The #1 Anti-Aging Tool You’re Ignoring (Hint: It’s Free and Happens at Night)

Coming up on this episode of the Dr. Hyman Show.

I often tell people that you can overeat your way fat, you can under exercise your way fat, you can under sleep your way fat, and you can also overstress your way fat. Stanford University, they found that just one night of sleep deprivation has a traumatic effect on suppressing leptin. Just one night of sleep deprivation, we're.

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For my website store for a summary of my favorite and thoroughly tested products. Human beings are the only species that will deliberately deprive themselves of sleep for no apparent good reason.

Like doctors, you mean?

And like doctors, exactly. But what does that tell us? That tells us is that Mother Nature has never had to face this challenge of sleep deprivation. So no wonder there are no safety nets in place. So no wonder that we firstly, you know, go down very quickly biologically in terms of our health. But also, don't forget that that is such a rare circumstance that when it happens, when the brain starts to sense, I'm not sleeping enough, Now, it doesn't know why because we're watching Netflix. It just says, red alert, break glass in case of emergency. I'm not going to care about you, the people that I love. I have got to go into essentially low battery status and take care of myself. So you lose your empathetic sensitivity. We looked at doctors and there's great study from a team in Israel too. And what they found was that they started to prescribe less, and it was necessary, less pain medication for their patients, the more sleep deprived they were. Why? Because they lost their empathy. They did not care. And so patients are suffering. They are more sort of ensconced in nociceptive, you know, drench of pain because the doctors just don't see it.

I mean, I remember honestly, Matt, because I was in, you know, residency and working hard and I was delivering babies, working as a family doctor. I mean, I spent many, many, many nights not sleeping at all. so not even having two hours of sleep, just not sleeping and working 36 hours straight. One shift was 60 hours. And, and, you know, I remember how I would feel, and I, and I was like, you know, when you force yourself at first, you're like, your body's just, like, shutting down, and then you learn how to caffeinate and override your body's sense of needing to sleep, and then you kind of will yourself through. And, you know, the idea is, you know, you're a doctor. You have to be ready to go at any time. You have to deal with. crisis and pick the right answer and do the right thing and be able to function in the worst conditions, which it's kind of like a Navy SEAL, you know? Yeah.

It's almost like a hazing that we went through it and you're gonna have.

To go through it. But it's horrible. I mean, my daughter's in medical school now, and she, you know, she called me one morning after one of her first shifts where she had to do this. She's like, I don't want to do this. This is horrible. And I'm like. And I think it's a, you know, this, the sleep deprivation crisis in America, it's like, It's sort of parallel to the lack of exercise, the crappy diet we have, it's degrading our health. And you combine all those things together with all the chronic stress, it's no wonder we're the sickest and fattest nation in the world, pretty much.

And if you look at the curve, the decline in sleep over the past really 70 years for which we have good data, and if you look, for example, at the rise in obesity over the same duration of time, those two things go in opposite directions. as sleeping is coming down, obesity is going up. And we know that a lack of sleep changes your appetite hormones. It changes your ability to dispose of food and specifically regulate your blood sugar. So you are more obesogenic in terms of your profile of weight gain.

Crave more carbs and sugar. I remember that. I mean, when I was like, you know, two in the morning, I'm working the ER, I'm exhausted, I'm like, give me the sugar.

Yeah, that's all you want. And that's exactly, it's not just that you eat more, which you do, it's what you eat, that's the problem. You go after the heavy hitting stodgy carbohydrates, simple sugars, and you shy away from the sort of, you know, the leafy greens, the nuts, and the good proteins, because you are just on a junk food binge. Well, you want to get energy.

Yeah. And you want it quick. Yeah, yeah, yeah. I remember that. So, you know, it's the question is, you know, is the sleep deprivation a big part of the cause? And because of the decline in sleep, it seems like it may, because I've read these studies, they take young college kids and they basically sleep sleep deprived them and they're healthy, but then the ones who get sleep deprived just eat more and eat more sugar and carbs.

That's right. And you can see that same replication of failure across multiple organ systems. So for example, I take a young healthy set of males, I limit them to, let's say, four or five hours of sleep for five nights. They will have a level of testosterone, which is that of someone 10 years their senior. So I can age a healthy young man by 10 years by short sleeping them for a week, you can take people who have perfectly regulated blood sugar, no problems with their blood glucose whatsoever, put them on that same regiment of four or five nights of short sleep, and at the end of it, someone like you would look at their blood work and you would say, you are bordering on being pre-diabetic right now. Again, that's within the space of days.

Days, yeah.

So I think it's, again, an A demonstration to us that sleep, we don't have any real wiggle room. It's not negotiable.

Yeah.

So in terms of the reasons we're not sleeping, it's clear we're not sleeping. Is it because we're too busy, too stressed? Do we have too many obligations? Is it because we're watching too much Netflix? Is it because we're scrolling on our phones? Is it some other factors? What are the main factors that are leading to the sleep deprivation crisis? and they're causing, you know, last I heard was like 70 million Americans having serious sleep issues.

Yeah.

Right? What are the main causes?

All of the above plus more. So there's not necessarily just one cause. Let's start at the hierarchical government level. There is no first world nation that I know of that has had a major public health campaign regarding sleep. Why not? We've had it for drunk driving. We've had it for safe sex. We've had it for, you know, all of these different things. But there's nothing there for sleep. And yes, you could argue from a cynical perspective, it's because we want you, you know, from a capitalist society, we really want you to be doing two things. You're either, you know, producing things or you're buying things or you're consuming things. And if you're asleep, you're not doing either of those two. So you could argue conspiracy. I don't think it's that. Yeah, probably not. But, and we've actually, I've actually just recently started a public charity, a foundation specifically designed for global sleep education. Take it a step down. There is the World Health Organization that I spoke to recently. There is no educational module for children translated into 37 different languages across different age ranges that educates them on the importance of sleep. So no wonder there is a parent to child transmission of sleep neglect. We have to change that too. Some of it is about education. The second part is mental health. We have a rising tide of anxiety, in society. People are so stressed and we get people coming into the center at UC Berkeley and they'll say, I am so tired. I am just so tired, but I'm so wired that I can't fall asleep. It's a tired but wired phenomenon. So the anxiety epidemic is causing sleep problems.

And that's adrenal too, right?

And that's adrenal.

Cortisol rise at night.

It's cortisol rise at night. It's because of that, what we call the HPA axis, the sort of the cortisol descending chain. It's also because the nervous system almost is forced into a locked position of the fight or flight branch, what we call the sympathetic nervous system, which is anything but sympathetic. It's very agitating.

Yeah.

And we cannot sleep when we are wired into the fight or flight branch. We have to switch over to the quiescent branch, the parasympathetic. so I think those two factors, the adrenal sort of nation, as it were, together with this fight or flight stance of the nervous system, is a royal roadblock to good sleep at night. I think it's one of the biggest factors. We've then also got the combative forces of entertainment and social media, which are on the, of course, consuming. I'm trying to get my wife to stop scrolling on X every night to.

Figure out what's happening in the world. I'm like, why are you doing that before bed?

And it's the worst time because In this modern era, we're constantly on reception. Very rarely do we do reflection. And the only time we do reflection is when our head hits the pillow. And that is the worst of times to do reflection. Because when you do that, you start to ruminate. When you ruminate, you start to ruminate. When you ruminate, you catastrophize. And when you catastrophize, you're dead in the water for the next two years. Because, you know, everything seems twice as bad in the dark of night. than it does in the light of day. And if we're doing that right before bed. So I think there are issues there. Sleep disorders are on the rise. Insomnia, which I think is a consequence of the anxiety and the stress. I often think that insomnia is the revenge of things that we've not processed during the day and got resolution to. We've got sleep apnea, snoring. I think that's heavy snoring or can be an indicator of that. that's certainly comorbid with diabetes and also obesity. So I think you've got all of this collection of factors together with the stigma that we described earlier, which is, well, I'm not really that proud of sleeping more. Why should I be? Because society doesn't reward it. You know, it's the type A, the early bird catches the worm. Maybe that's true, but I would say based on the data, the second mouse gets the cheese. And what's strange is that we... Never heard that one.

The mouse got the cheese.

But I find it funny that we chastise people who wake up late as being lazy. But we never say, oh, you go to bed early, you're lazy.

Yeah.

Well, that's night owl and that's morning lark. It's not your fault. So I think there are a whole collection of conspiring factors that together conflate to this enormous sleep challenge that we have in society.

Yeah, there's a couple of things I want to drill down into because I think that in your article, you talked about gut dysbiosis and gut dysfunction and the microbiome is playing a role in sleep, which is something that most people have never thought of. And it was a substantial part of your article and we'll link to the article in the show notes, but it was interesting to me because I think that inflammation plays a big role in sleep disruption. and the gut microbiome plays a role. And also environmental toxins may play a role, nutritional deficiencies may play a role, and there are things hormonal dysregulation plays a role, and these are things that are not really well investigated by conventional doctors and not well understood, but sometimes it's as simple as just giving someone magnesium, 'cause 45% of the population's low in magnesium and you give them magnesium at night and they're sleeping like a baby. Or their iron's low and they have iron deficiency and people don't realize that a low ferritin correlated with sleep. Yeah, restless leg syndrome and sleep deprivation and nobody checks that. So can you kind of walk us through some of those unusual kind of things that may be contributing besides the social factors and the stress and the adrenal and the, you know, the things that we just talked about?

Yeah, I think, you know, all of those factors that you just described will all feed into gut dysbiosis. And there is, I think, a bidirectional, and this is what we spoke about in the article, a bidirectional relationship between your gut health and your brain sleep health, meaning that when your gut is in balance with that sort of collection of the flora and the fauna in your gut microbiome, it can send a health related signal through the nervous system by way of a major highway that connects your gut to the brain called the vagus nerve. And that can help.

That's not like Las Vegas, that's V-A-G-U-S. That's for relaxation. That's the relaxation nerve.

That's the relaxation nerve, but it's also a major informational highway bidirectional communication path between your brain and your gut. That's how we think that the gut can influence the brain. And that's how we think that if you get the gut right, it may be a new approach to a sleep aid because then you can get the brain right. And it works in the opposite way. which is that when you are sleeping well, it can communicate a signal for improved gut health through the vagus down into the body. But when you are not sleeping well, and there's been some great studies, for example, in the extreme with jet lag, my goodness, do you see that when the brain becomes deficient in its sleep through this communication pathway, you will get significant gut dysbiosis. And many people will tell you one of the things that happens when I'm jet lagged, is that my tummy is just off. Oh, right. Oh my goodness, things don't go well for me and I don't quite understand why. I'm eating the same things, but it's probably because of this gut dysbiosis caused by a lack of sleep.

Interesting, you know, I'm wondering, and this thought popped in my head because we know as we get older, our sleep degrades. That's right. And we also know that as we get older, our gut microbiome degrades and the diversity degrades. Yeah. I wonder if there is a link there because why do people who get older not sleep as well? It's an interesting question if it's been answered.

But maybe we should have asked that. So it's not been answered yet. I suspect that we have enough data to do the correlation study that you just described, which is, are these two things related? For example, if you look across a longitudinal study, and if we, I mean we haven't been assessing the gut microbiome for probably long enough to have good longitudinal data yet in the gut microbiome, But we've got plenty of longitudinal data in sleep, meaning we've started off assessing people in their 30s or their 40s, tracked them over 15, 20 years, and then asked, is the sleep that they've been having across their life predictive of their all-cause mortality, cardiovascular mortality, cancer mortality? And we've got that data. What we now need is to look at GERT health and ask, as that sleep is declining across the lifespan, longevity, what happens to their gut?

What happens to the gut? Yeah. I just was listening to Lee Hood's talk for the Human Longevity Institute yesterday.

You know Lee Hood?

Yeah, yeah. Amazing. Fantastic.

Yeah.

Systems biologist. And he was talking about how pretty soon we'll be able to look at just a few metabolites in your blood to look at the diversity and health of your microbiome.

So through a simple blood test rather.

Than collecting your poop, which isn't really.

Fun for most people. No, no, yeah.

You have to be of a certain type to really enjoy that type of stuff. Exactly. So, I mean, there's- I think we're getting there. Actually, see these patterns and see the biomarkers and also the gut dysbiosis drives inflammation and it drives activation of an irritable brain. That's right. You know, I think we used to think that irritable bowel in medical school was what we called a supertentorial problem, which in English means it's all in your head. It's above the part of your brain called the centorium, which just keeps your, you know, your brain on the top. And, and it's like it was a pejorative view that we doctors had, which is if you're, if you have irritable bowel, it's because you're just a a neurotic person and it's sort of you're crazy and that's why your tummy's upset. And it turns out that the opposite is true, that it's the imbalances in the gut flora that are causing the brain to become irritable. And that's really what you're talking about here is that if you've got imbalanced flora, that your sleep isn't good.

That's right. And to me, that's one of the exciting parts of it.

Is that treatable?

Is that it's both treatable and it's a novel, you know, is it a novel sleep aid pathway? I don't know. I don't know if it's powerful enough to come close to that. It may not be.

But I had a patient and NF1, or maybe actually NF2 now, because both people have said this to me, there's probiotic companies making sleep probiotics.

Yeah.

I've seen them too.

And they said it dramatically increased their deep sleep. And I was like, wow, that's crazy. And I was like, how does that work?

I mean, I love to see the data, you know?

Yeah, yeah, yeah.

But it's interesting. Even, I'm not trying to be, you know, too skeptical, 'cause as scientists and doctors, you and I both know absence of evidence is not evidence of absence. So don't judge too quick.

But right now, I think the jury's out. Yeah, for sure. And I think, you know, inflammation also will drive dysfunction of the brain. And most of the brain diseases, and you could argue that sleep is a brain disease, right?

Yeah.

I mean, it's the brain not doing what it's supposed to do. Yeah, when you have sleep disruption.

Yeah.

Depression, anxiety, bipolar, schizophrenia, autism, ADD, depression, Parkinson's, Alzheimer's, these are all inflammatory brain diseases.

So, I'm- and Alzheimer's disease, there's some really fascinating data regarding inflammation and Alzheimer's disease as a causal relationship now.

Oh, for sure. For sure. Rudy Tanzi, actually, you know Rudy Tanzi, he presents an amazing set of data which has to do with a certain population that they've studied that have a gene mutation that prevents inflammation. And on autopsy, at death, these people were cognitively perfectly normal. On autopsy, their brains were just filled with amyloid, like the worst end case terminal case of Alzheimer's, but they were perfectly normal cognitively. Which was so striking to me, and it was the inflammation that's really the trigger.

Right, and I think we don't yet know what's happening with tau, which is the other tau protein, which is the other sort of culprit there, with inflammation, I suspect it may be the same story. It may be even more powerfully explanatory of cognition. But, you know, it's all of this just once again teaches us, I think you and I, and maybe people listening, that for so long in medicine and science, we took a siloed organ or system specific approach. I was a cardiologist. I was a neurologist. You know, I was an immunologist. We are an embodied species, brain and body.

I'm an everythingologist.

Yeah, exactly. And that's what, if your doctor says that, you're with the right doctor.

Yeah, yeah. I mean, this is how the body works. It's just common sense, right? We're one integrated ecosystem, and that's what Lee Redwood has really pioneered, which is the idea of systems medicine and systems biology, where we're a big network of networks, and everything's talking to everything all the time. And so, a sleep disruption is sort of the thing that actually, I think, is influenced by so many different factors, like toxins, and I personally had this happen to me. I was the greatest sleeper in the world, and then I got mercury poisoning. And we know mercury toxicity, one of the symptoms is insomnia. And I don't know how it works. I don't know how it causes it, but we were talking earlier before the podcast started about mitochondria and how many of the things that we are exposed to in the environment are mitochondrial toxins and that it's energy and the body needs energy to run everything.

And I imagine it's critical in sleep regulation as well. Fundamental.

Yeah.

And during sleep, we have a metabolic reduction. Part of the, one of perhaps the restorative functions of sleep is to have a metabolic downturn to a degree. But I think the other point is there is, you spoke about all of these different, you know, I'm a multi-system doctor. And yes, what we find is that all of those different systems, each by themselves, can all independently affect sleep if you're in inflammation, if you have high blood pressure, if you have abnormal hormonal profiles, if you have poor blood sugar, all of these will disrupt your sleep. So it's feed up to the brain, disrupt sleep, but it also is feed down. And I've often thought, and it works both ways for health and ill health with good sleep versus bad sleep. If you've gone into one of those fancy music studios and there's that mixing deck with all of those little dials on it.

That makes me so intimidated.

Yeah, and I look at it, oh my goodness. and you can move all of the different dials. They're all of the different systems. But you know that there's that one white dial all the way to the far left, that if you move that up, all of the other dials go up with it.

Yeah.

That to me is sleep.

If you're struggling with stress, poor sleep.

Or low energy, you might be magnesium deficient, like 75% of people. That's why I recommend magnesium breakthrough by bio optimizers. Unlike most magnesium supplements, magnesium breakthrough gives you all seven essential forms of magnesium for better absorption and real results. Deeper sleep, less stress, and more energy. I take it every night and I notice the difference. Try it for yourself at byoptimizers.com/Hymen and use code Hymen10 for 10% off your order. A lot of times people have restless sleep, they wake up in the middle of the night, they can't come back to sleep, and it really affects the quality of their health, their life, and everything else. So sleep is critical to our health, to longevity, to our mental health, to basically every physiological function we have, and it really is important to fix it. Let's talk about what you can do to stay asleep and to sleep more deeply. So we know that poor sleep makes us less productive and makes us tired, hard to focus. Basically having sleep deprivation is basically equivalent to being drunk in terms of your performance. You know, I read a study once where they were snipers who were, you know, excellent shots. And if they had eight hours sleep, they were like 100 accurate. If they had seven hours sleep, they were like 95 accurate. If they had six hours sleep, they were like 70 accurate. And if they were like less than six hours sleep, they were basically like 50. It's like almost hit and miss. So not good. Even when you're an expert in something, you can't function when you're tired. So next to sort of nutrition exercise and maybe even before it, some would argue sleep may be the fundamental foundation of health and disease prevention and even weight control. So why? Why is it so important? How to how to the sleep dysfunction lead to changes. Well, there's a very important hormone called cortisol, which is your stress hormone. And, and it helps when it's imbalanced to go up in the morning to get you energetic and focused and do the things you need to do for the day. And at night it's supposed to go down and you're supposed to calm down and relax. Now, a lot of people have an inversion where their cortisol is low in the morning, they can't get out of bed, and at night they're tired and wired. Sound familiar? I've had you some big experience that I certainly have at different moments in my life. When you lay, get down in bed, you're exhausted, but you can't fall asleep because you're just wired. It has to do with your adrenal glands. And they're designed to keep things in balance to regulate your weight, to moderate your stress response, to control blood sugar, regulate inflammation, and regulate sleep and wake cycles. So when we're constantly in a state of stress, we're actually often struggling with sleep because of the way in which it affects our sleep. So when you're thinking about it, when your cortisol is high, you're running from a tiger, you're in danger, you don't want to be sleeping, you want to be alert. And that's the problem. So if your cortisol levels are balanced and they're high in the morning and then low at night and your blood sugar stays even, we'll talk about why that's important. Because fluctuations in blood sugar often will cause midnight or middle of the night awakening. But when your cortisol and your body stress response is imbalanced and your pineal gland produces something called melatonin, that pulses really strong in the afternoon and the evening, which gets you ready for sleep and lets your cortisol drop off, and then you can feel calm and go to sleep at night and feel sleepy. And if you're healthy and balanced in your circadian rhythms and your cortisol and melatonin cycles, you'll be fine. But if your cortisol is high in the afternoon or high in the evening, you might feel tired and wired. You want to sleep, but you can't. or you might fall asleep because you're really tired. And then you wake up in the middle of the night, like between one and four. And, and that happens when you sort of go, go, go, go, go. Do your email, you're working, working, working and busy. And then you go to bed, you're like, and then you fall asleep because you're exhausted, but you end up waking up because your body is still in a stress state. There's still high levels of cortisol. So how does, how does stress affect your sleep wake Cycles? Well, it works in a lot of different ways. Psychological stress can be a big factor, right? Worries about family, work, money, physical stresses, lack of exercise is a stress, believe it or not, too much screen time, junk food, toxic lifestyles, hormonal imbalances, environmental toxins, all these drive increased inflammation, increased brain inflammation, and also increased cortisol. Because, by the way, did you know this, that when you eat sugar or starch, your body responds by jerking up the adrenaline and cortisol levels. So literally eating sugar is a stressful experience to your body. Even if you're getting pleasure and you don't think it's stressful and you're meditating while you're eating sugar, you're still gonna have high cortisol and high adrenaline. So what are the things that are the two most common things that are screwing up your sleep-wake cycles? It's probably blood sugar imbalances and spikes and crashes in blood sugar. and chronic stress. So what should you do to optimize nutrition so you can regulate your stress hormones through food and lifestyle? And how do you deal with actually regulating sleep throughout the whole night and get high quality sleep? So first thing is our bodies, whether we like it or not, are biological organisms, and they run in circadian rhythms, and they need to be balanced. So you have to live in Rhythm, and I I experienced the dangers of not being in rhythm when I worked in the emergency room. I would sometimes work seven in the morning till five at night shift, then I'd work at two in the afternoon till the two in the morning shift. Then I work at 11 o'clock at night to a seven in the morning shift. Then I'd work at eight in the morning to an eight in the morning shift, 24 hour shift. I was all over the place and my whole system became dysregulated. And ultimately it led to chronic fatigue syndrome and a bunch of other stuff. My system just kind of collapsed because I was pushing through all these circadian rhythms which have to be in balance for you to be healthy. And whether we like it or not, you know, we tend to do a lot better from our health perspective if we go to bed at the same time, if we wake at the same time, if we eat at the same time, our bodies are designed like that. So you wanna make sure that you actually don't eat before bed 'cause that's the worst thing you can do, but you need to make sure you're having meals in a regular time space. So don't eat three hours before bed. don't eat a heavy meal before bed, 'cause that guarantee you that'll screw up your sleep. Also carbohydrates, I think if you wanna actually eat some starchy things like sweet potatoes or some more starchy foods and you can handle it metabolically, make sure you do it at night because the serotonin levels go up and it helps with sleep when you have your carbohydrates, but still don't eat white flour, sugar, process, all that processed food. Also, not eating enough is stressful. If your body's not getting enough food, it's also considered a stress. Now you can do time-restricted eating and you can sort of narrow the window in which you eat for longevity purposes and so on. But you also want to make sure you're getting enough food and not actually starving because that will increase cortisol and you'll wake in the middle of the night. Now, if you want to lose weight, you can use what I think is probably the most effective treatment I've ever found, which is the 10-day detox diet. It helped people lose 120, 130, 200 pounds. It's like a gastric bypass without the pain of surgery, vomiting, and malnutrition. Another thing you can do is get stuff out of your head. Write your worries down at night. So get a little piece of paper or journal or maybe in your phone, write down all your worries, what you have to do, your days should be organized for the next day, free up your mind so you can actually let go of things and go into a deep restful sleep. Next, you can try a number of supplements and things that I found very helpful. Magnesium is super important. It's the relaxation mineral. It helps regulate the stress response, helps regulate cortisol, helps relax your muscles. I recommend 200 to 400 even more of magnesium glycinate before bed. Glycine also helps with sleep, so you can use glycine. And you can use that to help relax the nervous system and your muscles. Next, try some melatonin. Mellow out with a little melatonin. You can use half to up to two to three milligrams of melatonin at night. and that can often help you reset your circadian rhythms, particularly with travel. Also, ashwagandha is an Ayurvedic herb that can be really powerful for resetting cortisol. I use a product called Cortisol Manager, which helps at night to reduce the stress response and improve sleep quality. Also, make sure, as I said, to get in rhythm, where you can sleep at the same time. Try to go to sleep before 10. that's the best sleep you can have is before midnight, believe it or not. So get in bed by 10, try to be asleep shortly thereafter, 11 at the latest, and try to wake up at the same time every day. Also make your bedroom completely sleep supportive. For example, make sure you have eye shades or blackout shades on your windows or eye shades on your eyes, earplugs if it's noisy, make sure you really take care of creating a carefully controlled environment. Next is caffeine. You know, some is tolerated okay and metabolized, others don't. So I encourage you to sort of maybe stop after breakfast coffee. Don't have coffee throughout the day. That's particularly important if you're still struggling. I would probably just stop coffee and caffeine altogether. Alcohol definitely screws up sleep. So if you want to sleep well and you're not sleeping well, quit alcohol. Just get off it. It can interrupt sleep. It creates poor sleep quality. Also, sunlight is basic great medicine. What do I mean sunlight? I'm going to go to sleep, no, but 20 minutes of sunlight in the morning without sunglasses on, outdoors, not behind a window, has a big effect on your circadian rhythm. So, we are photobiomodulating organisms. The light affects us. It regulates our biology. And, it's important to make sure you have a good 20 minutes of light exposure in the morning.

Sleep is a very strange phenomenon. Like we don't even have a definition for what it really is, but with science we can see, we know when we're sleeping because there's a change in your brain waves.

So with- Deep sleep and light sleep.

And REM sleep and- Exactly. So we go from this normal waking state right now, we're kind of in beta, we can get into some gamma as well. And then we transition to alpha, theta, and the deep delta sleep. And so all of those sleep cycles are correlated with different processes, hormones release, neurotransmitters, in the body. And our key, it's not necessarily how many hours of sleep you get. It's really the quality of those hours because you can sleep for eight or nine hours and wake up feeling like trash, like a dumpster juice or whatever. I don't know where that even came from. But you can feel terrible because you're not actually getting efficient sleep cycles. And so that's what I focus on is how can we ensure that we're getting quality sleep? And for a lot of people, they can potentially sleep six hours and sleep.

Better than folks that are getting nine. Yeah. And the truth is, we've sleeping about two hours less than we did 100 years ago per night. And that is interesting stat. And also the quality of sleep is terrible. And, you know, tens of millions of Americans have sleep problems. And it's something that we don't really deal with very well in medicine. We say, oh, take Ambien or take Ativan or take Xanax or whatever. And those have serious consequences. And they reduce the quality of your life. They increase mortality. They increase the, the likelihood of cognitive impairment and cognitive dysfunction, dementia. I mean, these are real issues where people are dependent on these pills. So how do we get from our sleep deprived and disrupted sleep culture, what's causing it to fixing it?

That's such a great question. You know, today more than ever, there is, there's a epidemic for sure with sleep deprivation. And we're seeing this show its face in so many different areas. I think the first step is actually understanding the value of sleep and. so, for example, you know, real talk, nobody's waking up in the morning like, you know what? I want to look terrible today. You know, everybody wants to look good. And if we understood just how much our sleep quality affected our body composition, I think it would start to push that conversation forward. So there was a really cool study I was done. Sleep and weight are connected.

Oh, my goodness.

University of Chicago did a really fascinating study. So they took folks and they put them on a calorie restricted diet, which is what I was taught to do in a university setting, which doesn't necessarily work, by the way. Exactly. But they put them on this calorie-restricted diet, and during one phase of the study, they allowed them to get eight and a half hours of sleep. So sufficient sleep. Another phase of the study, same people, same exact diet. They're not cutting any more calories, they're not exercising more or less, and now they sleep deprive them. So now they're getting five and a half hours of sleep. They take three hours away. At the end of the study, they.

Compiled all the data.

And they found that when folks were getting a sufficient amount of sleep, they lost 55% more body fat just from sleeping. Yeah. All right. And I didn't say weight. They lost actual fat mass, not muscle, which is crazy. Like how I'm not saying you're doing like eight days a week CrossFit, right? You're just sleeping better. And the question for me is immediate, like, oh, my goodness.

How?

How is that happening? And so it's during sleep that we are releasing.

This is crazy.

Melatonin, this super glorified sleep hormone, which it really isn't that. It's kind of a regulator of your circadian rhythms, period. But it actually is a really profound fat burning hormone as well. So the journal Pineal Research found that melatonin... That's that gland in your head that releases melatonin. It's like... Pineal gland, correct. Which that's not the only place.

So we'll get back to that in a moment.

It's like your third eye gland basically. so the pineal gland and it responds.

To light and, you know, all the artificial light and the fact it suppresses it. It has to have Darkness.

Right. So the Journal of pineal research found that melatonin increases your mobilization of something called brown adipose tissue or brown fat. And this is a type of fat that actually burns fat that increases your metabolism.

Yes.

And the reason is brown versus the white adipose tissue is kind of the stuff we think about when we're trying to get rid of fat. Brown adipose tissue is brown because it's so dense in mitochondria, right? These kind of energy power plants, I know you've talked about many times on the show, but it's such a metabolically active tissue. And so if you're not getting adequate sleep, you're not producing that hormone, nor you get your greatest secretion of human growth hormone during sleep. This is the most, it's also known as the youth hormone in a way. It's the repair hormone. Kids have so much HGH. This is why they have so much energy. It's muscle sparing. and also it's a big component of you healing and recovering. And so you're missing out on that. And cortisol, that's another one. So if you're sleep deprived, one of the very first things we see is.

An increase in your cortisol levels.

That's the stress hormone. Exactly, exactly. And cortisol has this interesting ability to literally break down the muscle that you're working so hard to build. Oh, it's terrible. Gluconeogenesis, a process called gluconeogenesis, break down your valuable muscle tissue and turn it into fuel because it's this stressed, hyper, alert, cautious, dangerous state your body thinks you're in because you're sleep deprived. And I can go on and on.

I'll show one, share one more. I always say stress is bad because when you have high cortisol, it does everything you don't want, right? It shrinks your memory center in your brain, causes Alzheimer's, it causes you to lose muscle and gain fat, it causes your sex hormones to get screwy, it has so many horrible effects and It's not worth getting stressed about stuff. It doesn't matter. You know, like stuff, there's stuff that does matter that you have to worry about. But the truth is most of the things we react to and stress about are just our beliefs or thoughts. They're not really real, right?

Yeah, that's a, and I even focused on that as well because a lot of folks have what we call clinically just a lot of inner chatter. You know, the brain is a very vocal and kind of noisy organ.

Yeah.

You know, and so the great thing is a lot of our needs are met, especially if people are listening to this right now.

It's like the crazy aunt that lives in your head, you know?

Right. Right. But we have so many things covered in our lives that our ancestors didn't have to worry about. But the human mind is so expansive so we can manufacture things to worry about. And that worry can push us. And I often tell people, you know, when people are coming into my clinic, that you can overeat your way fat. you can under exercise your way fat or under move your way fat, you can under sleep your way fat and you can also over stress your way fat for sure. It has a huge component for our overall health and our body composition too. But I was going to share Stanford University, they found that just one night of sleep deprivation has a dramatic effect on suppressing leptin. And that's that kind of glorified satiety hormone. I mean, I'm sorry, satiety hormone. and ghrelin on the other side has this uptick and that's that hunger hormone, right? So just one night and it makes you crave a ton of carbs.

I want to ask you this.

I was gonna say, I know you've been up late before. Oh yeah. But I don't know if it's me or if anybody else listening, have you ever been up at like two o'clock in the evening, maybe at a party, maybe just kicking back watching TV and you're like, you know what, I really want a salad right now. Nope.

No.

If that's ever happened, please inform me. I don't get a craving for broccoli. I want salty, sweet, crunchy, like I want- Carbs, yes. Yes, because your brain is literally starving for glucose. Just one night of sleep deprivation, we're.

Seeing about a 14% reduction in glucose reaching your brain. Yeah, I know it's true. I remember working many nights in the emergency room, delivering babies, being up all night, and the next day all you want to do is eat carbs and sugar. You know, I'd go to McDonald's and get the apple turnovers and the french fries in the middle of the night. Apple turnovers. That was the only thing that was open in the hospital. So between- It was only closed between two in the morning and six in the morning, otherwise it was open 20 hours a day. It was the only thing open in the hospital, can you leave it? And I would go, you know, be sleep deprived and stay up all night. And I totally craved carbs.

And you did that work on that food, and now what you're made of now and the work that you're doing is just like exponential. Like you see that. I thought about this the other day. We're putting folks in space on vending machine consciousness, right?

Astronaut food.

Just imagine if we can get people on really healthy, real food and what we can create as humanity. It's exciting.

So what's exciting about your book about sleep is that you break it down. You talk about 21 strategies that are very specific to actually fix your sleep. Because I'm sure many people listening, maybe even half or more, have sleep issues, whether it's not enough sleep, whether it's disrupted sleep, whether it's poor quality sleep, whether it's more serious things like sleep apnea, people often don't know they have it. Can you walk us through some of the key strategies and what really matters?

Sure. So I've been really working to press this into public awareness for about five years now. And this was because seeing people in my office coming in and they're struggling with their blood sugar, for example. And we had about right around 75% success rate with getting folks off lisinopril and metformin and all this and working along with their doctors. Those are blood sugar and blood pressure pills. Yeah, and here's the thing, that 25% of folks who weren't getting those results, ironically, that would really bother me.

And I know you've probably felt the same thing.

Oh yeah. Ironically, kind of keeping me up at night. Yeah, 20%. What are you missing? And so it took about five years in practice, maybe a little longer, before I had the audacity to ask, how was your sleep? And what people would tell me blew my mind. I couldn't believe they're even sitting there. and this is another thing that we know is that folks don't really want to change too much to get the result they want. And I knew that. And so I just dug into the research and I wanted to find clinically proven strategies that people don't have to turn their world upside down. And once I implemented those with the patients I was working with, it's like the floodgates would come off. The weight would finally come off. Their blood pressure would finally come down. Their symptoms of depression would start to dissolve. And I was just like, this is really something special. I need to tell more people about this. And so eventually it's compiled into these 21 strategies. And for me, again, some of these things are going to be a reminder for folks today. But I want to talk about something that a lot of folks still don't have a big awareness of. And this is the fact that your gut and the health of your microbiome has a huge impact on your sleep quality.

So your poop and sleep are connected. What a concept.

In a way.

Okay, let's stick into that one.

Don't do the two together.

I know that's not. That's going to blow people's mind and even my mind. Tell us how the microbiome and your gut affects your sleep and what you can do about it.

Absolutely. So let's start with the basic component. And I know, again, these are going to be things people have heard about before, probably on your show.

Yeah.

But let's start with serotonin.

Okay. So it's pretty well known.

And by the way, there's more serotonin in your gut than there is in your brain. Exactly. So upwards of 80 to 90% of your body serotonin is actually located in your gut, produced by your enterochromaffin cells, by the way.

All right, so those are special cells.

In your intestinal lining.

Yes. I'm just translating all the big words.

See?

I like that.

We're like flipping places because I would do this for you. So here's what's so interesting is that serotonin, we talked about melatonin being important for our sleep and our circadian rhythm. Serotonin is a precursor or a seed to make melatonin. So already right off the bat, your gut environment, these cells in your gut are helping to make this compound that's related to your sleep quality. And with melatonin is what I want to liken it to. It's like that manual gear shifter for you to go through your sleep cycles properly and to actually get recovered. You need melatonin to be produced, and we'll come back to that. So that's number one, serotonin.

You can't just take melatonin.

I'll answer that in a minute. Okay, okay.

That's tricky. Okay.

So, well, I'll just tell you. So, I looked around because some of our colleagues would feel that, and this was just a theory, that if you take supplemental melatonin, it's going to reduce your body's ability to produce it itself. And that's actually, I couldn't find that anywhere. There was no evidence of that. What I did find was taking supplemental melatonin, taking too much or too frequently, can down regulate receptor sites for melatonin. so your body can still produce it, but the receptor sites that actually do something with the melatonin can get down regulated.

The key is there, but the lock isn't.

Yeah. So we do need to be mindful of that, and we can come back and talk about that. But here's the biggest, probably aha moment, hopefully, of this episode, is that it's not just serotonin that's producing the gut. And so check this out. And I just came across this. I'm gonna share this with you today. This was in. the World Journal of Gastroenterology. Listen to this. They found that there's upwards of 400 times more melatonin in your gut than in your brain. Because you talked earlier about the pineal gland. That's what I was taught in school. It's produced by pineal gland in the story. This study found that you can actually have a pineallectomy, which is a removal of your pineal gland, which I don't recommend, by the way.

Don't do that.

But it's like a frontal lobotomy. No, go there. And you don't. And you you don't actually lose those levels of melatonin that's located in your gut.

So you have a gut brain and a brain brain.

Exactly. And that's something really important to understand too. Your gut is really, it's often referred to as a second brain. We can call it the enteric nervous system. There's like 30 neurotransmitters just like your brain. It's like a mass of nerve tissue.

60% of your immune system and most of the genes in your brain.

Vagus nerve as well. That vagus nerve, so UCLA research has found that the vagus nerve, which we thought was just kind of like the brain communicating more, telling the gut what to do, 90% of those, the communication from those nerve fibers from the vagus nerve to the brain is your belly, your gut telling your brain what to do in many ways. Totally nuts.

And the other thing people should know is that when you're stressed, not only is your cortisol high and you lead to more fat accumulation, it stores belly fat, but it actually blocks your cells' ability to burn calories because the nerves from the vagus nerve help you metabolize your food, which is a relaxation nerve. It also has the effect of decreasing absorption of nutrients. So not only are you not absorbing, but your metabolism just slows down, which is amazing. It's just because of the nervous connection between your stress nerves and your relaxation nerves and all your gut function.

So profound. But this is just getting out of that isolation thinking, you know, this is what I was taught in school as well. It's like, well, that's functional medicine. The body's a system. Yes, everything is interconnected and it's a beautiful symphony if everything's working well. So Caltech researchers to kind of get to how does this all connect, they discovered that, and this was just, I mean, it's been around for years, but this is more of a recent like, okay, meta-analysis. Now we know that certain bacteria in the gut communicate with cells that produce these sleep related hormones and neurotransmitters. So your gut cascade, your microbiome has a huge impact on your sleep quality. And so now the question is, what do we do about it? How do we protect or support our microbiome? And that's one of the things that's gonna help to improve your sleep quality. So let's just go through a couple. The biggest thing in my opinion is avoiding things that mess it up. All right? So one of those would be eating processed foods. So that crazy amount of sugar has a tendency to feed pathogenic opportunistic bacteria. Right? So that's one thing, avoiding haphazard use of antibiotics. They have a place, but we shouldn't be using antibiotics every time you get the sniffles. And that's literally what, when I was a kid, just give them some antibiotics, right? We would even, like if my mom had some antibiotics, you know, just totally negligent.

Give them whatever's in the cupboard.

Also, pesticides, herbicides, rodenticides, heavy metals. Yeah, these things, side literally means to kill, by the way. But these have a pretty, because they're meant to kill small things, guess what your microbiome is made of.

And how many millions and millions of people are taking acid blockers, which also terribly disrupt your gut microbiome.

We're looking at that the wrong way as well. Just avoiding those things, but also what I want people to do is support their microbiome by, you know, and this should be just captain obvious at this point. And me working at a university for so long as a strength and conditioning coach before I did my clinical work, I worked with people from all over the world and I would ask them about their fermented foods and every culture had something. Yeah. Right. So whether it was like some kind of kefir or like pickled whatever, right. And so making sure that we're getting us at least just, you know, every couple of days, get a serving in of some fermented food or beverage.

Gotta eat the kimchi.

Yeah, I got a jar in my fridge. I love kimchi. And my mother-in-law makes it for me. And she's from Kenya, so they had, like, fermented. A fermented, like, kind of similar to kombucha. Like, she knew about this, like, 20 years ago. And I'm like, what is this weird stuff she's growing? Yeah, yeah. And the kitchen is freaking me out. She had grab, like, first time I came to visit. and they were growing grass, you know, like it was wheat grass. But I was like, Hey, why has your mom got grass in here? Is she getting high? I didn't know. So anyways, Different kind of grass. I didn't know. But that is a big component here is like shifting gears and having a more targeted perspective about supporting that gut microbiome. But also, and this is a really cool takeaway for everybody today is, making sure we're getting in servings of what I call good sleep nutrients every day.

Yeah, what is that? Because eating for sleep, nobody really talks about that.

So what does that look like? The first one I'd share, and this one is from the Public Library of Science. And so they found that vitamin C, which we know about vitamin C, we tend to associate it with the immune system, right? That's powerful antioxidant. But they found that folks in this particular study that were deficient in vitamin C had a tendency towards waking up more frequently. and getting vitamin C levels elevated reverse their symptoms. All right, so that's just one example.

So iron is the other one. If you have a little fairy.

Iron is another one. Yeah, that's. Oh, my goodness. That's huge. And especially more so for women. Yeah, it tends to be. And another one. This was published in the journal Sleep. All right, this is the big journal. And what they found was calcium.

Right?

So this goes back to that story that I was told about calcium. It is important for sure, but folks who were deficient in calcium had more interrupted sleep patterns as well. And so by getting those calcium levels up, but how do we go about that? I'll just pass it over to you rather than drinking like homogenized, glowing dark, you know, like from a mutant cow. What other sources of calcium do we have?

Oh my God, you know, when you look at the data on calcium, it actually isn't as great as we thought for bones, but the best absorbability in use is actually from greens like arugula and greens that we can have dark green leafy vegetables. Also, there's some great sources like tahini which is basically ground sesame seeds. Also, different things people might like, I like which is sardines with the bones in them and salmon with the bones in them like canned salmon. Those are really great to eat because.

They have a lot of great absorbable calcium. Exactly. Calcium is kind of like an end product. from this like biological transmutation. So bones have a great source of it.

But people say, oh, you need milk. I'm like, well, where do you think a cow gets their calcium from? It has strong bones. They eat grass. They should eat grass anyway.

It's this really fascinating process. It's kind of like a biological transmutation of sorts where certain things come together to create bone, right? So like you need silica, you need.

Boron, Boron, K2, yeah.

All of these things come together to make this magic happen. So by the way, I want to give some sources with vitamin C. Obviously, we know about citrus fruits like strawberries, sweet peppers, but there are these, quote, superfoods as well, like camu camu berry. This might be the highest botanical source of vitamin C, super tart, tangy fruit. It's like an Amazonian thing. Amla berry, Acerola cherry, those are super, super high sources of vitamin C. Another one, and this was, this is the last one I'll share. There's a whole list in Sleep Smarter. So this was a study conducted by University of Oxford found that Omega-3s can help folks to get deeper, more restful sleep. All right, so it helps with those modulating those rhythms, which it makes sense because it has to do with your brain. Yeah. Right? Your brain has these gates, you know, you have the blood-brain barrier, but the gate allows in certain VIPs.

Yeah.

And it's only like 30 things, right? And one of those is a megaphone.

Although you can have a leaky brain and then you get more trouble.

Oh my goodness. You know about the leaky brain issue? This is like, you're already, you're getting into some territory here. This is super fascinating stuff, right? Leaky gut, leaky brain. Who knew?

Yeah.

Right, who knew? So exciting. And also, there's some research that just came across that the brain kind of has its own nerve immune system in a way.

Yeah, it does. It has its own lymphatic system. which is like to clean the brain every night and guess how you do that? Sleeping.

Yep. It's 10 times more active.

Yeah. I mean, we know if you don't sleep, you're at much higher risk of.

Alzheimer's because you can't clear out the garbage and your brain gets toxic. It's fascinating. It's run by the glymphatic system. So that's like little shout out to the glial cells that help to run it. The body is just incredible.

So eat plenty of good sleep nutrients every day.

Magnesium, though? Oh, that was the last one actually. Okay. I was like, that's the first one I go to about patients. this is the big one. I was saving the best for last. I first learned about the benefits of magnesium probably from you.

Okay.

And this was again like, you've been talking about this for like 15 years.

Yeah, I'm getting old.

And I was like, holy crap, because it's responsible for so many biochemical processes.

Oh, my God, 300 enzymes and yeah. Yeah.

And so what that means for people is just like, so magnesium is responsible for these. Well, now we know like over 325 processes. what that means is there are 325 things your body can't do or can't do properly when you're deficient on it.

Yeah.

And it, by the way, magnesium deficiency affects 48% of Americans. And it's caused by stress. Yeah, chronic magnesium deficiency. It's caused by stress, it's caused by coffee, alcohol, and, you know, not having enough in our diet, which comes from mostly plant foods, beans and greens, nuts and seeds.

Yeah, absolutely. And this is one of the things that we can do something about. But like you said, it's a, it's kind of like an anti-stress mineral.

Yeah.

And so just the amount of stress that we're exposed, even, even today, even our environment is stressful. It's different. You know, we're indoors a lot more processed air, and we're not getting access to sunlight. Like, just our reality is more stressful. But then put on top of that.

Our work demands, relationship demands, you know.

How would you know if you're magnesium deficient? you can get a test done, you know, but I really always most of the tests are very inaccurate.

Red cell magnesium is better. Yeah. But it's mostly symptomatic. And actually, the way we really have to diagnose it is called a magnesium load test, where you give people a high dose of IV magnesium, and then you collect the urine for 24 hours. And if nothing comes out, it means their body sucked it all up. And if it all comes out, it means they have enough. Right.

So I think, you know, magnesium testing is tricky, so you got to go by the symptoms. Exactly.

Exactly.

That's the thing. And. What I was going to say is I always err on the side of how do you look, feel and perform? And in my practice, there were only a couple supplements I would recommend. Magnesium was generally, and maybe for 80% of the people that came in, because there's such a tendency for people to be inefficient in it. But here's the issue. So food first, obviously. Anything green is going to be a good source of magnesium. So just keep that in mind. Kale, collard, mustard greens. But outside of that, supplementation can be tricky because we have this bowel tolerance.

Yeah. Right?

So even if you take a little bit more than your gut can handle at that moment, and you might need to really get your magnesium levels up, you're gonna activate what we call clinically disaster pants, which means the poop, potentially pooping in your sleep. Yeah. Like the whole thing.

This goes full laxative. Milk of Magnesia, right? Magnesium citrate. is what they give people before. They have colonoscopies to clean out their bowels, right?

It works. So, and there's different forms and some are going to be better for different people. But what I, I don't know if you've done this or looked into this, but like topical magnesium? Yeah, you can use topical magnesium. That's what I do. I even brought some with me when I travel. You know, keep it in my bag and I love it. I think it's fantastic.

It's important and people can, you know, overlook symptoms that are all caused by magnesium deficiency, right? sleeplessness, insomnia, anxiety, palpitations, muscle cramps, menstrual cramps, seizures, arrhythmias, palpitations, all those things are caused by magnesium deficiency. It's interesting in medicine, we don't really think about it, but it's used as a drug in the worst cases because drugs don't work. For example, preterm labor, someone comes in having a baby too early, you give them intravenous magnesium. Someone comes in and they're having high blood pressure, and seizures in pregnancy, they give them intravenous magnesium. People have cardiac arrhythmias where their heart is beating crazy beats in the emergency room, and none of the drugs work, you give them magnesium. It's pretty interesting, and it's something we use all the time in medicine. We don't think about it in this way, but it is probably one of the most powerful things for sleep for people. Don't forget, there's a way to listen completely ad free. With Hyman Plus on Apple Podcasts, you can enjoy every episode without any breaks. Just open Apple Podcasts and tap Try Free to start your seven-day free trial. if you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at Dr. Mark Hyman. Please reach out. I'd love to hear your comments and questions. Don't forget to rate, review, and subscribe to the Dr. Hyman Show wherever you get your podcasts. And don't forget to check out my YouTube channel at Dr. Mark Hyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on the Dr. Hyman Show. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic and Function Health, where I am Chief Medical Officer. This podcast represents represents my opinions and my guests' opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided with the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, please seek out a qualified medical practitioner. And if you're looking for a functional medicine practitioner, Visit my clinic, the Ultra Wellness Center at ultrawellnesscenter.com and request to become a patient. It's important to have someone in your corner who is a trained, licensed healthcare practitioner and can help you make changes, especially when it comes to your health. This podcast is free as part of my mission to bring practical ways of improving health to the public. So I'd like to express gratitude to sponsors that made today's podcast possible. Thanks so much again for listening.