Improve Sleep and HRV for Increased Focus with Apollo Neuro’s Neuroscientist Dr. Dave Rabin

Welcome to another episode of the Longevity and Lifestyle Podcast. I'm Claudia von Boeselager, your host, here to bring you the latest insights, knowledge, and science to step into the highest version of yourself for longer.

My guest today is Dr. Dave Rabin. Dave is a leading neuroscientist, psychiatrist, and health tech entrepreneur with over 15 years of research on chronic stress.

He co-founded Apollo Neuroscience, creating a revolutionary wearable that I'm frankly obsessed with that enhances sleep, relaxation, focus, and calm using touch therapy. Dr. Dave's diverse roles include the executive director of the Board of Medicine and the Apollo Clinic medical director. His passion for consciousness and healing led to non-invasive therapies for conditions like PTSD. Additionally, he explores epigenetics and trauma responses and contributes to psychedelic-assisted psychotherapy research. A distinguished graduate of Albany Medical College, Dr. Dave shapes healthcare through innovation and leadership. Please enjoy. Welcome to the Longevity and Lifestyle Podcast, Dr. Dave. It's such a pleasure to have you with us today, my friend.

It's a pleasure to be here with you. Thanks for having me.

Oh, I'm so excited. And I'd love to start with something you were presenting on recently in Dallas at the biohacking conference around attention and safety. And I'd love if you could expand a bit on this because I feel that so many people have so much anxiety nowadays. They don't feel essentially so safe. And I really like the way that you were explaining this. So Could you walk us through what you were presenting in Dallas a little bit around attention and safety?

Sure. So I think the simplest way to sum it up is that our nervous system is broken down into two branches. And one of those branches is the sympathetic fight or flight stress response nervous system that evolved over hundreds of millions of years to turn on when we are exposed to threat. Threat traditionally is like lack of food, lack of water, lack of air, lack of shelter, a predator chasing us in the jungle, being able to like not sleeping, right? Those are like the core things that are supposed to turn on that fear response, that fight or flight response. And that whole part of the nervous system is balancing resources with the parasympathetic nervous system, which is responsible for rest and recovery and digestion, metabolism, sleep, all of these reproduction, right? All of these things that we want to be focused on when we're safe and in a relaxing, comfortable environment when we're not under threat, but things we don't want to be getting resources when we're running from a lion in the jungle, right? And these systems, again, evolved over hundreds of millions of years into what we call the autonomic nervous system, which runs in the background all the time, allocating resources in our bodies, i.e., blood, to different systems. And attention is a finite resource. So when we have anxiety, when we perceive ourselves to be under threat, even if it's from not a tiger, but, you know, too many emails, too many responsibilities, too much news, right? All of these things start to overstimulate us. And when we're overstimulated, it tricks the body into thinking that we're under threat, even though we're not. And so that takes resources away, precious, precious resources away from our ability to control our attention. And being able to have free will to control your, our attention, one of the single most, if not the single most valuable resource we have as human beings, because what we pay attention to dictates what comes into our awareness and what comes into our consciousness and then what becomes part of us. Right? So when we pay attention over time, we concentrate information into our brains and bodies, right? That's concentration, focus. So all of these things are related to parasympathetic vagal tone, getting blood, which only happens when we feel safe. And we can only be fully present when we feel safe. And that full presence allows us full command over our attention and what comes in and what we're focused on. And when we're under stress and threat all the time, the sympathetic fight or flight nervous system is just sapping attention resources so that we can't focus. And then that makes us really uncomfortable and struggle. And then we think we have ADHD a lot of the time, but we don't, we just are stressed.

And I think this is so paramount today because we're living in an information overload distraction environment in society with the pings and everything going off and the influx of emails and being CC'd in emails with 20 people and everyone responding and all these fun things as well. And so, you know, what are you seeing as the consequence of this over time, right? As social media has exponentially grown and that ever-ready, ever-present, ever having to respond to an email in 5 minutes, things like this as well. Like what is happening to people's mental health as a consequence?

I mean, it's deteriorating, right? Like we're seeing that unfold in the mental health, the prevalent, you know, these epidemiological studies on how common mental health disorders are. We're seeing them skyrocket. It, right? Especially ADHD. There's, there's so many people getting diagnosed with ADHD because people are so stressed out that it looks like ADHD that we now have an amphetamine shortage, right? We have a stimulant shortage, which is unreal when they're so cheap and easy to make that we cannot supply all the people who are getting misdiagnosed with ADHD, which adult ADHD right now is one of the most common new diagnoses. Right. So, so thinking about your specific question of like, how does chronic stress, stress impacting our attention result in a direct mental health correlation?

Yeah.

We are literally so stressed out that everybody looks like they have ADHD and we're misdiagnosing it as such rather than just dealing with the stress. We're giving people amphetamines. We're giving people meth, speed, right? To make them work harder. And focus more and have more energy when their lives are actually genuinely exhausting already and they just need a little vacation and some, you know, some breaks, right? Some breathwork and some yoga and some meditation and some time to do those kinds of things.

Um, what would you suggest, Dave, like for people who may be like, oh, you know, I was finally diagnosed with ADHD and like, oh, and now I understand, but maybe it was a misdiagnosis. Like, how should people analyze or assess for themselves? Like, if actually it's just because they were so burnt out and overstimulated that led to an ADHD diagnosis?

I mean, I would, I would just ask yourself, you know, like, I think a good doctor, a good, a good psychiatrist, which is who I would recommend most people go to if they think they have an ADHD issue. I wouldn't just go, you know, dial the number, go to the website that you're, you're, you're advertised, marketed to on Instagram, right? Like, that's not the best way to go about this because amphetamines like Adderall have side effects., right? And all drugs have a cost, and this— the cost of amphetamines is poor sleep, which decreases your restfulness and your— and it increases your reliance on amphetamines because then you start to sleep worse. So then you need more stimulant during the day to keep you going. So it has like a slight dependence potential, not, you know, enough to get people's sleep disrupted is a huge problem, right? That's like the core of all of our recovery and where all of our resources get replenished. So that's like a, that's a real problem. So we always recommend go to a psychiatrist, get evaluated, and then the psychiatrist will ask you questions about what's going on in your life. And once you understand, and then they'll help you understand what's going on in your life and how what's going on in your life actually might be impacting your attention and your ability to focus and function the way you want to. And then they'll give you techniques. You know, a good psychiatrist will give you techniques that you can work on in therapy. The best ones are cognitive behavioral therapy, especially for ADHD. Um, and there's some other techniques as well that work on trauma, which trauma and ADHD go very much hand in hand and are frequently co-occurring. Because when you've had bad things happen to you, it's distracting, right? So, so people can sometimes identify through trauma therapy and psychedelic therapy, these early life events that were traumatic for them, just by resolving all the emotion, built-up emotion around those events, you can actually start to free up attention resources. And that's all it is. It's just a resource allocation problem.

I love that, Dave. And I think that's so empowering because you read more and more like, oh, there's so many children now with ADHD, or, you know, that women are often misdiagnosed or left undiagnosed for ADHD. I mean, obviously there is a confusion around, obviously with perimenopausal, menopausal symptoms, or like, oh, it might be ADHD, lack of concentration, focus, etc. Misdiagnosis is a real thing. And as you said as well, that there is such a consequence to being medicated, you know, and an impact on sleep and lifestyle and obviously for the overall body and well-being as well. So I think for people listening, really just to check in, like, are you living a balanced lifestyle? What are other practices that you could be introducing, like you mentioned, like meditation, breathwork, better sleep, less devices, less pings?

Yeah.

Like, where— yeah.

And like, what, what things— not just what can you add, because I think what can you add is important, but it's also hard for people because they don't have time.

Yeah.

So, the biggest part of it is like, what can you take away? Yeah. Like, what can you eliminate? What can you delegate to somebody else to help you? Right? We all, like, you know, we all have people that we can talk to that can help in different ways. So, it's just about thinking, how do I empower this person to help me get what we both, what we all want done together done? And it's really like cutting back. And just to give everybody an idea of like how significant the overstimulation problem is, in the first hour, because of smartphones, in the first hour of being awake, people are consuming as much information as they were consuming in a week in the 1950s. Wow. So just think about that in the context of human beings being— we are sensory organs. Our entire bodies are sensory organs. They're all built around taking in information to the environment. And we are supersaturating ourselves. If you have a smartphone and you're looking at it in the morning, we are supersaturating ourselves with information, so much information that our bodies are kicking off the day in a stress response, even if we don't realize it. And that's the piece where that I think people really need to understand and why cell phone, smartphone use is so unhealthy for children. And unintentional smartphone use is also unhealthy for adults because it is a distraction from just being with yourself and being present. And distracting and numbing yourself to pain or discomfort is not a way to make discomfort go away. It just makes it worse. So, we have to remember the human parts and that it's not about smartphones being bad, it's about our unintentional use of them. So not having intention is what's bad. We're like letting, we're like letting the phone dictate our lives rather than us using the phone as a tool to change our lives and make our lives more the way we want them to be.

Yeah, beautifully said. So I have to ask, in an optimal scenario, what is your optimal routine with your phone? And like, how do you— what's your best practices for yourself and that you'd like to tell others? And I appreciate every day is obviously not going to be like that, but, um, when you're doing things well, What does your day look like and what do you recommend for patients of yours as well?

I mean, there's a lot of things, right? So like I have my phone on like notifications off almost all the time, like 90% of the time. So the reason, unless I'm expecting a call from somebody, my notifications are off. So like do not disturb mode. So like that is important because then my phone is not capturing. That's like number one probably is my phone is not in charge of my attention. It's not like buzzing, ringing. Ringing all the time, then I have to look over. It's something that every hour, maybe for 5 minutes or 10 minutes if I need to, I'll go into my phone, I'll check my messages that I can only get on my phone, and I'll look at the stuff that I need to look at on my phone. So I'm choosing the time of where my attention is going when. Right? So that is number one, probably the most important thing. And if we— so making sure that if we want to be notified, we're saying, okay, I want my attention to be notified by this phone. So for this amount of time, I'm going to turn my, you know, do not disturb off. But then for the rest of the time, I choose when I interact with you, not the other way around.

Right.

So I think like, if that's the starting place, then that dictates like the whole rest of the way that you interact with the device, because every time you, like, I also don't, I don't go on social media and like doom scroll. You know, I don't just like, I don't go through school socials. That's not, unless there's a certain topic, like if there's a thing that happened in the world and I, and I want to see what's going on, like in the underground on, you know, and from people's perspectives, I'll go into social media to evaluate what's happening now. Right. Like with the, a lot of the MBMA stuff that's going on, right? Like this is a particular time where like being engaged in what's happening on social media and what people are saying is important. But in general, like, I don't. Do any of that and it's very topic focused and that also frees up a lot of my time. You know, people are spending like an hour or two a day or maybe more like just scrolling, right? And, and like there are better things that like we're human beings, you know, we can, we can do so much more than, than just fill our mind. Like that's, we're giving our attention away to something that is deciding what's important to us and what we spend time focusing on. And it's a computer algorithm. Right? So that like, it's like giving up your free will to learn stuff that matters to a computer to decide what we learn. And that is, you know, not good for a lot of reasons.

Yeah. So hopefully for many people listening that it's like, okay, let's just have that self-awareness. How much time am I defaulting to, let me just check social media for entertainment, distraction, or whatever. And then, you know, an hour has gone by. So, you know, how could that hour be better spent or just going inwards or, or, you know, choosing a different path as well, or as you're saying, look for something specific.

Or do you learn, like, look up something you want to learn about? Yeah, right. Like, say I want to learn about MDMA-assisted therapy. So you go on socials for 10 minutes and you see what you find. Or better yet, you start out by looking at a reliable source, right? Like, go to Google, go to Google Scholar, like, look up some reliable sources to give you information about what it actually is. Go to, go to the, you know, maps.org, like, go wherever you need to go, learn about it from the reliable resource, and then go to social media. Right? Social media is opinions. It is not a reliable source for information, right? It's the zeitgeist. It's like the zeitgeist. It's just like whatever is going on that people are thinking and talking about. And most people's opinions, sorry to say, just, you know, are not based in any kind of evidence. You know, opinions are just opinions. So like people don't realize that when they're engaging with social media and then things that were clearly not true start to appear very true. And that can be really scary, not just as an— on an individual level, but it's scary on a societal level. Like, it's scary from the perspective of, like, groupthink, right? Which is a really dangerous thing, a concept that impacts entire societies to do things that they should never, ever, ever do. And that's, uh, and that's just something we need to be mindful of because it's always—

it's always a threat. Yeah, and I hear more and more sometimes at a dinner or something like that, someone's like, oh yeah, I was— I saw on social media, I was reading on social media. I mean, alone hearing that, I kind of cringe and I was like, it's like saying, you know, in the Daily Mail I was reading this or whatever. And I think that just to have that awareness of like, look, look behind it, like what, where is that coming from? Do the research as well. Because I think there's a lot of fearmongering out there that again will trigger the parasympathetic nervous state as well, or the sympathetic rather nervous state. So yeah, I think that's a really good advice. So thank you for sharing that. I'd love to shift gears for a second and let's—

can I mention one more thing on this before we shift gears that just takes it to like another level for your listeners? So this is— so I don't know if you saw this, but there was an article that came out several years ago that maybe it was 10 years ago now that showed that Facebook was intentionally deciding what you saw. Yeah, this is, you know, which, which, which now is like kind of commonly accepted. But what was, what I think a lot of people don't understand is they were running tests on people and they would have like several hundred or a thousand people only seeing negative stuff, or it was maybe more than that, only seeing negatively biased, language biased posts. Then they would have people mixed and then they would have people only seeing positively biased posts. And the people who were part of that group that was experiencing only negatively biased posts were actually negatively affected by that experiment that they did not consent to participate in. And so I think this is really important to understand when we think about what is being fed to us on social media is that it is basically, from my understanding, completely unregulated and uncontrolled, and they can serve you whatever they decide to serve you. And if that is negatively impacting your emotional state for the day and messing up your whole day, you can't go after them for that. That is because you chose to engage in social media and allow them to feed you what you trusted them to feed you. And that could be part of an experiment. You don't know, right? I mean, it's really like the whole thing's an experiment. So I think people should just keep that in mind, that like, this is, this is real and it actually impacts your mental health and people in a big way. So it's just curious.

Yeah, no, that's super important. And especially keeping away, you know, even news. I say like to clients and things to take a week off, like a news detox. I mean, the world is not going to fundamentally change by you not being up to date on every little last piece as well. And people typically look at social media or news just before going to sleep, which is probably one of the worst things that you can do. It triggers anxiety. The cortisol levels are up. You can't get to sleep. You're stressed, waking up with nightmares, etc., which will also impact your HRV, which leads to my next question as well. And the nervous system's influence on HRV. And more and more in the longevity and health optimization space, people are paying attention to HRV. And before we, we dig in, maybe you could just explain for people who might not be that familiar, what exactly is HRV and why is it such an important indicator that we're looking at more and more?

So, so HRV is really interesting. It's, it's, it stands for heart rate variability, which is basically the rate of change of our heartbeat over time. So, for mathematical people out there, it's the derivative or the slope of the curve over time between when— how much time there is between each beat. And, it turns out that when we're in a stress state, even an immediate stress state like we're running from a lion or we just have too many emails and we're overwhelmed, the heart rate goes up. That's one of the first things that happens when we experience stress. Even before we even know we're stressed, our heart rate's going up and our blood pressure's going up. And as heart rate goes up, as our bodies are starting to perceive stress or threat, then the time between each beat shrinks and heart rate variability goes down. And so that's how it's measured. And, you know, and it can be measured with lots of different tools now. Some of them are more accurate than others. Obviously the medical and lab stuff is more accurate than the consumer wearable stuff. But the point is that HRV, as your heart rate comes down, what's happening? Vagal tone is going up. Your parasympathetic nervous system is getting resources, which is your calming rest and recovery nervous system. And that sends information through the vagus nerve, the primary nerve of the parasympathetic recovery nervous system, straight to the heart. And it tells the heart rhythm machine to basically be like, you can slow down now. We're not under threat. You're safe. We're not under threat. And we know that all safety experiences like soothing touch, soothing music, you know, all of deep, slow, deep breathing, all these things induce vagal tone, which then slows your heart rate. And as you slow the heart rate, the time between each beat increases and it varies more, and that increases heart rate variability. So heart rate, HRV, heart rate variability is really our best measure. It's a metric for how much vagal tone or parasympathetic recovery activity in your recovery nervous system we have. At any time and over time. And the higher our HRV is at baseline, now we're seeing like people seem to live, live longer and healthier lives. They perform better under stress. They recover faster after stress. They're less likely to get sick, more likely to recover if they get sick. So HRV is becoming this proxy for vagal tone that you can measure through the skin that start is an outcome measure for how recovered we are. And how resilient we are, how likely we are to quickly bounce back from stress. And that's really cool.

Yeah. Because it's so easy to find with different wearables that people might be wearing. And so if somebody's HRV is low, and I know that it's, you know, relative, right, then not two people will be the same. But what are modalities to improve it that you've seen most effective, let's say? What would you recommend?

I mean, sleep is the number one, right? So, getting good deep restful sleep is the number one way to improve your heart rate variability. If you're not sleeping, that's the number one way to knock your heart rate variability down. And if you're sleeping but not sleeping deeply, your HRV will go down. If you're drinking before bed, if you're taking sedatives, hypnotics like Ambien, benzodiazepines, things like that before bed, all of those kinds of things knock down HRV slightly. So, getting good natural deep restful sleep is the single most important way to improve it. As you start doing that, you can see pretty big increases even over the course of 3 weeks. And, that's actually how Apollo works to improve HRV cumulatively is that it improves your sleep. And, when your sleep gets better, then your HRV goes up, which is really cool. And so, it takes about 3 weeks to really see big shifts. And then, the other things are healthy exercise. Even just doing a 15-minute walk a day minimum is really helpful to just get your body moving. And, that improves physical endurance and just your physical capacity to deal with stress. And, it's good to push yourself once in a while. Doing deep breathing improves heart rate variability in the moment if you do slow deep breathing. Your HRV will go up and you can measure it within minutes. So, that's the fastest way to improve your heart rate variability. And then, as you do deep breathing exercises over time, if you combine them with yoga and stretching, it's probably even better. And if you do that over time, your HRV starts to cumulatively go up also. So, those are soothing touch also improves heart rate variability. Apollo improves heart rate variability through soothing touch. So, those are all the soothing things that you can do.

That help. Beautiful. So I'm excited to dive into Apollo and to share with my audience as well, because A, I'm obsessed with it and pretty much has it with me every day since having it since November. And I'd love to maybe take a step back if you can explain the journey to deciding to launch Apollo, Apollo Neuro, right? And it's the soothing touch device, if you will. So can you share with the audience and for people perhaps, you know, not watching but listening, maybe just to describe it a little bit so that they can envisage what exactly is Apollo Neuro, what is it doing, how did you decide to launch this really cool device?

So, thank you. And I'm so glad you're enjoying it. I'm wearing mine too on my chest. I'm talking. So, Apollo is the first wearable technology to improve vagal tone, recovery nervous system activity in real time and over time just by wearing it.. And it does so by delivering soothing sound wave vibrations to the body that the body feels as soothing touch, similar to holding a purring cat or getting a hug or somebody you like holding your hand. All of those things, taking a deep breath, all those things send safety signals to the brain and that helps the brain to feel safe enough to allow the recovery nervous system to start getting resources again. And so Apollo is a wearable tool and the first of its kind that starts, that delivers that benefit, which improves heart heart rate variability, also the first to improve heart rate variability and scientifically proven to do so. And, it does it in real time and over time by just calming the body and you can measure it. So, that's the technology. And, where it came from was as a psychiatrist and a neuroscientist, I was studying and working with in the clinic veterans and women and others with severe treatment-refractory trauma. So, PTSD that never got better and people who were really, really struggling. And what we realized was from working with those people and just, I started to see that the treatments we had available weren't working well. And only like 30% of people responded to the treatments that were considered the gold standard, which still are at the time, which are like Zoloft and Paxil. So most people are, we're not doing well. And so I started to look at the literature and see if anybody else published on these patterns of these kinds of patients not responding well to treatment. And it turned out that lots of people had, and lots of people had also started to publish on HRV. And that looking at HRV in these people was generally low. And the lower their HRV, the less likely they were to recover from PTSD. And so we started to think about, well, what are the ways that we could naturally boost HRV? Soothing music, soothing touch, like deep breathing, you know, there's all these natural things we were just talking about. So that boosts vagal tone, HRV goes up. So what if we we try to experiment with sending those signals to the body, would the body start to naturally increase heart rate variability and feel calmer and get better sleep and focus better and all those things? And so as we started to experiment with that, we realized that soothing touch was actually the single fastest pathway to get there. And the reason is because it, it's existed again for hundreds of millions of years since the oldest mammals first started nursing their young. Because after a mammal gives birth, it holds its young, and generally speaking, and then it nurses its young. And that creates a physical connection that releases a ton of, of oxytocin and dopamine and other empathy and reward-focused molecules that create bonding between mom and baby that also soothes baby and helps babies stop crying. Right? And this is a nonverbal instantaneous response that calms baby and creates and calms mom and creates, is based on activating the safety response system. So we were like, well, touch is a natural fit and people like to be touched. We just don't get enough of it. So what if we designed a technology that we could wear that helped give us some of that, more of that soothing touch on the go? And calm the body on the go, would that work? And it did. And then that was between 2014 and 2018 that we did that research at the University of Pittsburgh Medical Center in the Department of Psychiatry. And then, uh, Catherine and I pulled it out of the lab after the first double-blind randomized placebo-controlled trials came back positive. And we saw that HRV was going up reliably and significantly. And then we started testing that in the real world and then commercializing it in 2020.

This episode is brought to you by Apollo Neuro. Since I began wearing my Apollo in November, I've hardly taken it off. Literally, I'm obsessed. Apollo's wearable technology uses soothing vibrations to naturally regulate your body's stress responses and improve sleep quality, crucial for long-term health and longevity. You can wear the device on your wrist, ankle, or clipped to your chest, and the paired app has different vibration settings for waking waking you up in the morning with more energy, to focus time, calm, and helping you wind down in the evening. It also has an innovative stay-asleep feature which turns on if you begin stirring during the night, allowing you to sleep soundly throughout the night. Users report up to 19% more deep sleep, a 40% reduction in stress, and an 11% improvement in heart rate variability. Apollo tailors also for women, helping to manage stress associated with hormonal fluctuations. So if you're looking for a way to enhance your wellbeing and support lifelong health, you'll love Apollo. It's not just a wearable, it's a lifestyle enhancer. Check out Apollo Neuro today and save an automatic 15% off an Apollo wearable by visiting apolloneuro.com/claudia. That's A-P-O-L-L-O-N-E-U-R-O.com/claudia, C-L-A-U-D-I-A, or use code Claudia at checkout. This episode is brought to you by Nuchido TIME+. NAD+ has gained a lot of attention recently for its role in promoting healthy aging. There are many NAD+ products on the market, but unlike NR or NMN, Nuchido TIME+ is clinically proven to fix the root causes of NAD+ decline by switching back on NAD+ production pathways and reducing inflammation so the increased NAD+ can be used to enhance cellular health. Nuchido TIME+, is also clinically proven to reverse your biological age. Nuchido was founded by Dr. Nicola Conlon, a molecular biologist specializing in cellular aging. To try Nuchido TIME+, go to nuchido.com. That's n-u-c-h-i-d-o.com. And for 10% off, use code LONGEVITY at checkout.

So exciting. And now, so many people get to enjoy it as well. For people listening and watching, what are some of the use cases? Maybe you can just walk through how it is. And I absolutely love that in the app, it kind of has that pre-program of what, what you can do and the different cases. But can you share a little bit the thinking behind it and how it can be so powerful in different situations, essentially?

Yeah, I can do my best. It's a big question. So, Apollo, because it calms the body and basically puts us into meditative flow states, it can be used in tons of different kinds of situations. But, the most common way that people use it, and again, it can be worn anywhere on the body. It can be worn over clothing or under clothing, doesn't matter as long as you can feel it. But, the major use case of it is that people wear it to bed, and then they'll have it put them to bed at night and wind them down before bed. And then, they'll wear it overnight. We have an AI that we released, which is also the first of its kind that uses predictive AI to detect when you're about to wake up in the middle of the night and then turn on preemptively to prevent you from waking up. And, it actually works. We see people get up over 60 minutes more sleep at night if you're a middle-of-the-night waker-upper. So, that is a really interesting example of how AI is being leveraged to actually shift health outcomes in a way that we've never succeeded to do before in conventional medicine. If you talk to any sleep specialist, you talk to any mental health provider, there is not a single good solution for people that's effective in more than 50% of people to prevent middle-of-the-night wake-ups. I don't think there's a single solution at all that prevents them. You just have to do something after you wake up. So, this is actually like an application of AI that solves that massive public health problem. It's affecting like over 100 million people in the US probably. So, that's the main use case of Apollo. And then, after— so, it keeps you asleep. When you say, "I want to be asleep between midnight and 7:00 AM," it puts you to bed, winds you down, puts you to bed, and then regulates your circadian cycle so that you're asleep when you say you want to be asleep. Then, it wakes you up in the morning with gentle soothing vibrations. You don't have to use an alarm clock anymore. And then, it keeps you energized and focused throughout the day so that you don't need to use as many stimulants and don't disrupt your sleep. And then, it winds you down again at the end of the night. And so, it regulates your entire energy and sleep cycles for us like a wearable soundtrack for our emotional nervous system. And, in doing so, it helps to create that basic sleep structure that allows us to feel so much better. In— across— over time, not just immediately. But I would say about like 30 to 50% of people—

like, you had an almost immediate response to this when you first tried it, right? Yeah, I loved it. And you notice it straight away. And I think what I, what I really love is the different use cases. So you were saying with sleep as well, and I have the Oura, right? So I can see what's going on. But I'm not a middle-of-the-night waker, but I just feel more, more rested as well. And particularly though, during the day when sometimes, like, you know, after many calls and things like that too, attention might be a little bit down, it helps you really just to stay present and focused. And that I think is so powerful for, you know, that you don't need that extra cup of coffee or whatever is it that people might, might use as a stimulant. And the good morning setting that I love as well, it helps to kind of get you awake in the morning as well. And I think for people, I was telling some friends about this, like, I can't imagine it at all, but it's like this gentle vibration on the skin. And I think as you were saying was that it's one of the biggest receptors, right, that we have. And so having that gentle touch to— in the right vibration, you know, helps you to wake up or to be more focused. Or I think you have like a social setting, right? You've like different scenarios, which is quite fun as well. How does it work with sound? Like, how are those different frequencies? How did you ascertain which is the right frequency for the wake-up versus the calm versus focus time?

So, we did a lot of research. It starts by reviewing everything that had already been published about this topic before we got into the lab and started doing our own prototyping. And then, we started doing our own prototyping. And, there was actually a decent amount known before we got in about how sound and vibration affect the body in different ways and how they affect the autonomic nervous system. And, we know how the autonomic nervous system has to be tuned in specific ways to achieve sleepy states or energy states or focus states there has to be a certain balance between vagal nerve rest and recovery and fight or flight, right? Like when you're focusing, you have some sympathetic activity that keeps you energized and focused and zoned in, but you also have a bunch of parasympathetic vagal recovery. So there's a balance. And so when we started to understand how the nervous— because this has been studied for 100 years, right? So none of this stuff is new. What was new is that we then took that information from the past literature and we went into the lab and we created these vibrating prototypes that could deliver these vibrations to the body in the frequency range of the touch receptor system. So, this is specifically subwoofer-level frequency ranges. So, it's music level. If you hold Apollo to your ear, you can hear it very gently, but it's bass, deep, deep bass. So, 10 to 200 Hz, it's very low frequency. And so, in that frequency range, our touch receptor system is actually more sensitive than our ears by a lot. And so, we were able to use that frequency, those frequency ranges, and then compose dozens of different vibration patterns across the spectrum and then send them to people in these double-blind randomized placebo-controlled trials and say, "Hey, after you felt this for 30 seconds, we're going to measure all your biometrics and your EKG and your brainwaves and all that stuff, but tell us how you feel." Can you notice a difference between 30 seconds of this and the last one? And people overwhelmingly, within just as little as 30 seconds, could reliably report how it made them, how it changed how they felt within just 30 seconds of feeling it. So that was really, really, really interesting. And they had no idea what vibrations they were getting. We had no idea what vibrations that were being sent to them. The computer randomized everything. So it was really really fascinating research. And then that formed the foundation of a map of the nervous system and how the vibration patterns affect the nervous system in specific ways. And that became the prototypes that we put out into the world.

So exciting. And is every part of the body— because I know you can wear the Apollo Neuro like on the inside of your ankle or on your wrist versus like, as you're saying, like by your chest— are there different receptors? I mean, does everything go to the brain in the same way? Or— you know, the farther away it is from the, the brain, the more of an impact, the more power you need, and, and frequency. Like, how does that work in terms of how the body receives, um, in different locations, the frequency?

Yeah, it's interesting. You know, distance from the brain doesn't seem to matter that much, physical distance, because Apollo, Apollo's base vibration, so it actually conducts better through dense material, and dense material being like bone, right? So Apollo on the ankle, I think, is the favorite spot for most users, and that is even women. And that is because, from what we could tell, the ankle bone is one of the biggest, densest bones in the body, or the leg bone, the femur, and the tibia and fibula. So those bones together are conducting, and the proximity of Apollo to the head of the tibia or fibula, that is transmitting in addition to the touch receptors in the surface of the skin, it's transmitting or the subdermal layer, it's transmitting that through bone to the brain. And, that vibration is really, really powerful. Proximity to bone matters the most. And, it just needs to be felt gently. It doesn't need to be distracting. The whole point is to be mindfully present. And Apollo induces those mindfully present states you were talking about earlier. And that's what gives us access to our attention resources, taking it full circle to the beginning, right? It helps us feel safe and calm in our bodies. Recovery nervous system gets activated. All of a sudden, where our brains are like, amygdala comes down, our brains are like, oh, I'm not under threat anymore. So then I have more brain resource availability to devote to whatever I want to pay attention to. You restore attention control. Focus increases, right? It's literally that straight of a path. And that's what we're trying to teach people to do. And Apollo is just another tool that helps people get there.

Which is so exciting because it's so simple, essentially, as a small wearable device that has so much impact and power, I think, on mental state, mental capacity to focus, to be present, which I think is what most of us strive for.

So, I congratulate you guys for this amazing device. And anybody who's listening, by the way, if you want to feel Apollo right now, you can join us on good vibes by just downloading the Apollo app to your iPhone. If you have an iPhone, this is not available for Android yet, but if you have an iPhone, you're listening, go to the App Store, download the Apollo Neuro app, A-P-O-L-L-O space N-E-U-R-O, and then just open it and wait till you see Feel Apollo on the screen. And then you can click Feel Apollo and you can actually experience Apollo through your iPhone with us right now.

So definitely worth checking it out. And obviously the device is amazing and we'll have links in the, in the show notes below. And Dave, I also want to talk about combining treatment touch with psychedelic-assisted therapy. I know you're very passionate about this. Where, where did your interest and passion come from, um, from going down and getting trained into psilocybin-assisted therapy, MDMA-assisted therapy, um, and and how are you bringing that treatment touch into play?

By treatment touch, you mean like therapeutic touch, or you mean specifically the psychedelic-assisted therapy protocols?

Well, so for the protocols, you're also including the, the treatment touch as well, and you're using Apollo Neuro as part of the psychedelic-assisted therapy, if I'm not mistaken?

We are. Apollo is the only wearable that's being used to help improve outcomes in psychedelic-assisted therapy. It's being used currently by ketamine clinics in the real world throughout the U.S. before, during, and after ketamine sessions. And then, it's also being used in a trial in British Columbia for traumatized first responders with, I believe, ketamine and psilocybin. And then, it's also being used for integration after MDMA therapy in collaboration with MAPS and Lykos. So, that is what's happening. Currently, but we don't have, I mean, we have seen lots of fantastic results from the community of people, which is why we started these studies who have been using Apollo with recreational psychedelics, hundreds and hundreds of positive reports. So that's been really exciting. And then, you know, the results from the clinical trials will show even more, but the fact that ketamine clinics are actively using it and in an unregulated environment, because it's a wellness device, is, is really exciting. You know, that is— and it's nice because it's like same category as an Apple Watch. Anybody can use it for that.

Um, but yeah, can you explain the benefits, um, specifically around— and maybe just for people who are not that familiar, like, what is the power of psychedelic-assisted therapy? We've had obviously a few different guests on, um, some that you'll know very well discussing it, but in case people missed that episode, you know, why is there such a renaissance happening around psychedelic-assisted therapy in your view? And how is, you know, Apollo supporting the processes from the before, during, and after integration of these treatments?

Yeah, that's a great question. The research into— so for everybody, so everybody understands, the research into psychedelic-assisted therapies like MDMA-assisted therapy, from the published results to date, are the best results we have ever seen in the history of psychiatry for any mental illness ever. And so people that are being put in. Yeah. So, so, and I'll give you an example, right? So, so right now, the current standard of care for treating depression or PTSD is select, is SSRIs, selective serotonin reuptake inhibitors like Paxil and Zoloft. And these medicines are, are often good at stabilizing people, but they are not good long-term and most people never actually get better.. And I would say, you know, on the order of with PTSD, it's like over 70% of people, 70, 7-0%, are never getting better from PTSD. They always have a diagnosis for life with SSRI treatment alone, even if you try both and try and therapy and everything. So that's like not a good statistic. So with the way MDMA, and what happens is when, even if the drugs do work for people, if they stop taking them, relapse almost 80% of the time. They have become symptomatic again, right? So, it's really like a medication for life strategy in the current paradigm that we're using. MDMA-assisted therapy, that is 3 doses, 42 hours of psychotherapy with 2 therapists over 12 weeks. So, it's a 12-week prescription experience, confined 12 weeks, not for life, 12 weeks. And in 12 weeks, something like 50-something percent of people are no longer meeting diagnostic criteria for PTSD. 50, 5-0? Yeah, 5-0. And these are people who have had PTSD for on average over 17 years, treatment resistant. Nothing has worked for them. And over 50% of those people are no longer meeting diagnostic criteria for PTSD. This is double-blind, this is double-blind randomized placebo-controlled. Studies. And, one year out, which is even more remarkable, that number goes up to 67% in the phase 2 trials after the treatment is stopped. So, this is again unprecedented in the history of psychiatry. This is more like the effect of antibiotics to treat infection, right? Whereas infection prior to the discovery of penicillin used to be in large part a fatal illness or an illness that resulted in amputation or chronic lifelong illness. Then, you know, Alexander Fleming invented penicillin, synthetic penicillin, discovered it in 1928. And all of a sudden, within like 20 years, human lifespan dramatically improved and healthspan dramatically improved. It was like a world-changing discovery and thought to be one of the greatest discoveries of the 20th century. And he won a Nobel Prize for it. Right. And that was based on single, single-person trials, case studies. Right. That's how antibiotics started out and came to be. It was case studies, not double-blind randomized placebo-controlled crossover trials, right? So this is— so MDMA is really like that effect. It's taking what was thought to be incurable mental illness and creating, from the study data, long-lasting outcomes because it works from what we can tell so far. Again, this is— studies are still out, but what we can tell so far is that MDMA therapy seems to work, just tying this back to the safety and attention thing, to help us feel safe enough by activating molecular pathways of safety and safety learning in the brain. It helps us to feel safe enough by amplifying the safety that's already present from the two therapists holding this safe container for this patient. It amplifies that safety enough for people to go back and remake the meaning of past traumatic events. And then resolve the emotion, the unresolved emotions around them, and then integrate that into your life and then figure out how to feel safe enough to trust yourself and heal yourself. Because Hippocrates and all the Eastern tribal medicine practitioners, like history says that the source of healing is within the person seeking to be healed. It can't come from outside. So this technique is so paradigm shifting because with MDMA because it's amplifying safety enough that it's almost looking like, psychologically speaking, like a reverse trauma, like safety learning being the opposite of fear learning, which is what happens in trauma. So, it's like a reverse trauma that is starting to molecularly shift the functioning of our neurons and our brains around safety and healing. And, safety unlocks healing. And, Apollo works really well in this situation as does consensual soothing, ethical soothing touch, these work really well in these situations because what do they do? They amplify safety. It all comes back to safety. And so, that's why psychedelic medicines are so interesting is because they can be used to amplify that.

And it's not just MDMA, but MDMA is the best example of it that we have. Today. Yeah. And I mean, those numbers are just so astounding. I hope that that's really registered by a lot of people. You know, I grew up in the '80s in the US and the whole, you know, dare to be different and don't take drugs. And when you start looking into the background of actually where that came out of, I think it was one of the Netflix series had a funny way of portraying, you know, those hippies got their hands on LSD. No one wanted to go off to war in Vietnam. Politics and was like, okay, how do we get them to go to war? Let's ban LSD, even though there was such promising research out of psychiatry for treatments already in the '50s and '60s, right? And so that brainwashing that's been done and people so fearful of it— what would you, what would you say, Dave, so people could be more open if they are in need for psychedelic-assisted therapy?

Because it's so powerful. Yeah, I mean, I think it goes without saying that all of that negative news that came out was generally speaking, back in the day, it was generally speaking propaganda-based news. And we know even now looking back from the Nixon tapes and the interviews that the decision to ban LSD and other psychedelic drugs was actually a racially motivated decision. It was to specifically have a reason, a legal reason, being drug possession, felony, et cetera, to prosecute and imprison war protesters and especially minority war protesters. So this is known. And so it's very, very clear, and it should be made clear to the entire scientific community, at least at this point, that psychadelic medicines used properly are extremely safe and they have overall overwhelmingly a lower side effect profile when used properly, just like any instructions that come with any drug, right? That when used properly, these have less side effects than most other current prescription medications that we use for mental illness, and they have longer lasting benefits when used properly. It's a big caveat there. Right. But that's the same for any medicine, any surgery has to be done according to protocol. And those protocols are known. It's known what works and what works well and consistently.

So yeah, that's kind of the gist. Yeah, beautiful. What are you most excited about? What's coming up in the field of psychiatry, neuroscience, psychedelics? What's happening in your world, Dave, that is making you very excited?

Well, I mean, there's so much good stuff going on. I think to tack on to the last question that you had, I think most people don't realize that ketamine is the only legal psychedelic medicine for treatment of depression and other conditions can be used off-label. So, ketamine is the only legal one, and it's only an hour-long experience and it can be done with psychotherapy and it can be extremely effective requires more doses than 3, sometimes 12, but it is extremely effective with psychotherapy. And, we do this practice currently in our clinic. We have other clinics that provide that we partner with that do this work around the country. And, it's extremely successful work when done properly with good therapists or therapists in our case. So, I think for anybody who is interested in psychedelic therapy, ketamine is the best first option. And, even when MDMA and psilocybin come out, ketamine is still going to be the best first option because ketamine can be delivered while you're taking other drugs. And, a lot of people don't realize that you shouldn't be taking psilocybin or MDMA or many other psychedelics when you also have an SSRI antidepressant on board or other antidepressant medication or other mental health medication. They don't always mix well.. But ketamine makes most things well. So, it's a very safe, very effective medication. It's been studied for over 70 years. It's safe. It's used in children for surgery, pregnant women for surgery. It's extremely safe. So, that is the best first option for anybody who's listening who's interested. And, what I think is really exciting is that we have that and we have the ability to deliver ketamine therapy now over Zoom. To people because ketamine is so safe. Pharmacies, they've been using it for chronic pain management from home for a really long time. And so, now we can use it for psychotherapy at home at much lower doses, much more occasionally, infrequently as what's being used for chronic pain. And, it has very few, if any, side effects, which is really great. It increases access to care dramatically when you don't have to come into the office as often, to get your treatment. And that is a huge deal for patients. It decreases the cost of care, increases access. And then we can start to use tools like Apollo in those experiences because you don't have a therapist there to hold your hand when you need, when you want somebody to hold your hand, but you can wear an Apollo and have you being, and you can be in control of when you're touched, right? And when you're soothed and calm. And that is actually extremely powerful and therapeutic for people in these experiences, which is why so many ketamine clinics are using this. I think we've had a couple thousand patients now over the last several years who have been treated with Apollo as an adjunct to their ketamine therapy.

So exciting. So exciting, Dave. Yeah, I'm so grateful for the work that you're doing and how it's impacting so many lives.

You're multifaceted.

You're so busy with so many different things as well, but your passion is so clear. And being at the forefront of this space as well. So thank you so much for all of that. Where can people follow what you're up to, reach out to you? Where would you like to send people?

And we can link it in the show notes. You can find me at my website at drdave.io or apollo.clinic. And you can also find me on socials at Dr. David Rabin on Instagram and Twitter.

And you can also check out apollo-neuro.com, A-P-O-L-L-O-N-E-U-R-O.com, or wearablehugs.com, which is what the kids call it. I love it. And we'll have everything linked below in the show notes. Dave, do you have any final ask or recommendation or any parting thoughts or message for my audience today?

I mean, I think the— there's a lot of things for us to do for ourselves in the world. You know, it's very— it's a really overwhelming Life is a very overwhelming experience for many of us right now, myself included. And, you know, I think one thing that we teach our patients that, you know, I've been practicing myself that I found really helpful is just to try to find reasons to be grateful more often. Beautiful. Right? And it doesn't require— it actually requires almost no effort to do, which is the beauty of it. Because normally we're still using those brain resources to think about stuff, but we're thinking about them from the standpoint of how much they suck. And, we could be just spending that same amount of effort thinking about how grateful we are for ourselves or the ability to take a breath or for getting out of bed this morning or for taking care of ourselves or anything about ourselves, just directing that attention to gratitude and saying, "I'm going to express gratitude for myself right now rather than thinking about how annoying it is that I have to go live another day, that kind of thing. And that actually rewires your brain. It actually rewires your brain. It's actually shifting the association of your life and yourself and everything around you to one that is more graceful and grateful rather than one that is more fear-based or upset or shameful or guilty and afraid. So, that's, I guess, what I would leave everybody with, because we can do it in any moment, and it's always good to have a reminder.

Yeah, thank you also for the reminder. So I'm so grateful and so much gratitude for you and the work that you're doing. Such a great friend. So thank you everyone for listening and tuning in, and thank you so much, Dave, for coming on today. Such a pleasure.

My pleasure. Thanks again. Thank you.