Why You Crave Carbs When You're Tired And How To Improve Sleep

Coming up on this week's episode of.

The Doctor's Pharmacy, sleep may be the fundamental foundation of health and disease prevention.

And even weight control.

Hey everyone, it's Dr. Mark. Now I know there are a ton of functional medicine practitioners who listen to this podcast and I want to ask you a question. Are you tired of wasting valuable time on complex lab ordering procedures? If so, I got fantastic news for you. Rupa Health has revolutionized the process for ordering labs and in just a few clicks you can access over 3,000 tests from over 35 companies all in one convenient portal. Plus, Rupa Health ensures that you you pay only one invoice for all your tests, making everything simpler and more efficient. No more juggling multiple invoices or dealing with administrative headaches. And the best part?

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Episode of the Doctor's Pharmacy.

Hi, this is Lauren, one of the producers of the Doctor's Pharmacy podcast. Sleep is one of our most basic human needs, yet millions of Americans suffer from insomnia or get insufficient sleep. Thankfully, there are many ways to get your own sleep hygiene on track, which will improve every aspect of your health. In today's episode, we feature five conversations from the doctor's pharmacy about how sleep affects all the systems in your body and strategies to improve overall sleep quality. To start, Dr. Hyman speaks about the basics of sleep hygiene. He then speaks with Shawn Stevenson about sleep cycles and how to improve your sleep, with Dr. Todd LePine about how blue light suppresses melatonin, with Dr. Andrew Huberman about the importance of honoring circadian rhythm, and finally with Dr. Cindy Guyer.

About practical tips to improve your sleep environment. Let's jump in. So we know that poor sleep makes us less productive. It 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 hour sleep, they were like 100 accurate. If they had seven hour sleep, they were like 95 accurate. If they had six hour sleep, they were like 70 accurate. And if they were like less than six hour 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 is it so important? How do the sleep dysfunction lead to changes? Well, there's a very important hormone called cortisol, which is your stress hormone. 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. That has to do with your adrenal glands. And they, 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 and balanced in 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, in 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 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 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, do 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 experienced the dangers of not being in rhythm when I worked in the emergency room.

I would sometimes work a 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, you want to make sure that you actually Don't eat before bed because 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 because 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 wanna 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 you regulate cortisol, helps relax your muscles. I recommend two 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, you know, 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. 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 basically great medicine. You know what 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 what's deep sleep and light sleep.

And REM sleep and. Exactly. So we go from this, a 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, you know, 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 an 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 study, 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. It's 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.

Release 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.

So the Journal 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, the 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 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.

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And now let's get back to the.

Sixth episode of the Doctor's Pharmacy. 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 come into my clinic, that you can overeat your way fat, you can under exercising 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 glorifies hunger hormone. I mean, I'm sorry, satiety hormone. and garlin on the other side has this uptick and that's that hunger hormone. Yeah, 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, 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. So 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, you know, they're struggling with their blood sugar, for example. And we had about right around 75% success rate with, you know, getting folks off, you know, 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.

Yeah, ironically kind of keep moving. 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? Yeah, and what people would tell me blew my mind. I couldn't believe they're even sitting there. Yeah, and so 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 want 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 the, 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 gonna be a reminder for folks today, but I wanna 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 dig into that one.

Don't do the two together. I know that's not, you know, that's.

Gonna 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 downregulate 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 pinealectomy, 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. Go there. And you don't actually lose those levels of melatonin that's located in your gut.

All right, 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 body 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 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's towards 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 going to 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. All right. 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.

Yeah.

Give them whatever's in the COVID also. pesticides, herbicides, rodenticides, 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, you know?

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

Yeah, we're looking at that the wrong way as well. And so, 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 work 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 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? 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 ferritin 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, glow in the 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 and 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 biological transmutation. So, bones have great source of it.

But, you know, people say, oh, you don't, you need, you need milk. I'm like, well, where do you think a cow gets their calcium from?

It has strong bones.

There's a cow bone.

They eat grass. They should eat grass anyway. It's this really fascinating process. It's kind of like, 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. 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. and 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, we 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 mega. 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?

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.

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 with my 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, I got 300 enzymes and yeah. Yeah. And so what that means for people is just like, so magnesium 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, and by the way, magnesium deficiency affects 48 30% of Americans. And it's caused by stress. Chronic magnesium deficiency. It's caused by stress, it's caused by coffee, alcohol, and 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 kind of like an anti-stress mineral. 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.

So 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.

So I think magnesium testing is tricky so you gotta go by the symptoms. Exactly, exactly. That's the thing. And what I was gonna 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, maybe for 80% of the people that came in. because there's such a tendency for people to be in deficient 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. 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 going to activate what we call clinically disaster pants, which means the poop, potentially pooping in your sleep.

Yeah, like the whole thing. This goes full force. It's 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. Yeah, that's what I do. Even brought some with me when I.

Travel, you know, keep it in my.

In my back and I love it. I think it's fantastic.

It's important and people can 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. Absolutely. And Oz told me that he would use it for open heart surgeries to keep that heart going.

It's profound.

It's really profound. So, and it's sort of the relaxation.

Mineral, sort of an antidote to stress. So, besides the nutrients, the processed food, all the stuff we're eating, what are the other key tips that people need to know if they're not sleeping and what are the other causes of sleep issues? Because you mentioned the gut microbiome being a cause.

Right.

So you can take all this stuff and eat the right diet, but if you don't know what the cause is, so tell us about what the causes are that are common and then what are the other key strategies to actually help people?

That's such a good question. One of the biggest causes that I would see is having a upside down cortisol level or abnormal cortisol rhythm. So folks are having their cortisol too low in the morning, making it very difficult to get out of bed, and then it's too high at night. And so they're just like, up.

Up.

And so this cortisol rhythm, and by the way, so cortisol has definitely gotten a pretty bad name, and rightfully so, but it's not all bad. You actually need cortisol to, like, make thyroid hormone. It's just if it's produced at the wrong time in the wrong amounts, then it could be a problem. And so to help folks to reset that cortisol rhythm, or we call it a cortisol reset, this is super low hanging fruit, and anybody can do this.

This is so cool.

And I've seen so much good success with this.

Appalachian State University.

Hanging on the edge of my seat here. So Appalachian State University did a study and they went to find out would the timing of your exercise affect your sleep quality. And so they took test subjects and they had them train exclusively at 7:00 a.m. for one phase, train exclusively at 1:00 p.m. in the afternoon, and then train exclusively at 7:00 p.m. for the final phase of the study. They compiled all the data and they found that morning exercisers, first of all, they tend to spend more time in the deepest, most anabolic delta stage of sleep. by exercising in the morning. They found that they had a tendency to sleep longer. They had more efficient sleep cycles overall. And here's something cool. They also found that the morning exercisers on average had about a 25% greater drop in their blood pressure at night, which is kind of correlated with that deactivation of that sympathetic fight or flight. And one o'clock wasn't good? 1:00 p.m. It was negligible in the change. And they did see some benefit with the 7:00 p.m. Ironically, which you've got to be careful with that because that might get your body temperature too high your cortisol can get elevated. But I even have a children's book that I read to my son when he was little and they take the kid through a bedtime ritual with the characters. One of their rituals, like old timer type things, is doing exercise before bed, right? Like tire yourself out, I guess, is the approach that you might think. And there's a difference between getting great high quality sleep and passing out for exhaustion.

Right? Because then people are tired and wired and they fall asleep and they wake up because their cortisol is still high.

Exactly, exactly. And so what we want to do and how does it work out in the morning? It gets that cortisol rhythm. It gets that cortisol elevate in the morning to kind of put it back on track because it should be elevated if it's a normal rhythm somewhere around at its peak, maybe 8 to 10 a.m. and gradually drop as the day goes on. And so, but the question is, well, you know, maybe I can't. I have whatever in the morning, you know, kids, work, whatever. I work on the afternoon. Just five minutes, four minutes. You can do Tabata, right? 20 seconds of exercise, 10 seconds of rest, set your phone timer. Incredible. First of all, you're gonna get some fat burning benefits, right? And that post-exercise oxygen consumption, right? You're gonna be burning more calories, but also it's gonna help with your sleep quality at night. And so that's one of the big.

Low-Hanging fruits is just to get in at least five minutes of exercise in the morning. Amazing. That's pretty cool. Yeah. So fix your gut. exercise in the morning, take the right supplements. What are the big things people can do?

Now, this one is a little bit more common knowledge now, but the question really is, what are we doing about it? And this is our issue with our tech, right? This is like the most pervasive thing we're dealing with right now. And Harvard researchers have confirmed that the blue light spectrum coming from your iPhone, from your desktop, from your, they found that at night, this does in fact suppress melatonin production and elevate your cortisol. Not during the day, during the day there's no impact.

That's fine.

But at night, and here's what they found, and this is just an approximation, every hour you're on your device at night, you suppress melatonin for about 30 minutes.

Wow.

So you might be up on your device or watching TV for three hours and you go to bed because you're just physiologically exhausted or just like, I really should get to bed. You're not even producing adequate melatonin. to take you through your sleep cycle for almost two hours into sleep. And so again, this is why we're waking up tired and we're not really getting high quality sleep. It's because we're destroying this process of producing melatonin.

Artificial light at nighttime, I think is a big, it's the sort of the elephant in the room. And for people that have had sleep problems, one of the easy things that you can do that can help to fix that is to have blue blocking glasses at night.

Yeah, I actually have them. I do, too.

Absolutely. So, when you look at the-- you-.

Look goofy, but you sleep good.

Right, exactly. Yeah. And, it's actually in the medical literature and these LED lights have a very high blue spectrum and blue light is the type of thing that sort of wakes your body up and it suppresses melatonin. So, melatonin, which we can measure, we can measure that easily in patients. is the hormone of darkness. So one of the times when I'm seeing patients, not only do I measure their sex hormones, their adrenal hormones, but I also measure their sleep hormone, which is their melatonin. Dr. At night, maybe. Yeah, at night. So you actually, you can check it in the morning, and you can also check metabolites of melatonin. And your melatonin levels tell you whether or not you're getting enough darkness. So you can take melatonin, and as you get older, our bodies produce less melatonin. But the thing that you can do to boost your own melatonin is not expose yourself to light at night.

Candles, back to candles.

Back to candles, yeah, exactly. Blue blocker glasses. Yeah, yeah. Candles actually work quite well. Yeah, they do. But the LEDs on screens and all the, you know, all lights now, there.

Are no more incandescent light bulbs. What about the, you know, the sort of night sort of setting on the computer iPad?

Does that just go dark? It doesn't cut the mustard. It's not as...

But what if you wear the glasses when you use the screen?

Yeah.

And you'll know they work because when you wear the real ones that really cut out 99.9% of the blue light, you can see.

I did it the other night. I was tired, but I put my glass on and my blue blocker glasses I got from TrueDark, and you go to truedark.com, and you put the glass on and I watched my movie on my computer in bed, and I was like, normally kind of mess with my sleep a little bit, but it was like fine. I had a great deep sleep.

I was like, wow, this is really amazing.

Yeah.

I mean, whatever you're gonna do with computer, whatever, it's not gonna look normal, but you will sleep a lot better. And I do that myself. And I actually, this is where it really hit me about the effect of light. I was in New York City one weekend and I was giving a lecture and it was a Friday night and I was lecturing the the next day. And I'm walking down, you know, just what are you doing in New York? You walk down Broadway. So I'm walking down Broadway. It was about 10 o'clock at night. I did it for about a couple hours. It was like 11, 12 o'clock. Oh, yeah. And, you know, the lights on Broadway, I could not sleep that night. And that's where it really hit me. I was like, oh, my God. This is, I mean, this was obviously real, real bright LED lights, but it was phenomenal. I just could not fall asleep. Wow. I could not stay asleep. That's incredible.

And that sort of got me down that path of really understanding.

Light. So, light is a big problem.

Light pollution. Light pollution. Exactly. I mean, there's a book I read years ago called Lights Out, which describes the advent of chronic disease and obesity with the light bulb. Yes. And how that affects our sleep wake cycles, how it affects our circadian rhythms, how it affects our hormones, how it affects our metabolism, which is something we don't really don't think about.

Exactly.

Especially in traditional medicine, we never learned about light.

Exactly.

But now, you know, there's, I mean...

And one of the best things that you can do, and I try to do this as often as I can, is early in the morning exposing yourself to light. So, darkness tells you to go to sleep, light tells your body to wake up. And exposing your eyes, actually even without glasses, to the sun. I'm really a sun worshipper now. I sort of, you know, sun gazing is very, very powerful for sleep.

You're blind, but you sleep fine.

Yeah, right.

Yeah, you're blind, but you sleep fine, exactly. But exposure to light shortly after you get up is one of the things that helps to synchronize your circadian rhythm.

Every morning, my wife and I, we get up and we take the cats for a walk around the yard. Yes, our cats go for a walk. they're well-trained Burmese cats. And we literally walk around and get the sunlight and spend 20 minutes out there just walking around the yard. And it's just so nice to get.

That sunlight in the morning. Exactly.

Yeah.

And, and that, and you want to do it relatively early within, I think, 20, 30 minutes of getting up and exposing us to the sunlight is very.

Very helpful for synchronizing your body clocks.

So, so that's one reason that people.

Are having so many sleep issues.

And, and what are other reasons people have sleep issues other than the light?

Pollution?

Sometimes it can be medications, medication side effects. Some of the people are taking these stimulants, so I'm tired. So here, your doctor gives you Ritalin or Adderall, and then that is a stimulant and it's sort of keeping you up. Excess amounts, overuse of caffeine or having caffeine too late in the day. Some people are very caffeine sensitive and they can't have any kind of tea or coffee. most people in general, I'm going to say that if you have one or two cups of green tea, coffee, and it's early in the day, it's not going to affect your sleep. The half-life of coffee is about six hours. So in six hours, half of it's out and then another six hours, a quarter of it is out. Definitely nothing after noon. Exactly. Nothing after noon.

In most people, it's not going to affect them.

And alcohol is a big sleep. Oh, alcohol is a big one. In fact, I was telling you about a case. So I had a patient. patient who was, you know, eating late at night. That's another one. That's another one, right? Another one. And that actually, I think also affects sleep also. Because when you're sleeping, you don't want to be digesting. You really want to be in a fasting state.

One is going to interrupt your sleep and two is going to make you fat. Yeah, exactly. It makes you gain weight.

It's basically storing it instead of metabolizing.

That's how Sumos, right? The Sumo diet. That's how Sumos get fat. They eat and go to sleep. That's right. That was actually That was actually a chapter in my book, one of my first books, Ultra Metabolism was called the Sumo Wrestler Diet.

Right, because the Sumos have a recipe for knowing how to put weight on. You eat and go to sleep. And it was a simple patient came into me and they were eating late at night. It was like anywhere between 8 to 10 o'clock at night and they were having a couple of glasses of wine. Which, that sounds okay. Well, it was a combination of eating late at night and those two glasses of wine or alcoholic drinks. And very commonly, especially as you get older, maybe after 45-50, you'll get what's called rebound insomnia. So the alcohol sort of relaxes you, whatever, but when it wears off, the brain sort of wakes up. And I started to experience this myself when I started turning 45-50. And so I'm very aware of it.

So any patient- so you drink wine in the morning.

You drink wine in the morning, exactly. happy hours at noon.

So no coffee or wine after lunch. Yeah, right.

So one of the things that you do with patients is get them aware of their circadian rhythm, their sleep-wake cycle, the importance of light in the morning, darkness at night, and then also get them off for maybe two months of getting them off of all alcohol and all caffeine and sort of see where their baseline is. See where their baseline is. And then it's for them to decide how much and how often and when to have those things. A good cup of coffee is pleasurable. A glass of wine is pleasurable. But too much, too late is not a good thing.

Yeah. And there are other things that are sort of off the chart a little that people don't think about. But I had severe mercury poisoning and that really interrupted my sleep. So insomnia can be related to heavy metals and toxins, for example. It can be related to thyroid problems. People have low-grade, low thyroid function. That can be a sleep disruptor, hormonal issues. Obviously, menopause is another one. Yeah, menopause, but even like blood sugar issues, people who are diabetic or pre-diabetic they can get hypoglycemia in the middle of the night that wakes them up, they get night sweats and hot flashes. So, there's a lot of reasons people have sleep issues that are biological that you could fix.

And even nutritional factors, low magnesium and other factors can be really a big issue. Exactly, yeah. And it was interesting you said because There are some people who will have a very big cortisol response at nighttime. Cortisol is the adrenal hormone sort of your get up and go hormone. We're supposed to have cortisol rising as we wake up. There's a test that we do called the cortisol awakening response. How much does your cortisol rise as you get up? Well, there are some people that will have problems with cortisol secretion at nighttime when it should be really, really low. And that's another thing that I think is the important thing that interrupts people's sleep is excess amount of cortisol stress hormone at nighttime.

You don't want to be watching scary things and stimulating things and get your adrenaline up before you go to bed. And I think often we live a sleep disruptive lifestyle. So we eat late, we drink, we have lots of lights, we engage in stimulating activities before bed.

24/7 news, email before bed.

We don't do things to wind down. Just having a simple sleep hygiene routine. I'm really rigorous about this, but at least an hour, maybe even two hours before you turn everything off, maybe I take a hot bath with Epsom salt, I put lavender drops in there because lavender actually reduces cortisol levels, to lavender essential oils. I've made my room completely black. I have a blackout shade. Even have eye shades, earplugs if you need them if you live in a noisy area.

Yeah.

I use this when I travel.

Blue blocker glasses. So, there's a lot of ways to structure your environment so that it's really good. Make sure the temperature is right.

Yeah. You know, you just, there's another clinical case. I had this older gentleman who.

He.

Had a whole bunch of different kinds of problems and had probably a little bit of early Parkinson's mild sort of slowing down. He's in his late 70s. And he on his own found out that when he turned the thermostat down from 70 degrees to 64 degrees, he slept so much better. And again, that's the other thing is what happens to animals at nighttime? actually out in nature. And guess what? We're animals too.

It's true.

We're actually designed to be out in nature. And that lowering of the temperature also, I think, is very, very good for inducing sleep. And I actually think this is my own sort of theory is that when you take the warm bath and then you go to bed in a colder environment, that shift of the temperature differential.

Once you really appreciate how vital sleep is and how great life can be if you're getting good sleep, and how terrible it is for our health, both immediate and long term, if you're not. I think then it creates its own sleep anxiety. And so one of the things that I've been very active in that for sure. Yeah, where you think, to be fair, the body and brain are resilient. If you don't get a good night's sleep every once in a while, it's fine. You can manage that. Certainly new parents do just fine over time, although it's challenging. But there are a few things that really help with sleep. So in terms of, and there are a lot of causes of insomnia and things. So they're the basics like avoiding caffeine in the afternoon, if you're caffeine sensitive, et cetera. But one of them is to start to understand that this state of sleep is not something that you should be able to drop into unless you do a couple of other things properly. And based on the research done in part by my lab, but mainly a guy out at the National Institutes of Mental Health named Samer Hattar. He's the director of their Chronobiology Unit. He's done these beautiful studies showing that light exposure early in the day, getting bright light exposure ideally from sunlight within an hour, ideally within 30 minutes of waking up, is vitally important for getting sleep later that night. And the reason is, is it basically, once every 24 hours, you're going to have a spike in cortisol. It's non-negotiable it's built in your genome.

It's going to happen.

So, do people in like Arizona sleep better than people in Seattle? Well, they do actually. And a lot of people in Seattle need light boxes because if you live in an area where you can't get sunlight first thing in the day, feel free to flip on artificial lights. But, basically, the rule is you want as much bright, ideally natural, but if you you can't get natural artificial light would be fine early in the day. And what that does is it basically times this cortisol spike to wake you up. That spike in cortisol isn't to stress you out, it's to wake you up. And then it sets a timer on your melatonin release. So 14 to 16 hours after your bright light exposure, you're going to get a pulse of melatonin, which is the hormone, of course, that promotes sleepiness and puts you to sleep independent of any supplementation. of melatonin. Light inhibits melatonin through a direct pathway through the eyes to the brain stem and then up to the pineal. It's a well-established pathway. So the number one thing is get bright light exposure to your eyes. So no sunglasses, eyeglasses or contacts are fine early in the day. How long? Well, it depends on how bright. So anywhere from two minutes to 10 minutes. Ideally, you're not looking at your phone during that time. Ideally, it's sunlight, but if you wake up before, flip on a bunch of artificial lights and then get outside once.

The sunlight is out.

Just outside taking a walk, you're not looking at the sun, right? You're not looking directly into the sun. You don't want to burn your retinas out. Indirect exposure is fine. But there's a class of neurons called the melanopsin ganglion cells that reset your circadian clock and time things nicely. They time the cortisol, the time the melatonin. So that's the number one thing for, I wouldn't just say for sleep, but also for optimizing levels of alertness throughout the day. The other thing is that you really want to avoid bright light between the hours of 11:00 PM to 4:00 AM if you're on a standard schedule. Shift workers is totally different. The reason is Samer's lab and a guy named David Berson at Brown University have shown that bright artificial light of any color, blue blockers or no, if there's bright artificial light, it activates a pathway in the brain involving this brain structure called the habenula. When I was an undergraduate, actually someone asked in neuroanatomy, what's the hebennula do? No one knew. The hebennula is involved actually in generating our feelings of disappointment. It suppresses dopamine release for several days afterward. Now, if you have to go to the bathroom or you have to pull an emergency trip to the supermarket or something in the middle of the night, you don't have to worry about crushing your dopamine long term. It's a chronic thing, but you really want to dim the lights. in the evening starting at about 10.

P.M. And so you're saying those blue.

Blocker things, that doesn't work? Well, the blue blockers will work, but if the lights are bright enough, it doesn't matter what wavelength they are. And this is because these melanopsin cells, these neurons in the eye, they do respond best to blue light, but they're very broad spectrum. The wavelengths that they will respond to, you can shine bright red light on one of these cells and it will signal to the brain time to wake up. Amazing. So it's really key to just dim things down. and I always say blue blockers are terrific, but you don't want to wear them during the morning and early part of the day because blue light is the optimal stimulus for this wake up signal. So we took, the blue blocker thing is great in principle, but people kind of took it too far. So bright light when you want to be awake, and alert, and dim light when you want to be asleep.

So how many hours before bed? Because, you know, people are up on on their TVs and their screens, computers and phones.

Yeah, so the subtle things that people can do are to start dimming the lights in the evening, right about the time the sun goes down, is when you want to say, oh, the sun is going down outside, and if it's overcast, it's getting dark. Well, that's a time to dim the lights in your home. The other thing is because of the where these neurons are situated in the eye, overhead lights will activate this wake-up signal much more readily than lights down low. So the Scandinavians have it right. in the evening, you want desk lamps. Most people aren't going to have floor lighting in their house. Desk lamps in early in the day and throughout the day, that's when you would want overhead lights. So, those two things are going to be very beneficial. A lot of bright light, overhead light throughout the day, ideally from sunlight. And then in the evening, avoid bright lights of any color, any kind, between 11:00 p.m. and 4:00 a.m. Don't get neurotic about it, but many people find that just making these changes.

So you don't have to be off.

From 6:00 at night.

No, no, no, no. And there's actually the third tool, which is also grounded in really nice work, a paper published in Scientific Report, shows that if you get some sunlight in your eyes in the evening, right about the time of sunset, if you can't get it from the actual sunset, just go outside. You don't have to see the sun setting. You just need the light, the ambient light, the outdoor light. in the morning is sufficient. There's so many photons out there, even on a cloudy day, you'd be amazed. In the evening, if you see or get outside and get some sunlight or you get some light in your eyes, that has an effect of lowering the sensitivity of the retina, of the neural part of the eye, and provides you a kind of insurance. It offsets a little bit of the late night bright light exposure. I call it sort of your Netflix inoculation. It kind of protects you against some of the ill effects. Now, if someone's schedule is really messed up, I mean, they're not sleeping, they're really screwed up. There's a study out of the University of Colorado that showed that this is a little extreme, but going camping for two days, reset these melatonin and cortisol rhythms for two weeks. It's pretty incredible.

It's really incredible. I noticed when I go camping or I go out in the wilderness or far away from technology. I just sleep way better.

Yeah.

And we had a, we had a storm my house last summer, and we got power out for four or five days, and we just had candles at night. And it was unbelievable.

I loved it.

And it felt so good to not have all that bright light at night and to go to sleep and sleep better and deeper.

Yeah.

You really reset. And you mentioned, I'm glad you mentioned candlelight. Candlelight in the evening is fine. Actually, not to turn people into geeky scientists, but there's a great app. I have no relationship to it, but it's completely free. It's called a Light Meter. And you can run this experiment. You can download the app. You go outside on an overcast day in Boston in January and press the little button on Light Meter in the morning, and it'll show you that even though you don't see the sun, it looks like dense cloud cover, there'll be something like 5,000 lux of light. You'll go inside, you'll point the thing at a really bright artificial light, and it'll say 300 Lux. Close the window to the outside and it reduces it by about 50 fold. So you don't want to do this through a window or a car window. And then you say, well wait, you just said that there's very little light intensity coming from artificial lights. Why is it so bad at night? I should be able to turn on every light in the house and it won't reset. Ah, but the clock and your eye get more sensitive as the day progresses. So you have to control it at both ends. and candlelight is fine, dim light in the evening is fine, but throughout the day you really want to try and get some bright light exposure. And for many people that are whose schedules are just really screwed up, anchoring to these two or three things of bright light exposure and avoiding bright light in the evening hours between 11 p.m. and 4 a.m. often, not always, can really reset people's ability. And once you're sleeping well, everything else gets better. So that was kind of the first question you had. The other one is that I'd be remiss if I didn't mention there are things that people can take. I'm sure you're familiar with several of these as well. Obviously, well, we have a doctor right here. So talk to a doctor. Obviously, I'm not a physician. I'm a professor, so I don't prescribe anything. But the three things that have made a tremendous difference... You profess, you don't prescribe. I profess, I don't prescribe. That's right. That's how you usually say, profess lots of things. The three things that I've certainly benefited from and I know a number of other people have and for which there's really good research are apigenin, A-P-I-G-E-N-I-N, which is, it's very inexpensive, it's chamomile extract, and it basically turns on a chloride channel mechanism in the brain. It turns off thinking. It's kind of the equivalent of an alcoholic drink. It just turns off thinking. You could still drive on the stuff.

But it makes people drowsy.

They drink chamomile tea or you have to take a concentrated. Some people get that benefit from chamomile tea. Other people like the Apigenin. And the other ones are the magnesium. The magnesium and magnesium threonate and by glycinate in particular. Threonate spelled T-H-R-E-O-N-A-T-E and by glycinate, I won't spell out, but sort of just as it sounds, those cross the blood-brain barrier more readily because you're ingesting this obviously into the gut and then that magnesium needs to get into the brain. And basically the magnesium seems to act as a precursor to GABA, the inhibitory neurotransmitter. And so for people who have a hard time turning off their thoughts, that can be very beneficial. So there's the kind of light, which is a kind of ancient mechanism by regulating alertness and getting into sleep. And then there's the modern thing, which is supplements. And there's something sort of in between worth mentioning, which is there's a great tool that was developed by my colleague who's our associate chair of psychiatry at Stanford. His name is David Spiegel. He's actually a clinical hypnotist. He's done a lot of work on pain management and even breast cancer outcomes from hypnosis. And he's developed a free app that's on Apple and on Android called Reverie, R-E-V-E-R-I-E. RI. It's a 15-minute hypnosis that you do in waking, which trains the brain to sleep better. And I think that a lot of people hear hypnosis and get a little bit freaked out, but there are a lot of clinical data showing that this can help people to learn to turn off their thoughts and to relax and go to sleep. And there's some other nice hypnosis scripts in there as well. It's David's voice, and he kind of walks you through it. So those are, aside from the supplements, the light and the hypnosis are free resources that I most everyone could benefit from. If I wake up in the middle of the night, oftentimes I will do one of these hypnosis scripts. And just one other thing about sleep, a lot of people wake up at 3 or 4 a.m. and can't fall back asleep. Okay. I never understood why that was. And then I talked to the folks in the sleep lab at Stanford and I talked to the chronic. Here's probably the reason. There's an asymmetry in this seesaw that we all equipped with internally, which is that we can all push on and stay awake more easily than we can just force ourselves to sleep, right?

That's true, right?

At some point we fall asleep, but if you're waking up at 3:00 or 4:00 a.m., unless you're drinking too many fluids and that's the reason why, chances are you are running out of melatonin at that point. The levels of melatonin in your blood are dropping, and what it means is you stayed up too late and you probably are one of these people that should be going to bed at 8:30 and waking up about 3:30 or 4:00 a.m. And people don't like that answer because they think, no, but I want to be the person that goes to bed at 11. And there are ways to shift your circadian rhythm that we could talk about, but try and go to bed one hour earlier and chances are you will wake up feeling better at 3:00 or 4:00 a.m. Now, it's not exactly a solution, but if you're in an argument with your spouse or something about going to bed at one hour or the next, you can leverage biology or cite this discussion.

Wow. So we really have this sleep epidemic problem and people are struggling with figuring out how to deal with it. And your lab and you have worked really a lot on how do we navigate the landscape of sleep because as we're having this conversation, whatever I ask you, you keep coming back to sleep, which is fascinating to me as a foundation. And we always think diet's the foundation, exercise foundation, meditation, but sleep is sort of that neglected fourth leg of the table.

Well, and it's the thing that we've been encouraged to push through. And, I mean, there are some elements, I mean, that we could get down into the fine science of it. You know, we sleep in 90-minute cycles, ultradian cycles, better to wake up after six hours, than seven, right? You know, for most people, for sake of alertness. So waking up at the end of one of these 90-minute cycles, you're going to feel more alert than you would say if you slept into seven hours would mean you were about, you know, you weren't complete through your last ultradian cycle. But sleeping at 7:30 would be even better if you can, you know? So getting the right amount of sleep is it, it's a process that you want to master on average, right? You know, the one occasional all-nighter you'll be okay. You drink coffee too late, you'll be fine. but on average you want to be sleeping. Most people, it's going to be anywhere from five to eight hours a night. Naps in the afternoon seem to be okay. The hypnosis script and the other things will really help people get centered around this. I think that the idea of breaking up one's sleep, there were these crazy sleep cycles that were promoted, not to be confused with Huberman, they called it the Uberman schedule. I just want to be very clear, not Huberman schedule. There was a study that came out recently that showed that it's incredibly detrimental to all sorts of inflammatory cytokine markers. To take a nap in it? Oh, no. To try and sleep two hours, wake up, sleep two hours, wake up, sleep to around the clock. There are people that they found they could compress their total sleep time. This was kind of a Silicon Valley thing, like trying to master one, you know. You just- you- do you have these human bodies? You gotta actually- yeah, you can't conquer that. But I think sleep is vitally important.

First and foremost, we have to recognize that sleep, you and I trained in an era where sleep deprivation or how little sleep you could get by on was a badge of honor. We need to shift that internal dialogue that we all have that, oh, if I'm sleeping, I'm wasting my time and I'm not getting my stuff done. So first, honor the importance of sleep for your overall health and well-being, and even your ability to stick to your intentions around choosing healthy foods and sticking to your exercise plan, then create a sanctuary that's really conducive for rest and relaxation. Dark, quiet, cool, ideally electronics out of the bedroom or turned off if you can. Getting rid of all of the light exposures, even your chargers, you know, that.

Have that- yeah, like those like lights, like this red green lights on different devices. I'm like, that drives me crazy.

I used to, I had a patient who told me she traveled around with black electrical tape whenever she went to a hotel and she would put it over all the little light sources in there.

That's a great idea. I travel with eye shades because you never know where you're going to be.

So those two, quiet, calming. And I think this idea that you go, go, go, go, go, hop in bed and turn it off like a switch, that doesn't work either. So building in a transition to rest and relaxation. If you can do an hour, that's great. And getting off the devices, not watching TV, maybe reading a book or journaling or Doing something, taking a bath, stretching in the tub. I mean, there's all kinds of wonderful.

Ways to ease into rest.

I like the hot Epsom salt bath and lavender drops because the lavender lowers your cortisol. All the magnesium relaxes you and the.

Sulfur and the Epsom salt helps you detox. That's my favorite as well. And then you go to your cool bedroom and you do your legs up the wall yoga, restorative yoga position and.

Bingo, you've got your transition to rest and relaxation.

So powerful.

And alcohol obviously is a big factor for people.

Oh yeah, that's a tough one. That's a tough one. So the rough analogy is this. It's funny when they asked partners of people with insomnia how many of them were suggesting that they have a drink to go to sleep, it was about a third of them. So people think alcohol is gonna help you sleep and it might make you fall asleep, but then as it clears out of your system, there's an arousal that can exacerbate hypoglycemia. Lyme disease, it makes you wake up, it's going to make sleep apnea worse. If you're a woman in midlife, oh boy, it's a bladder irritant, it's a hot flash trigger. So it's really affecting sleep in a lot of ways. The rough equivalent is there's about an hour of sedation followed by an hour of arousal.

Yeah.

So if you had a glass of wine at six and you go to bed at 10, it's probably not going.

To impact your sleep as much as.

If you have two glasses at eight.

Or like your late dinner last night.

If you had a glass or two of wine. You had a beer.

Yeah.

That has another impact on your sleep.

I just noticed it.

Actually, I had an aura ring for a while. I was tracking my sleep and I noticed whenever I drank, my sleep's pattern was so disrupted. Quality of sleep, the depth of sleep, the amount of REM sleep, deep sleep, snoring, you know, all that.

It's really interesting. And then caffeine also is another big one, right? Yeah, absolutely. And we're all different in terms of our caffeine metabolism. ability. Some people are really fast metabolizers. Sorry, fast metabolizers. I happen to be one of those. But if you're a slow metabolizer, half of your cup of coffee from noon could still be in your system at nine o'clock at night. And most of the time we're not thinking back to that new cup of coffee. With food, it's really about quality, quantity and timing of food. It's all three. Yet another area that's impacted with the health of the gut microbiome is sleep. And data is suggesting that people who eat a wide variety of colorful fruits and vegetables tend to have better sleep quality, whereas a highly processed standard American diet is associated with more sleep disruptions and less deep sleep. So quality matters. We already touched a little bit on the timing of eating. So eating your calories earlier in the day, also helps re-regulate those circadian rhythms. So this, the clocks in the brain and the clocks in the body that are ideally going to be working in sync with each other, they're influenced by light, by movement, and by food. So when we line all those things up during the day, it's going to help us get the rest that we need at night.

So important.

This is such good information.

Thanks for listening today. If you love this podcast, please share it with your friends and family. Leave a comment on your own best practices on how you upgrade your health and subscribe wherever you get your podcasts and follow me on all social media channels at Dr. Mark Hyman. And we'll see you next time on the Doctor's Pharmacy. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic and Function Health, where I'm the chief medical officer. This podcast represents my opinions and my guests' opinions. Neither myself nor the podcast this podcast endorses the views or statements of my guests. This podcast is for educational purposes only. It's not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner now. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It's important that you have someone in your corner who is trained, who's a licensed healthcare practitioner, and can help you.

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