.

What Anything else that you might use for sleep maintenance, I guess is there? I think melatonin's kind of the go to and all the other things we.

Mentioned over if, if someone's waking up, not going down the medication dysautonomia route, adaptogenic herbs, you know, pushing the phosphatidylserin on the front end, pushing more the relor on the front end, pushing some other combination of adaptogenic herb on the front end, thinking that it's either going to be a dysonomic thing or a cortisol thing. Yeah. The other question is the whole sugar thing, you know, some. So something is like what do we do about that?

Yes, I have a solution.

What's your solution?

I feel like I just cut you off.

Oh, but this is not ideal but consuming like some kind of fat, the protein, before you go to bed.

Yeah.

Because the pro, the fat will slow the protein breakdown. Your body can take the protein, there's some carbs and protein, not a lot. Yeah. You can also convert amino acids to sugar.

But the other cool thing that I think this is old school naturopathic is you can give someone just a teaspoon of local raw honey before they go to bed. And now you might want to mix it with some fat and carbs so you're not causing hyperglycemia. But the reality is, is that when that glymphatic system kicks in, it is utilizing glucose as fuel. When your brain is doing housekeeping, it's using glucose. And if your glucose is inadequate, you are having problems. So during the day, your body, your neurons, they love ketones, they love that fat. Right. But at night, those astrocytes, those microglial cells, they work on glucose. And so if your glucose is dysregulated, they're not gonna be efficacious. If you give someone that's popping up at night with one of these episodes that you think is low glucose related, tell em take a little bit of honey before they go to bed and see what happens. Try it for a week and if it doesn't get better, no biggie, no harm, no cow, it's good for you. The other thing is that honey's a complete protein. It's also pre and probiotic and it's natural allergy medicine. So maybe you're addressing some histamine related things. So I love that as kind of an old school remedy. Maybe you stirred in your chamomile tea. I don't know.

Yeah, I used to put in My tea at night, but then I cut back on my sugars because my other issues.

So, yeah, cool.

What else?

I think that's it.

That's probably good sleep efficiency. That is a different issue. That's when you go to bed on time. You get. You're in bed eight to nine hours and you wake up feeling tired.

You wear your cpap, you wear your.

Oral appliance, you do all the things you're supposed to do. Those individuals tend to have some form of mitochondrial dysfunction in my understanding. A lot of times it's your low level chronic fatigue person who just has been tired all the time. You know, it's your person who has something, you know, else going on might have a low level HPA axis dysregulation, you know, the adrenal fatigue we talked about before. So those people are more tricky because there's not a herb or supplement that's gonna make you wake up feeling, like, refreshed. It's more like everything else. What are we missing? And if you do everything else perfect, you remove the mold from your house, you treat your chronic Lyme disease, you're dealing with the mast cell stuff, you've been doing all the mito stuff, you've been using high dose thymine and B vitamins and carnitine and creatine and all that kind of stuff, and betaine and taurine, because everybody's got taurine deficiency these days. And used your C15 because you heard the newest layers are on C15. Right.

I might even have those patients invest in red light therapy first thing in the morning, just kind of start the day, try to preemptively strike, you know, just getting things, getting those circadian rhythms reestablished. I think the initiation of sleep starts earlier, like we talked about. And it actually, like you said, starts at the very beginning of the day when you wake up, which is to say set your rhythms that your body know that it's supposed to be making cortisol by waking up appropriately, consistently, at the same time and exposing yourself to light. And if there's no light outside, unfortunately, that means artificial light or red light, which would be healthier. That's a nice alternative. Do you ever use things like kava or passion flower or any of that kind of stuff for sleep?

You mean for waking up for.

No, just for sleep. Like, whether it be initiation or maintenance or any of these other botanicals.

Well, Passion flower is one of the calming herbs.

Yeah.

So like, if you get like a Gaia has a. Actually a sleep formula, I think has passion flower in It.

Yeah, I don't use a lot of that stuff.

Stuff.

I don't know if that's any success with it.

Those are more like your general herbalist. Calming herbs usually is a combination nutritional Chinese medicine. They're using like these. These combinations of different things.

Like that jujube is another one that I think is pretty good for that. Okay.

Yeah.

All right. I think there's utility for all of them. I think the point being that it's gotta be situation specific. You gotta know your patient and know what they need and then try something.

Yeah. So basically we've given people so much information, they could probably take this episode and just kind of sleep great. Clean protocol. Yeah.

Fix stress and sleep great.

Obviously, you know, gut stress sleep. If you're having sleep disturbances, look at the gut. Yeah. Look at your stress levels. If you're still not sleeping great, you look out a little bigger, you start looking deeper. Functional medicine, nutritional levels, you know, do you have an autoimmune issue? Do you have positive auto antibodies? Do you have nutrient deficiencies? You know, that's where the whole functional medicine paradigm approach becomes more important. If you've worked through all this stuff, which goes back to working with a practitioner. If you've done a bunch of stuff and you're not getting better.

Yeah. Agreed.

Cool. Well, I think that's it. Again, post your questions below so we can answer them when we come back next time around. Hopefully it was helpful. Please, like subscribe share this information. That's how we get it out there. We actually enjoy doing this. We enjoy talking and take care. We'll talk to you all soon.