A Data-Backed Approach To Perfect Sleep w/ Tom Hale (Oura CEO) & Dr. Rebecca Robbins | EP #73

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Let'S do a little research. Learn more@finra.org TradeSmart how much sleep do.

We need and why is it important?

There's really a sweet spot when it comes to sleep duration.

We know that if you don't get enough sleep, your incidence of a car crash will end. 33% increase for sleep deprived folks and that actually gets dramatically worse the more sleep deprived you are.

How do you feel when you wake up? And if you wake up and you tell me you don't feel refreshed and restored by your sleep, odds are the quality wasn't very high.

If you don't sleep well, you're 20% more likely to suffer a heart attack.

The question is, can you get yourself a good night's sleep without any supplements, without any medication?

It's concerning because we just don't know the long term implications of this.

Breathing and counting are super underestimated in the toolkit because both of those things put your body, you know, your physiology into a restful state. Sleep is sort of like this universal superpower that if you can harness and you can access it benefits almost every dimension of your life.

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Everybody, welcome to Moonshots and Mindsets. This session is one of my favorites. It's a conversation about something I care deeply about and I talk a lot about. And it's about sleep. And I have two incredible people with me, a CEO and a scientist that surround aura and are all about helping you today get a evergreen toolkit on how to have a great night's sleep. So, Tom, a pleasure. Rebecca, a pleasure to have you both. So, Tom, where are you on the planet today?

I'm in San Francisco, California, Sunny and bright.

Nice. And Dr. Rebecca Robbins yourself.

I'm calling in from Boston. Also sunny, thank goodness.

So first of all, I love my Oura ring and I got my best night's sleep ever last night. I scored a 97 on my Oura ring, which I've never had before, not even close. So it was something about prepping for this session. So we'll talk about that in the last segment here. But before we jump into that, my goal here is in the course of this hour to give those individuals who suffer from too little sleep or inadequate or sleep that doesn't revive and refresh a how to on the basics of sleep so that they can get that superpower as well. So let's jump into part one here for me, which is the basics and also the medications around sleep. So first of all, the basics. How much sleep do we need and why is it important? Let's get down to that because there's big debate about can I get away with five hours, six hours, do I need eight hours hours? And why the heck is sleep so important to health and longevity? Rebecca, do you want to kick that off?

So great question, Peter. You've hit on one of the tenants of sleep health, which is duration. We kind of often lament that it's kind of the front Runner. Right. We're all so focused on how much sleep we're getting and sleep duration is part of the equation for the vast majority of adults. 99% of us do best have the best health kind of through and through, from mood to chronic disease profiles in the range of seven to nine hours. So below that we see risks and interestingly, we also see risks when sleepers are individuals are consistently getting longer than the nine hours. So there's really a sweet spot when it comes to sleep duration. So unfortunately, the vast majority of us are not meeting that sleep need. We do have some good data to show that only about 35% get sufficient sleep. So meet their number each and every night. Now, in addition to sleep duration, there are also kind of other elements of sleep that are really important to consider. And one of them is how do you feel when you wake up? And if you wake up and you tell me you don't feel refreshed and restored by your sleep, odds are the quality wasn't very high. And so that could be stemming from a number of different issues. Maybe you had too much caffeine the day before, maybe you had too much stress that you weren't managing over the course of the day. Maybe you drank too much before bedtime or had an extra glass of wine. And we'll get into that in a little bit. But there are a lot of things that go into that quality equation and that allow us to wake up and be refreshed and restored. So there are a couple aspects that go into that question of what is sleep? And the next question of why is it so important? We have so much data to show that sleep is truly the cornerstone of our truly health and performance. When we're not getting enough good quality restorative sleep, we all can attest, we wake up and we feel groggy. We're kind of burdened by what we call kind of of brain fog. We're less productive, we're less likely to seek creative solutions to complex problems. In business context. We have good quality data that we underperform, but we also make fewer ethical decisions. We're more risk prone as opposed to risk averse and kind of keeping the long term in mind when you're well rested. So there are a host of kind of adverse things that happen when we're not meeting that target. Need from kind of cognitive to physical health starts to deteriorate.

Even your immunity goes down. Right. You're more likely likely to get sick if you don't sleep well. I like to think about it is if evolution could have done away with one or two hours of sleep, when you're not foraging, you're not protecting yourself, it would have. And we need those seven to nine. Tom, anything you want to add there?

I would just call out that fatigue is the flip side of sleep and fatigue. We know that if you don't get enough sleep, your incidence of a car crash will increase. 33% increase for sleep deprived folks. And that actually gets dramatically worse the more sleep deprived you are. It's almost worse than drinking. You know, many, many accidents are thought of as drunk driving, but they're actually people who are sleep deprived. We know that it's 70% more likely to sustain a workplace accident if you're not, well, slept. That's, that's the cost side. Then you think about the opportunity. People who have, you know, better sleep have better health. And I think that's maybe the key here is when you think about heart health, for example, you know, if you don't sleep well, you're 20% more likely to suffer a heart attack. Conversely, American Health association believes that sleep is one of the foundations of long term heart health. You mentioned immunity. 30% more likely to catch a cold. So sleep is sort of like this universal superpower that if you can harness and you can access, it benefits almost every dimension of your life.

Yeah, I think it as a tenant of longevity, which we speak a lot about on this podcast. So seven to nine hours sleep, it's important for your health, every aspect of it. So now the question becomes, how do you get it? And we're going to spend the rest of the show having that conversation. Unfortunately, a lot of people turn to drugs, to Ambien, to Lunesta, to other supplements. Some supplements are useful and additive. I was having dinner with Elon Musk last Sunday and he said he finally kicked Ambien. He said it was hell on the third day. And can you talk a little bit about drugs like Ambien and Lunesta and just the addiction and the detriment of that? I want people to realize it's not a panacea.

Totally. What an entree to a conversation last night over dinner with Elon Musk. Peter, I love it. So great point and great question. Essentially, that's a classification of sleep aids, the pharmacological aids that in some cases can literally be a godsend. So there's definitely a time and a place. Individuals suffering from grief could be a good example or prolonged stress or other issues. And so of course it's an issue to kind of Speak to your doctor about if you're in the zone that would require that type of intervention. But generally speaking, we want to look at those as a kind of a band aid. So they're getting you through a period of time that is extremely difficult to get through. And then when you're on the other side of that, then we can start to taper and then start to think of behavioral strategies. But, but what's so interesting, if we take individuals that are truly suffering from chronic insomnia, and we take them, we do randomized controlled trials where we put one group on the pharmacological intervention, Ambien, Lunesta, the like. The other group gets intensive behavioral therapy called cognitive behavioral therapy for insomnia. What's so interesting, in the clinical trials that have looked at these two components, both do very well, almost equally as well in the short term. But in the long term, behavior wins and has improved efficacy over the pharmacological intervention. It's really this remarkable area of medicine where so many areas of medicine, of course, are impacted by behavior, but sleep so much so, and there dictates that we could all really learn from the tenants of CBTI that we can get into. The other thing that we're starting to kind of notice is just the incredible surge in melatonin. Some data was published in JAMA not too long ago on this explosion in use. And I think that even the reports that we have of nationally representative surveys, we think are underestimating really how pervasive this use of melatonin is. And it's concerning because we just don't know the long term implications of this supplement. And it really is a nutraceutical. And so it's widely unregulated, this market. And so we're really not sure the purity of the melatonin that is on the market. But then again, the long term implications are really in question. So we need a lot more science before we really promote AIDS like that.

Yeah, people talk about 1mg, 2mg, 5mg long duration or slow release. And I guess if I were thinking about it, I'd rather be using melatonin than Ambien. But at the end of the day, the question is, can you get yourself a good night's sleep without any supplements, without any medications? And I think that's where I want to spend the majority of this conversation. Tom, you want to add anything before we jump into that?

I think it's really important to understand that melatonin is what your body produces to Sort of get you off to sleep. Melatonin doesn't keep you asleep. Melatonin doesn't make you calm down or have any of the agency of a Lunesta or an Ambien. Melatonin is just like the starting gun for sleep. And so taking melatonin right before bed, I think in many ways is the trigger for people to kind of signal to their body that this is time to go to bed. But there's lots of other levers that you can pull. You don't necessarily have to have an intervention. I'm a big believer in melatonin, and I agree with the comment about nutraceuticals being unregulated, but a high quality melatonin, actually, I think it can make a difference for folks who want to kind of get into a regular routine of getting sleepy right before falling asleep.

And one, just one important thing to add is melatonin, of course, isn't a sleep aid really the most kind of primary use case is when individuals are trying to change its sleep schedule. So if you're really out of sync, your internal clock with the clock on the wall or a new schedule that you'd like to start, perfect use case for melatonin, because as Tom mentioned, the melatonin that's endogenous inside the body is what allows us, when the sun sets, when we go into a cool, dark environment, to calm down and start to prepare for sleep. And then the floodgates of melatonin stop as soon as we wake up and we get sunlight exposure in the morning. I think it is being marketed as this panacea, this sleep aid, this miracle drug, but it really isn't so. Well, I think there's a lot more education we can do on how to use it, how much, when, and all of that with efficacy.

Sure. And we'll talk about sleep hygiene, which is sort of the how to get yourself ready. How do you get yourself into the proper. It's not just close your eyes and go to sleep before we do. While we're still talking about chemicals, pharmaceuticals, let's talk about caffeine and alcohol first. So talk to me about your advice for everybody's favorite caffeine and alcohol. I actually have gone off caffeine for now two months since the start of the year, and it's been amazing. I miss it a little bit. I miss the routine of it. But where people who are drinking caffeine, who are drinking two cups, three cups, four cups a day, what's your advice for them if they're not Getting a great night's sleep.

And that last bit is the key, right? Because if it's not broken, don't fix it. I think sometimes we have a tendency to kind of over medicalize everything and over prescribe and introduce health tips when they're, it's again, not broken, don't worry. But essentially the key thing is, as you're falling asleep, is your mind racing. That's one sign that you're just having too much caffeine. And one thing to cut out if you are struggling with falling asleep. And if you have too much caffeine, though, your sleep quality can take a hit. So just be mindful. And this is where just keeping a little diary about what you do over the course of the day can be really helpful and powerful from the standpoint of behavior change. Just being mindful, was it three or four cups that I had and maybe thinking about pulling down to two or, you know, maybe three at the outset? But caffeine is the most widely consumed drug in the world and it does have a half life. And so it stays in your system from anywhere between five to nine hours. And there are genetic differences in how we metabolize caffeine. So some people are lucky and able to metabolize it quickly and able to go to sleep shortly thereafter. But keep in mind how much and importantly, when you're drinking, so many people will say, oh, I have a Venti from Starbucks in the morning at 7am and I chug it and then I have one last coffee after lunch and then I'm doing the math. And that's a lot of caffeine. So be mindful of how much.

And you can find out if you're a slow or fast metabolizer from your genetics, whether your liver is processing it rapidly or not. But I think when you had your last cup of coffee is really the single most important metric here. Tom, you want to add anything there?

Absolutely. I mean, look, I think from personal experience, I spent most of my career waking up to a couple of jolts of coffee and then maybe having a drink at night to put myself to bed. And having changed that behavior completely, it's been transformative for me. It's like. It's like coming out of a black and white movie into the Technicolor world. By stopping caffeine, I've learned that my body wakes up and does fine in the morning. I don't need the jolt of caffeine. Now, to be clear, I do use it on occasion because it does focus the mind and give you Kind of a burst of focused energy. But I try and keep it before noon, and I try and limit the consumption, and maybe we'll get to alcohol in a second. But, like, the other thing is that alcohol, which I think many people view as sort of the antidote, you know, what you would take after you were, you know, your mind's racing, you're heading off to bed, you take a glass of wine to kind of take the edge off. Thing is that that is a poison for your body and it ruins the quality of your sleep.

Yeah. So let's jump into that, because that is amazing. You know, people, historically, I think this is sort of social norms. And you know, what we see in the movies, that I'm going to have a. That nightcap, that glass of wine or scotch, whatever, to help me get to sleep. And it does. If you have an oura ring, which I do, I can tell, you know, it decimates my deep sleep. You know, what's the science here? Because you think of it as a sedative, but it does just the opposite for you.

Totally. My college students, I feel like, push back on this. You're wrong, Dr. Robbins. Alcohol is great. I'll go right to sleep. And it will put to sleep because it has some sedative properties. So it can maybe help you fall asleep. But as you. You mentioned from your experience. You're exactly right, Peter. It starts to destroy the quality of our sleep. It virtually starts to pull us out of the deeper stages as our body tries to enter them. So you might notice on your oura ring, you have more awakenings, you have more fragmented sleep, lower kind of readiness scores, and that's all. And there's kind of a stepwise function with alcohol, implications for our sleep. So the one dose, one glass wine, beer, could maybe give you about a 10% hit on your overall sleep quality, according to the literature. But then a second glass gives you about a 25 or 28% hit, and then kind of so on and so forth from there. And your body mass does factor in a little bit here. But the most powerful thing when you. This is one of the best reasons to have a tracker, is it kind of can help you do this n of one experiment where if you're willing to try, if you find that your sleep is suffering and you're doing desperate for your coffee in the morning, you're desperate for a glass of wine at night, just consider yourself at this little end of one experiment. What if I go off for two days and see how I feel just cold turkey? No coffee, no alcohol, and just notice how you feel during the day. And then if you have a tracker, the data that you're getting from that device and that behavior change is the most powerful because then you can really see how these things really have big implications for our sleep.

Yeah, absolutely. It's like I do that for myself. I mean, I look at the first thing I do when I wake up in the morning is I look at my OURA ring data, and I'm looking at, you know, how much deep did I get, how much REM did I get, how what my duration was, what my sleep score is. So funny. I was with a group of X Prize individuals in Panama last week for an adventure trip. Tom, you'll like this. And I turned to one of the individuals on the trip, and I said, so, how'd you sleep last night? And he goes, 93. So that's. It was like, you know, it was perfect. It said so much, right? To have a single number that was able to, like, convey so much information.

That's the key, right?

Right.

If you actually have some data as opposed to just how you feel. I mean, you probably know when you feel terrible. You had a hangover, you drank too much, you stayed up too late, you know that you feel it. But, you know, what we're talking about is optimizing on the margins. And really, if you know that you can actually optimize your sleep by changing a behavior, you need something to reinforce that, and data is the key. My personal experience was, you know, when I started seeing my sleep scores change, you know, when I made some very sort of basic sleep hygiene changes, I was really amazed at the degree to which I didn't realize, you know, what I was losing by not sleeping.

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You, please go and check it out. Go to fountainlife.com Peter When Tony and I wrote our New York Times bestseller LifeForce, we had 30,000 people reached out to us for Fountain Life memberships. If you go to fountainlife.com Peter will put you to the top of the list. Really, it's something that is for me one of the most important things I offer my Entire family, the CEOs of my companies, my friends. It's a chance to really add decades onto our healthy lifespans. Go to fountainlife.com Peter it's one of the most important things I can offer to you as one of my listeners. All right, let's go back to our episode. So I want to get into the now. So you know the summary here. Sleep's important. Seven to nine hours. It's critical for your health on every aspect of it. You know, sleep aids in a case of emergency, fine. But it's actually changing your behavior that's going to have the best long term benefits for it. Caffeine in the morning, after lunch, alcohol is going to really do you damage at night. Now the question is your sleep hygiene, getting yourself ready for a great night sleep. And let's jump into that. And I want to hit on a number of different things and you can tell me what I miss here, but there's a circadian rhythm. And when I think about it, probably what got me to a 97 last night, which I'm so proud of, right? It's like the highest score I've ever gotten. And it's just appropriate for the day of this podcast was I got to sleep at my perfect time, I wore blue light blockers and I prepped a half an hour getting into sleep. So let's talk about circadian rhythm, about what time you go to sleep, what time you wake up for a second. And then I want to talk about the different elements of it. I want to give people the tips and tricks to get a great night sleep. Rebecca, do you want to talk about the circadian side of this?

Sure. So our sleep is governed by two primary forces. The first we refer to in the field is the homeostatic drive for sleep. And it's just your overall feeling of sleepiness. So that simply starts to increase with each additional hour you've been awake. But that's not all of the equation. We can all attest to this. If you ever recall a time where you're like, oh, I'm going to get on track and go to bed three hours early. You know, I'm going to go to bed early. And people, you know, oh, this is a good thing, but wrong. Because this, the second force that governs our sleep is something called a circadian rhythm. It's Latin for about a day, circa dies. And it refers to processes in the brain and in the body that operate in an approximate 24 hour fashion. We've all adjusted our rhythms over thousands of years to the pattern of light and darkness on earth, which is about 24 hours. What's so fascinating is if we put individual cells in petri dishes, they actually demonstrate this circadian. So there are these tiny clocks that govern when things should be firing over the course of the day, which makes so much sense. So we're not going at a million miles an hour the entire day. We have a period of time as human beings where we can rest and then other cells and organs in the body can do the same. So this circadian system is housed in the brain in a tiny region called the suprachiasmatic nucleus.

I love that, man.

It's my favorite. If you want to impress someone at a cocktail party, say that 10 times fast, right? Suprachiasmatic nucleus. And it refers to this tiny little region of the brain that sits above the optic chiasm. And so light comes in from your environment, enters the brain through the eyeball, triggers the on switch to the circadian rhythm, telling the brain to stop the floodgates of melatonin and that it's time to become alert and awake. And then sun sets in our environment, and it's that setting of the sun that we perceive through our eyeballs. And then triggers the secretion of melatonin. And it's not instant. There's actually something fascinating that happens right after sunset. We actually have the strongest drive for wakefulness. Think about that. Right after sunset, which is kind of counterintuitive when you think about it. But we think it played this evolutionary role of hunters and gatherers running out to forage for the night before they go in to hibernate. Then we about 90 or a little bit longer minutes thereafter, we start to become sleepy. And if we weren't in an environment with fluorescent light bulbs, we would have no light to keep us awake. And so we'd fall asleep. And then sunlight again in the morning would trigger the on phase of that circadian rhythm. So sleep is a circadian rhythm. Our heart rate operates on a circadian rhythm. Our body temperature ebbs and flows also and again, virtually every part of the body. So what that means for our sleep is that the timing of our sleep is incredibly important. We recently went through the painful time change of the hour lost during daylight saving time. And we can all probably attest to that one hour making a huge difference. But there were a couple things going on in the spring forward transition. The vast majority of Americans don't prepare for that. So they just generally take that hour hit from their sleep duration. And Americans aren't getting enough sleep. So that translates into a very sleepy country. More heart attacks, more car accidents, more something we called, this is another favorite science term called cyber loafing. Employees show up at the office but slack off by surfing the web. So all these bad things happen, but in part is that loss of an hour. And we're shifting our clocks also. And so that one hour, believe it or not, makes a big difference. And that has implications for sleeping in on the weekends. So we want to try to resist that as best as possible and really be laser focused on your target fall asleep time and your target wake up time. And that will allow your circadian rhythm to know when it's supposed to be tired and when it's supposed to be alert. And then organize itself within those windows.

Yeah, mine. Interesting. I've fine tuned it. When I was in medical school and I was at HMS where you are faculty at Harvard Med School. I remember I was 2am was like when I would hit my stride between 10pm and 1am until morning rounds. And that shifted everything again. But today I need to be in bed by 9:30. I need to be in bed by 9:30 to get my score. And then I'll wake up at about 6am on my own, typically. And it's interesting as you're. That changes throughout life, doesn't does so.

Peter, your schedule in medical school sounds a lot like my college students and medical students that I mentor. They're traditionally owls, true owls. We're not sure why this happens. This is research at Stanford. But we, for some reason around puberty transition collectively, by and large to being more evening like so our youngsters after puberty until the early 20s, as this change really persists, there's a strong preference for eveningness or, you know, being productive in the evening hours, coming alive in the evening hours.

And I heard that was generally speaking.

After that you can just.

I heard that was basic, basically, to get away from your parents, to go find your mate and reproduce. I mean, I can imagine that.

It'S a good hypothesis. Peter.

Tom, how about you? When do you wake up and go to sleep?

Yeah, you know, it's funny, I'm a sort of 10pm to 5. 5am or 6. 6, you know, between 5 and 6. And I've actually been experimenting with a blood glucose monitor. And the thing that I learned that fascinating from that was that the beginning of my circadian rhythm in the morning is a cortisol spike. They call it the dawn spike. And anybody who's worn a glucose monitor might know this, but it's basically your body. When you're waking up, your temperature starts to elevate a little bit coming out of sleep, you get this little blast of cortisol which is there to wake up your body, and it starts the production of glucose being released into the blood, which gives you energy in the morning. And the thing is that if you time that right, that little spike of cortisol and that glucose spike is something that kind of launches you into your day. It's actually, I think in many ways what's responsible for me feeling like I don't need to drink coffee in the morning because I've got that little jolt of energy coming in from waking up. So the circadian rhythm, it defines so much on the other side the night, the going to bedside. For me, the factor that mattered the most was eating late. Because if I eat late, and particularly since I have a fondness for sugary desserts, it would have an impact on my sleep if I wasn't careful. So I have now made a real habit of making sure that I give a nice window before bed time of not eating and I try and avoid the sugary desserts at night. And it's made a huge difference again in the quality, not necessarily Just the quantity, but the quality of my sleep.

Yeah, let's talk about those specific getting ready for bed, the do's and the don'ts there. And one of them is eating for sure. You know, those of you who've been my podcast, we talk about intermittent fasting and it's basically, can you eat dinner at 6, 6:30, and then fast till the next day and get a good 12 to 16 hours of fast time? That helps the body in different ways, but one of the other ways it helps you is to get a good night's sleep. If you are snacking. And people who take Ambien, for example, one of the things that it does is it lowers your inhibition to eating. And a lot of people are snacking late at night when they're on Ambien, which has a lot of detrimental effects in terms of obesity and others. But the impact of eating late on your quality of your sleep. Let's talk about that a second.

And the two things that kind of you know what you're eating and when also. But one of the things that I love to talk about on this topic is the old adage from nutrition of a breakfast of kings, a lunch of princes, a dinner of paupers, has actually been tested from the standpoint of our sleep. And that also is better than much better to structure your nutritional intake a little bit heavier in the morning, heavier in the afternoon, and then lighter in dinner. I think that's kind of a good across the board, kind of, you know, guidepost to keep in mind for all of us. But then the intermittent fasting literature is amazing. This is all Sachin Panda's work at the Salk Institute, and his work is just so compelling. It shows that we can move people from being pre diabetes, this health trajectory in the direction of type 2 diabetes and pull them out of that nosedive, really, with these small changes that are also, I think, really powerful because behavior can become a little bit mindless at night. We've been processing information all day. We've been doing, we've been responding, and then your day suddenly comes to a halt, and then maybe you want to spend some time with your spouse and then you're watching a Netflix episode and then maybe one more. So our behavior can kind of start to spiral and then maybe enjoying some popcorn with that movie. But I think one of the single things about intermittent fasting that the science is so cool, but it's also just helpful to have guardrails around behavior. You know, try to be done eating by a certain time and at least give Yourself an hour and a half, two hours. And then any more would be better of a buffer between the last time you finish eating and your bedtime. But two, three hours would just be. Would be terrific.

Going to ritual of getting ready for bed. And Tom, I'm curious your thoughts here. My ritual just to share it and then we can comment off of that is I try and give myself a half hour wind down where I'm off computer. I'm not watching tv, I'm wearing my blue light blocking glasses and I'm typically actually using audible to listen to a book like a bedtime story. And then I'll put on my eye shades. I love my manta mask and I use a mouth guard. We'll talk about that in a minute for sort of like not, you know, getting good airway. And that is a ritual that gets me off to a great night's sleep and then I'm out. Talk about rituals and what that sort of approach to landing, so to speak. As I'm a pilot, I think about getting ready to get your airplane prepped and get down onto the Runway of sleep. Tom?

Yeah, I mean, obviously not staring at a computer screen is so key. You know, the kind of light that comes off of a LED display is blue light. And blue light is a signal to your body that it's not time for bed and that you shouldn't have that surge of melatonin, which is the starting gate. So absolutely, that's probably, you know, first and foremost the second one, I think, and Dr. Robbins can confirm this. But your body temperature actually, you know, when you go to sleep, your body temperature declines a little bit about a degree. And so setting that up and getting your body into that cooling cycle is really important. And you can see that there are products that actually help cool your bed or taking a hot shower at night, which actually forces your internal thermostat to adjust lower. These are all factors that kind of ready yourself and ready your body for deep sleep in particular. There are other things, of course, as you said, like something that's calming or soothing and takes your mind off of the cares of the day, whether that's reading a book or listening to a soothing podcast or a sleep story. Those are all demonstrated, obviously, dark, you know, going to a dark room. The other one, I think that's really interesting is just the nature of how you use your bed. And using your bed not for other things besides sleep, makes it a place where it trains your brain to expect that when you go to bed, that this is the time for sleep and you start to build this kind of association. All of those factors, I think, come together. I think the key is everyone's different. And so you have to kind of experiment with each factor to see which one is maybe most powerful or most impactful for you as you're optimizing your sleep.

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Now back to the episode. Yeah, let me, let me hit on something you said and then I'll turn to Dr. Robbins here. I have to have my room set at 64 degrees or 63 degrees Fahrenheit. Right. And I also have a, you know, Inn8 Sleep, a chilling mattress, if you would, that brings the temperature down. And a lot of times if I ever wake up, it's because I'm too hot and I haven't turned the mattress on or I haven't set the proper environmental controls. But cold is my dear, dear friend for getting a great night's sleep. Dr. Robbins, what are your thoughts on all of these sort of the prep mechanisms, the hygiene of sleep here?

That's all right on. Temperature of the bedroom is a key consideration and there's some individual preference and difference within the range, but generally, you're really right on target. What we generally recommend is somewhere between 65 and 68. That keeps you in what's called a thermal neutral zone because in certain stages of sleep, we're not able to thermally regulate our body shiver if we're cold, sweat if we're hot. And so we want to keep you in a zone where you're not going to be susceptible to those swings. And if that in your environment where you live, if that does, you know, the Colder mattress pad or if you're able to turn your thermostat down in the warmer months. Some data came out last summer that looked at sleep in the uk, where air conditioning isn't as common as the US and there were a couple heat waves and sleep quality was just abysmal across the country. So temperature really, really matters. The other dictates of a great room for sleep are quiet and cool, or sorry, dark quiet and cool. So our eyelids are very thin. I love that you're wearing an eye mask. If you have any light that comes in at your doorway in the morning or through your curtains, then an eye mask is a great way to go to make sure that you're doing your best to create a really dark, dark and kind of cave like environment. You really want to walk into your bedroom and be able to turn everything off and just literally have a hard time getting around because it's so dark. Because that can again help trigger the secretion of melatonin. And I think we all are maybe a little guilty of spending in other areas of our life than our bedroom. One of my kind of jokes is I love asking people when they got their mattress and where because very people, few people can actually articulate those things. They're like, oh, you know, Uncle Jim gave it to me 10 years ago. And so we're so much more likely to go, but, you know, buy a pair of shoes, then invest in our, you know, sleep environment. And I think that's starting to change. We're kind of collectively waking up as a society to the importance of sleep. So I think that it's a really, it's just an exciting time in sleep tech and sleep science for that reason.

Invest in your sleep critical.

Invest in your sleep. There's so many tools and there's so much education available now, right, that people can, people can draw on. The thing is, again, everyone's a little bit different and some people's lives don't actually lend themselves to, you know, having a really, really great sleep routine. Maybe you've got young kids or maybe you have a demanding job, whatever it is. But there are definitely things that can work. So for example, if you do have to stare at screens, as you said, Peter, having blue light blockers, you know, which are glasses that will, you know, keep the blue light from getting to your, you know, optic nerve and then affecting the production of melatonin, like that is actually really, you know, that's a great solution. And I will admit that sometimes I do check my phone after nine, you know, just for, for a last minute look at the day and I, when I do that I'll wear a blue light blockers and, and, and you know, my sleep scores and the experiments that I run to sort of see what the impact is, illustrate that those kinds of things work. So it, I think the key I think is that there's lots of tools available and you need to find what works for you. And having a tool that allows you to measure and track your outcome, if you can't measure, you can't manage it.

Exactly.

This is, not everyone's the same. These are all great pieces of advice but they, you've got to find what works for you and your life and where you are and your, in your, you know, in your existence. Because you know, folks like, you know, who have young kids sleep, it's hard for them to get good sleep. That's just the nature of the business.

Yeah, I have 11 year olds now and you know, when they were young. But there are different phases in life and you should always be trying to do your best. Dr. Robbins, you were going to say.

Oh, I just wanted to chime in. I love your comments Tom, around how individual, especially the pre best bedtime is and whether it's an eye mask. I love your routine, Peter. The eye mask, you know, the couple things you can really think of that as your checklist. What are the two or three things that soothe you? And I love the question, you know, what is the most relaxing thing to you? Is it the idea of being at a spa? And if that's the case, maybe get some really nice hand creams or an aromatherapy, a smell that you love and make sure to integrate that into your routine. And so whether it's a warm bath and then you take off your makeup or wash your face and brush your teeth. Teeth and then you turn off your iPhone. These steps, they sound trivial but they're actually really important because then you start classical conditioning from psychology. You start to train your brain to understand. Okay, it's a warm shower, a couple pages in a book. I turn off my phone and then I meditate for five minutes or I do the four seven, eight breath technique or alternate nostril breathing or another one of my favorites is progressive muscle relaxation, a really easy one to do in bed. Crawl into the sheets, turn off your phone and then clench and release different muscle groups. And as you're inhaling kind of imagine like a part of tension or you know, a place where there's tension and then as you're exhaling you let that go from your body. And if you just do that and you know, work the way up the body, you might, you know, find yourself sleepy by the end. So whatever it is, think of those things as your toolkit. And I've used that word because that toolkit gets you to fall asleep. But then that toolkit is also there for you if you're having middle of the night insomnia. So if you're up for whatever reason you had to use the bathroom or you're stressed, then go back to that toolkit, that playbook that gets you to sleep.

Next on my list. Let's talk about that. It's 3am, your eyes pop open and you're hoping it's 6am in the morning, but it's not. It's 3am in the morning and you know you can't go. Just get up right now. And so the question is, what do you do? So you were saying, go to that toolkit. I've heard people say, if you're really in insomnia, get out of bed and go and change your environment for a few minutes and just don't lie there and then go back to bed and try and reinitiate. Any advice for people who have that bout of insomnia?

Well, the first thing is to notice that this is part of the fabric of the human condition. Awakenings are actually not something necessarily to worry about. Our ancestors were sleeping in two periods. They were up for a stretch of time in the middle of the night. So number one, think about, just notice how you're talking to yourself. If you wake up and are you kicking yourself like, oh, not again. And as soon as you do, try to change that narrative and just tell yourself, no big deal, I'm up. I'm gonna think about doing whatever maybe got you up. If it's using the bathroom, go do that. And the self talk is really important. Just I'm up, no big deal, I'm gonna go back to bed and then crawl back in the covers and give it a shot and go back to that playbook. 4, 7, 8. Breath technique. Think about happy thoughts. Maybe read a couple pages in a book and then try again. Turn on, you know, slip into, close your eyes and then if that little voice comes on again, it's like, ah, not again. That's when you get out of bed. As soon as that little voice comes on and, and go to your floor, Do a meditation technique, do some gentle yoga poses, maybe read a couple pages with the lights low and then try it again. Come back when you're tired. And if you're really experiencing insomnia that dictate of really being diligent about this, leaving bed as soon as you toss and turn. Because there's really this kind of old wives tale that if you stay in bed, any sleep will be better than no sleep or leaving the bedroom. And kind of leaving bed is really key to kind of reset yourself and set yourself up. Actually for your best shot at getting.

Back to sleep, I'll mention something, Tom, I'll ask you if you have any other advice. A lot of times what will wake me up is my mind is racing. I've just thought of something and what I typically have learned to do is go get out of bed, go to my desk with the lights low or my blue blocker lenses on and do a brain dump. I'll write down everything I've been thinking about and the list of things I hope I remember in the morning and it will feel complete when I get it out of my head and then go back and try and reinitiate. Tom, any other advice on insomnia that.

I would totally echo what you just said, Peter, because I think that sort of waking up and your mind racing and you're starting to kind of process information, maybe formulate some strategy like writing it down. One, it saves you the need to sort of store it in memory so you can kind of let it go. And then two, I think actually as you said, you kind of say, okay, good, now I've kind of taken care of that. I will say this. I think breathing and counting are super underestimated in the toolkit because both of those things put your body, you know, your physiology into a restful state. And if you can work deep nostril breathing, long breaths, whether it's box breathing or four, seven, you know, whatever approach works for you, breathing is so powerful, especially if you, if you couple it with sometimes like a sleep story, something that takes your mind off of the, you know, whatever is causing your mind to race. And so breathing, distraction and having something that allows you to sort of, you know, export the information from your mind so you don't have to store it in memory. I think those are, those are all.

Really good tactics and just the relaxation response. Just to add, a colleague here wrote a book on this topic and it's not innate. And so really thinking of our ability to relax is kind of a muscle that you need to build. And whether it's a breathing technique or the progressive muscle or a prayer, whatever gets you into that state. It's something that though, as Human beings we really have to work at. Any mother of a new child, you know, screaming baby coming out of the womb can attest to this. There's no natural reflex, which is interesting when you think about. Right. So it's something we have to kind of ever work for.

Let me touch on two last subtopics and I want to turn to the sleep tech these days, which is naps during the day and dealing with jet lag. All right, we're back in our travel schedules again. Tom, I saw you in Saudi Arabia last October. 12 hour time zone change the worst. So do you think Dr. Robbins naps are okay? If so, when, how long and then any advice on dealing with jet lag or you just, you know, are you just stuck with an hour change per day?

Naps in many cases. Ken, let's start with naps. Naps can in many cases be a part of a healthy sleep routine. If you're a healthy sleeper and you maybe feel a little bit groggy in the afternoon, totally fine to go for what we call a power nap, which is about 20 minutes minutes. It's going to get you a little bit of rest. Not a lot, but it's enough to kind of power you through and a much better solution than coffee. It always makes me laugh that people will literally do anything. But the one evidence based thing that pays off, sleepiness, which is sleep. And everyone's like, no, what's the 10 hour energy drink or whatever? Sleep guys, it's not rocket science and so can be a godsend. A lot of companies are waking up to this, putting nap pods and things like that and work sites so they can be a part of a healthy sleep routine. The one. I'm so sorry, my dog is snoring. I hope you guys can't hear this. Very on brand for the sleep podcast. I am so sorry. So, but okay, so the one exception is anyone who's suffering from insomnia. We want to build what we talked about earlier, that homeostatic drive for sleep and give that person the best chance of hitting that peak in their homeostatic drive and then coupling that with their circadian rhythm and their target fall asleep time. So that's the one exception. But otherwise, again, indulge in a nap if you're feeling a little bit groggy.

You know, I'm about to have a chat with Chris Paul, basketball player and our ambassador, and one of the things that he swears by is the afternoon nap, especially for the night game. You know, you think about for someone who has to Play a game at night, they can't control their bedtime because who knows how long the game's going to go. And then you take a bus back to the hotel. All these kinds of things. The nap before the game in the afternoon is like. It's a standard in high performance athletes. And again, it does go back to like it is your natural thing. If you were tired, the natural thing to do is to fall asleep. I think the other thing to call out and we didn't really talk about this yet, but it is about daytime activity. One of the most important daytime activities that contributes to good sleep is exercise. Right? Just keeping your body both moving and activated, particularly not close to bedtime, but during the day it gives you that opportunity both to wear off the mental stress that you might have, but also it does help prime your body for better sleep.

So when I've exercised at night, that has had a negative impact on my sleep. So I do exercise first thing in the morning. I'm usually a 7 to 8am weight workout person. And is that true in general that exercising at night has detrimental effects?

Well, the science is a little bit mixed on this. I think we need more studies, but it kind of depends on the population. I think there's been some studies with endurance athletes that have shown no detriment. There have been other populations, but I think one of the key things is just noticing what works best for your body. We talked a little bit about circadian rhythms and we didn't get too far a little bit into cross, which basically refer to your preference for being alert and productive. A true morning person will tell me, I want to get up. Peter, this sounds like you often type A individuals are this morning type, you know, morning workouts, I'm up, I'm ready to go, and then you're winding down at night. And then evening people will conversely tell me that they become alive at night. And so evening people might do well to have an evening workout, have a dinner and then wait two or three hours, set themselves up, shoot for a 1am bedtime. But then their challenge is going to be keeping the morning light out of their bedroom. So really investing in thick curtains so that they can sleep in their optimal window and not be disrupted.

Let's talk about jet lag, which destroys a lot of people and I'm not immune to it. Typically it hits me on the second night and the third night. Any advice? I mean the old adage is it takes you an hour to shift an hour. I mean a day to shift an hour. Time zone is that still correct, Dr. Robbins?

I believe so. And essentially this all refers to modern day air travel and the amazing ability to wake up, you know, rocket lag.

Yeah.

But of course our internal rhythms are lagging behind in our home location. So the key question for me with this is how long is your trip? Are you going to be there for two days? Then I'd say rip off the band aid, you're going to be in survival mode. It's not going to pleasant, but I'd say it's probably not worth adjusting to your new time zone and then having to readjust back because if you do want to adjust to the new destination, the destination time zone in a perfect scenario, you're really being thoughtful and preparing. So using that, you know, one day per hour and then thinking, okay, if it's London from Boston, I'm going to start preparing a week out and move my bedtime methodically in the direction. One of the kind of the myths is people say, oh, I'm going to take an overnight flight, I'm going to wake up and London and I'm gonna walk around. You know, best thing, walk around in the morning. But what that's actually doing, if you think about it from a circadian rhythms standpoint, I've landed in the middle of my biological night. And so if I expose myself to light, what I'm actually doing is extending my rhythm, basically putting myself on California time. And so think about where you're moving towards and then how you're shifting your internal rhythm. And I'm telling you, we'll get circadian scientists together and be like, wait, which direction again? It's so confusing to think about this, you know, light and rhythms and time and the directions. But do use blue light to your advantage. But if you're going from say New York to London, the key time to expose yourself to light is actually in the afternoon. So wear sunglasses in the morning and then try maybe get a small nap and then sunlight exposure. And you're really going to be on kind of a modified schedule for the first, you know, night or two anyway and then hopefully adjusting thereafter.

You know, this is the hardest problem of being kind of a global business traveler is that there really is no perfect solution. Honestly, I do find that light exposure is really powerful for sort of, you know, sort of setting that trigger. And if you're intentional about light exposure, you can make a, you can make a big difference in the feeling of jet lag. You know, you can give yourself that sort of feeling of wakefulness. I've often used A product called Timeshifter, which is basically a schedule for set of activities, whether it's drinking coffee or going to bed later or light exposure to start to shift your time, particularly for long trips. That's actually what I used when I went to Saudi Arabia and it did make a difference, but it was not a perfect solution. There is just some amount of shifting you're going to have to go through with your body adjusting to a new time zone and a new rhythm.

Hey everybody, this is Peter. A quick break from the episode. I'm a firm believer that science and technology, technology and how entrepreneurs can change the world is the only real news out there worth consuming. I don't watch the Crisis News Network. I call CNN or Fox and hear every devastating piece of news on the planet. I spend my time training my neural net the way I see the world by looking at the incredible breakthroughs in science and technology, how entrepreneurs are solving the world's grand challenges, what the breakthrough breakthroughs are in longevity, how exponential technologies are transforming our world. So twice a week I put out a blog. One blog is looking at the future of longevity, age reversal, biotech, increasing your health span. The other blog looks at exponential technologies. AI, 3D printing, synthetic biology, AR.VR blockchain. These technologies are transforming what you have as an entrepreneur can do. If this is the kind of news you want to learn about and shape your neural nets with, go to dmandis.com blog and learn more. Now back to the episode. All right, let's go to the third part here. I'm a geek. I love tech and I love my Oura ring. I think I was one of the earliest users of Oura when it was, you know, really huge. And, you know, I'm holding my ring here and it's just an exquisite device because of the tech that's packed into it. Let's see if we can rattle off. Tom, one second. What? First of all, the OURA ring has become beautiful. You beautified it nicely. But what is inside, we got, we have Bluetooth transmitter to get to your phone. We've got batteries in there and a bunch of sensors. Yeah.

Infrared LEDs. You've got red LEDs, you've got green LEDs. Those LEDs are different for different kind of wavelengths and of and also their resistance to noise. So green LEDs are great for heart rate during the day, red LEDs are great for continuous measurement during, during the night. So if you're measuring SpO2 and you're using a ring, you'll often see a red A red light around, around the edge of your ring. There are negative tenure, negative temperature coefficient sensors, advanced calibrated sensors. There's finger detection, an IR sensor, there's SpO2 sensors. There are, there are the sort of photoreceptors that are reading the light that comes back from the light that sh shining into your body. Battery life is very, very effective. Where we kind of expect to be able to get you five to seven days under heavy usage. There's memory on board the device, 16 megabytes to store data so that you can go for a couple of days and not have to copy the data up to your phone or into the cloud. All of these things will enable you to track your heart rate, your temperature, your respiration, your blood oxygen, your sleep, including sleep onset and the sleep stages. We're just about to introduce a new sleep staging algorithm which is, is on par with the most accurate gold standard that there is. We've got things for women's health. So being able to look and see how your cycle is affecting all sorts of aspects of your physiology. Your temperature of course is hugely implicated in where you are in your cycle. So we can see very clearly when you're about to have the surge of the hormones that regulate your cycle, we can see those things on your temperature changes and then content. Of course, all of these things are in the app to help you understand your data and your experience translated into data in a way that you can understand it really easily through three scores. Sleep activity and readiness. And sleep is of course, how well did you sleep? And congratulations Peter on your 97. That may be an all time high. I don't think I've gotten anywhere near that. I've pressed in 90 a few times.

Yeah, I was really shocked by it. I want to come back to that in a minute. But for those of you who have not, Ouraring.com is the website website. It's amazing what's been packed in this. I mean, again, just from a tech standpoint, it's a beautiful packaging and if you're watching this podcast on YouTube, you know, the ring looks like a wedding ring. It's not. It used to be. The early versions had a very large head on them that had the tech, but the tech has become super micro miniaturized and you have it in gold and silver and black and stealth and the whole slew of different, different designs. And I know a lot of people who actually use it as their wedding ring, which is pretty cool. And just to again, it's measuring those LEDs, the red and the green and the blue LEDs are looking at pulse waveform in the little arteries on the underside of your finger. Is that correct?

That's right. Yeah. That's important, by the way, because I think many people think about, you know, the ring, of course, is being very small and very light. It's 4 grams. So it feels great. It's actually a great tool to go to sleep with because it's the one thing you don't take off your body when you get into bed. You know, you're just. It just sort of goes with you. But it is really important to understand that this site on the body is a really excellent site for measurement. And the reason for that is twofold. One is it's on the leading edge of the pulse waveform. So when your heart pulses and blood shoots down your arteries, down your arm, it goes straight through the palmar artery right underneath the sensors. And there's. There's not very much flesh in between that pulse and your sensors. Plus that flesh is very uniform. You're talking about basically kind of very little muscle and a little fat. That's basically the tissue. So the signal that comes back from this sight on the human body, when you shine light into it and what light is refracted back, it's 50 to 100 times better and more accurate than what you might get on the outside of your wrist. And why is that? Well, first of all, you're receiving the signal on the trailing edge of the pulse waveform. You're getting capillary action as it's returning to your heart. Secondarily, the tissue here is not uniform. You've got bone, you've got sinew, you've got tissue, you've got hair. Your skin may be darkened by light and melanin. This is a famous court case. Right now, Apple's being accused that their measurement for people of color is actually not as accurate simply because the light that's absorbed into the skin, based on different profiles of melanin, actually. Actually changes the readings that the device gives back. So all of these things add up to a really great site for measurement. And you think about it, when you go to a doctor, they put the pulse ox monitor on the tip of your finger and shine a light into it. That's where they put it. They don't put it on the outside of your wrist. So that accuracy is really key. And that translates into accuracy around sleep as well. Because the way we interpret sleep is we're looking for these changes in things like your temperature. We have accelerometers and gyros on the device. So we're looking for motion. We're looking for changes in your heart rate and respiration and your hrv, which turns out to be a really interesting predictor of moving between different stages of sleep. So the accuracy is really critical because it means that really the software and the sensors get to know you personally. And rather than sort of giving you some average, it's really personalized to your experience and your physiology.

Yeah, for me, this is about when people say, what does your oura ring do for you? It's about gamifying my sleep. Right. I know when I go to sleep at night, I'm shooting just for fun, because that's who I am. I'm shooting for my best night's sleep. And I know if I get to sleep at 10 versus 9:30 or if I have that glass of wine in the back of my brain, it's going, it's going to impact your sleep. And that becomes a trained behavior for me. And it works. I mean, if you can't measure it, you can't improve it. We said that before, and it's true. And I guess, can anybody get to 100? Have you ever seen 100 score on this thing?

It does happen. Yeah, it does happen. It's very rare, and we think it's pretty amazing that people can do that. But there's a slew of factors that if you really drive, you can get there. It's not necessary. You know, just making incremental improvements in your sleep will yield major improvements in the quality of your life. And as you point out, your, your mindset, your mental health is tied to it, but also your longevity. I, I, I go back and forth on the gamification and actually philosophically at the company, I think we're mostly about giving your body a voice and allowing you to really, you know, understand that voice and how it changes from its baseline. That is the key. It's about saying, you know, I'll give you an example. One of, one of my colleagues has a body temperature that's actually about a degree below 98.6. And so when he goes to the doctor and he has a temperature reading that says 98.6, you know what he's got, he's got a fever. And that's because he is different from everybody else. And the thing is like giving your physiology that kind of baseline so you can understand the deviations from it. That's the key, because as you change your behaviors, you can see the deviations and understand how you can improve or how that affects your physiology. So sleep would be one example. Heart health would be a another. Fitness would be another. All these things are measured from your baseline. Because you know what, for some people, 10,000 steps is great. For other people, 2,000 steps is way too much. So it is important to think about it as a personalized experience for you.

Which is really the future to think about just how personalized the advice. Because when we give people these to almost bring it back to sleep duration. If we give people these ranges or a number, like eight hours, go for that. And then that's hard if someone's, you know, that's not their target number, and then they feel uncomfortable and then can spiral kind of into some sleep difficulties. So the personalization is really exciting.

It happens all the time. I mean, people are always. HRV is a metric that in some sense it's not as well understood or well known, I think, by the common public. You know, heart rate variability, it's maybe where heart rate, resting heart rate was in the 90s. You know, people didn't really know if it, what was, what was good or what was bad or, you know, what zone they need to. We've all become, I think, really attuned to that because largely, I think fitness wearables have educated people. HRV is one that's great for recovery. It measures sort of the degree of change between heartbeats. And that degree of change between heartbeats is a good indicator almost of the tension between your nervous systems, your parasympathetic and your sympathetic nervous system. So HRV is one of these metrics that as you get educated about it, you learn how important it is and you start to see how sensitive it is. A bad night's sleep, a glass of wine, a big workout two days ago. Like, you'll see that in your heart rate variability. And it becomes something that you start to really change your behavior around as you, as you learn it. I think it's so important to recognize, though, because we get this question all the time, what's a good heart rate variability? And the answer is there isn't one. It's what's good for you. And by the way, it does change over your life. And men and women have different ranges, but there's not one answer. It's a set of guidelines. And frankly, it's about your physiology and the voice of your body talking to you. You just need to. How to listen to it and what to do about it.

Amazing. Well, Dr. Rebecca Robbins and CEO of Oura Ring, Tom Hale, thank you for this hour. I hope those of you listening realize sleep is a critical superpower for your health, for your peace of mind, for those that you love and those that love you. I love my Oura ring. Just gonna put it out there. If you haven't played with one one, they are relatively inexpensive and they'll change how you spend a third of your lifespan in sleep. So check it out. And, guys, thank you so much for our time together today.