Sleep Doctor: “8 Hours of Sleep” Is a Lie (Here's What You Actually Need) | Dr. Michael Breus

This is the most powerful drug in the world, and if you can figure out how to use that to your advantage, now we're talking. If you were a patient of mine and you walked in and let's say you were taking 10 milligrams of Ambien, I could utter one sentence looking at your medical chart and I could make that Ambien not work. I could just turn to you and say, you have cancer. Boom. You ain't sleeping that night.

His research has changed the way top CEOs, elite athletes, and millions of people think about sleep, energy, and performance a bestselling author and one of the most trusted sleep experts in the world, Dr. Michael Breus.

Thanks for being here. I think sleep is kind of like the volume knob for greatness. When your volume is low, nobody can hear you. You can't hear you. You can't perform at the levels that you want to perform. Sleep affects every organ system and every disease state. Literally everything you do, you do better with a good night's sleep.

What ruminates in the mind that causes us not to sleep?

That is literally the number one question that I'm asked is, what do I do if I wake up in the middle of the night somewhere between 1 and 3 and I can't get back to sleep?

What do you do?

So I've got a whole routine and I tell people all the time about it.

So first of all, you said there's a difference between sleep experts and sleep doctors. What is that difference?

Yeah, so it's not just a nuance, it's a whole different kind of area. So a sleep expert, and, and by the way, I love sleep experts. They really help me do my job really well. Sleep experts are folks who are a lot of times academicians, right? So they're running research, they're looking at things. But when, when you do a research study, it's in a very controlled environment, right? And, and you get these interesting results and you can talk about them and, and tell people all these interesting things. That's what a sleep expert does. They kind of create an overwhelming theory based on all their research and, and try to explain a problem. I'm a sleep doctor. I take care of people's sleep. I take care of people's apnea, narcolepsy, insomnia. I look at these things called chronotypes, which I know we're going to get into, but I pressure test all of their ideas in the real world and then I manipulate them so that they work. So a lot of times it works in the research lab, but it might just not work in your bedroom. Yeah.

Yeah. Well, it's interesting because before we started, you were talking about how you have two French bulldogs that sleep in bed with you. Yes. You have a, you know, a 60-inch big screen TV, flat screen TV, bright lights on the whole time. And right away I was like, that's everything that sleep experts say not to do, right? They say to have it, you know, 50 degrees or something, you know, 60-something degrees is the perfect temperature. Blackout shades, snake plants, like to have all these like cooling temperature sheets, like to have the perfect environment, which I actually love the idea of having the perfect environment to allow yourself to sleep. But it sounds like as one of the top sleep doctors, you don't do that.

Nope, nope.

And I've also heard sleep experts say like, don't sleep with your partner because like any movement is going to disrupt your sleep. Like if you could have optimal, optimal sleep, they're saying this. But I'm also like, okay, but who has that, right? Exactly, exactly.

Right.

So as a sleep doctor, you go against the rules of a lot of sleep experts.

What I try to do is I try to adapt them, right, and try to figure out what is the mechanism inside of their research that they're finding can help people with better sleep, and then how do I adopt that to people's real living and real lifestyles, right? Yeah. I know you're an entrepreneur, right? Entrepreneurs sleep differently than other people sleep. Let me give you an example, right? So I work with entrepreneurs all the time. And, um, one of the classic things that I hear people on the, on the doctor side is, hey, I fall asleep just fine, but I wake up somewhere between 1 and 3 o'clock in the morning and I, it either takes me an hour or I don't fall back to sleep. You know, what is that and how do I fix that? By the way, that's the number one question that I get asked. But it's different for an entrepreneur. When an entrepreneur wakes up in the middle of the night, they're not stressed, they're excited.

They're thinking.

They're like, I've got the idea. I figured out what my business problem is. And so we have to be able to change some of the thinking that we used to have for insomnia and adapt it to the entrepreneur mindset. Mm.

Yeah. When I was growing up, it would take me hours to fall asleep.

Really?

And it would take me hours. And I think it was just like a stressful home environment. And I didn't feel maybe psychologically or emotionally safe. And, you know, I knew my parents loved me, but they didn't have a healthy relationship with each other.

Right.

So there was a lot of uncertainty and screaming and fighting and silent treatments. And then just this, what's going to happen? You know, the uncertainty of life as a 7, 8, 10-year-old.

Yeah. I would argue a lot of sleep-related issues are fear-based. Right. So you want— you might have been safe physically. Yes. But emotionally, Things weren't necessarily where you thought they should be or understood they should be. And that fear can really play a role. Most of sleep issues that I deal with have an anxiety component to them. And when I think about anxiety, it's not like, oh, I'm afraid of this, or I've got a phobia about that. It's, there's a level, my heart rate is up, there's stuff going on, it's not working here, and I'm concerned, I'm scared. That will override just about anything. Really? Yeah. I, I'll give you an example. If you were a patient of mine and you walked in and let's say you were taking 10 milligrams of Ambien, I could utter one sentence looking at your medical chart and I could make that Ambien not work. I could just turn to you and say, you have cancer. Boom. You ain't sleeping that night, right? It overrides the pharmacy, right? This is the most powerful drug in the world, is your brain. And if you can figure out how to use that to your advantage, Now we're talking, right? So I'm not saying anything against pills. There are plenty of people out there who use medications, and, and by the way, there's nothing wrong with that. There are certain situations where pharmaceutical intervention makes a ton of sense, right?

Yeah.

If you're a paranoid schizophrenic, you get your Ambien, okay? You know, if you've been in a motor vehicle accident, you've got terrible pain, hey, you might need a sleeping pill. My goal is to try to get people off of those medications when they're not necessary. Yeah, almost everybody was able to sleep without pills when they were younger. So let's see if we can figure out how to get back to some of that.

Yeah. And as a psychologist, then what shifts in the mind that causes people not to be able to relax and slow down their thinking?

Right.

What is it? A traumatic event? Is it a— is it a reoccurrence of an uncertainty around events? Is it a constantly thinking about the past, worrying about the future? What ruminates in the mind that causes us not to sleep?

All of the above, right? You, you literally hit almost all of them. So it's traumatic events, but it can be as, as simple as daily worries.

Yeah.

Right. I mean, here's the thing, uh, you know, I've heard this many times. It's a lot of people, they wake up in the middle of the night and they get monkey mind. Right now, I'm not sure I have to give a formal definition of monkey mind, but I think we all know a little bit of what that is. It's, are you worried about your kids? Are you worried about your job? Did you get the right groceries? Um, you know, is the, what's that noise?

Any worry?

Letter in the house.

Yeah.

Right. Like there's a whole host of things that can be out there. This causes a level of what we call physiological arousal. What it does is it turns on what's called the sympathetic nervous system. So you've got an autonomic nervous system breaks out into two pieces, sympathetic and parasympathetic. This is the fight or flight was just sympathetic, and then the rest and digest is the parasympathetic. We want, at least before bed and during sleep, we'd love you to be in the parasympathetic. But when you wake up in the middle of the night, here's the thing that's kind of crazy. Have you ever woken up in the middle of the night for a good reason? Has anybody run into your room and said happy birthday in the middle of the night?

I don't know, maybe, maybe, but not many times.

Not many times. Believe it or not, our brain is built when we wake up in the middle of the night, we immediately go to the negative and that can be problematic. And so you start to think about different things. Sometimes people will flip on the TV. I, I gotta be honest with you, you flip on the TV nowadays, it's tragedy all over the place. It's geopolitical stuff, it's financial stuff, it's emotional stuff. I mean, there's a lot of things that are influencing us on the regular. What I try to explain to people is you need runway to land the plane, right? So you need time before bed that we don't have all of those things going on so that I can lower your heart rate. So here's the crazy part is if everybody gets just one piece of evidence from, from this podcast, you want a heart rate of about 60 or below to enter into a state of unconsciousness. Right? If your heart rate's above that, it's gonna be tough for us to get you there. Now, don't get me wrong, there are people out there with high blood pressure who may never get a heart rate below 60, but I'm just talking about a lowering of the heart rate pretty significantly to allow your body to begin to relax and then allow the sleep process to take over.

And if your mind is constantly ruminating on stressful things, or it's watching stressful things, it's going to be hard to bring it back down.

Exactly. So I use all kinds of different techniques for people, even when they wake up in the middle of the night. 'Cause like I said, that is literally the number one question that I'm asked is, what do I do if I wake up in the middle of the night somewhere between 1 and 3 and I can't get back to sleep?

What do you do?

You want me to go through it?

Yeah.

All right, perfect. So I've got a whole routine and I tell people all the time about it. So first of all, don't go pee. Yeah, you heard it here. Don't go pee.

What if you have to pee?

If you've gotta really pee, please go pee.

Yes.

Okay. But here's the thing, people wake up and they say to themselves, I'm up, I might as well go pee, right? What happens when you go from a lying position to a seated position to standing position?

Your heart rate starts up.

Your heart rate goes up. Exactly. And so then you have two problems on your hands. So what I tell people to do, roll over to your back, count to 10 or 15, see if you really have to pee. If you have to pee, please do me the favor, go pee.

Don't wet the bed, right?

Yeah. Don't put on some Depends. Okay. Like that's not what we're talking about here. But if you're gonna do that, have some strategically placed nightlights along the way. Mm-hmm. Because if you flip on lights, you just told your brain it's morning. And it doesn't actually work out so well. Step number 2, don't look at the clock, right? Here's what people do.

Then you start ruminating more.

Well, you instantly do the mental math.

Oh man, I lost this sleep. I need this much more sleep. Now you're still tomorrow, right?

You're like, you spin up and now you're pissed off. Yes, right. You're like, oh my gosh, it's 3:30. I got to get up at 6. Sleep, sleep, sleep. Like, that doesn't— in the history of time, No one has ever forced themselves to sleep without anesthesia. Yeah.

Okay.

So it just doesn't work that way. So if you can avoid the clock. Now what I tell people, plug your phone in across the room. You can still hear it if there's an emergency. Yeah. Because everybody always tells me, oh, what if my kids call? Or use it for my, you know, alarm clock. Great. Stick it across the room. But what happens, most people when they wake up, they grab their phone and they head to the can.

Yeah. Right.

And you know what they do? They're checking social media, they're looking up their te— Who needs that at 3 o'clock in the morning? Nobody. So if you can avoid it, don't go pee. If you gotta pee, remember, please go pee. Avoid the clock. Now you're lying there and you're wondering, well, what am I supposed to do? I wanna back up for a second and describe to everybody why this has occurred, because by the way, it's biology. Okay? So here's where it gets really, really interesting. Your core body temperature rises, rises, rises till about 10:30 at night, and sleep follows your core body temperature. It hits a peak and then it drops. That drop is a signal for your brain to release melatonin. Melatonin is kind of the key that starts the engine for sleep. It's not the only thing that you need, but you ain't got no melatonin, you're not going to be able to fall asleep. Your core body temperature continues to drop, drop, drop, drop, drop. At some point in time, if your body doesn't heat up, you go hypothermic and you die. Guess what time that is? Between 1 and 3. Really? Every human on Earth wakes up between 1 and 3 o'clock in the morning. But here's what happens. They burp, they fart, they roll over, and they go back to bed. I'm talking about what happens if that doesn't occur. What happens if you don't fall back asleep immediately? Here's a technique that I have all my patients do, and they love it. It's called 4-7-8 breathing. Mm-hmm. So this is a technique that was developed by Dr. Andrew Weil, Harvard-trained naturalist, believe it or not, used in the military. To help our snipers be able to shoot in between heartbeats. Because, you know, if your heartbeat's beating too fast, you can actually change the trajectory of the bullet.

One little— one little— yeah, flinch.

Exactly right. And so here's what it is. And by the way, it's exactly what it sounds like. You slowly breathe in through the nose for a count of 4, you hold for a count of 7, and you slowly push for a count of 8. Now you need to do this about 20 times, and those cycles will dump your heart rate below 60, which is kind of our magic number. Now, I'm going to be honest with you, when I try this myself— and by the way, I've had this happen to me, I'm not immune to having sleep problems every once in a while, I mean, I'm a human being, right?— I lose count, and then I get anxious, and then my heart rate goes up, and now I've completely screwed the whole thing up. So here's what I do, is I have people take their hands and make light fists, and when you do 1, 11, 4, 7, 8, you stick out a finger. 2, 3, 4, 5. You get to 10, you wrap them back. Most people don't even make it back because you're, you're also like heavier, right? Exactly. And you do it down by your sides, right? And so now you're doing something distally, and then you're breathing. And here's the kicker, is you want to picture the number in your head because you can't count and think of anything else at the same time. It's impossible. So you picture that 4, then the 3, then the 2, then the 1, then the 7, all the way down, and then the 8 for the push. And now, it's not a hard push, to be clear. It's very gentle, very light. It's a breathing in and breathing out. Also, I couldn't hold my breath for 7 seconds and push when I first started doing it, so I modified it a little bit. So I did a 4-5-6 for about 2 weeks, then a 4-6-7, and then a 4-7-8.

Yes, a breathing strategy, which I think is really important.

Now, here's also what happens if this doesn't work. What happens if you get through 20 cycles and you haven't fallen asleep? Couple of different things you want to think about. One is there's actually data now to show something called non-sleep deep rest, otherwise known as yoga nidra, right? Lie there, relax. It's actually rejuvenative. So even if you don't fall asleep but you're chilling out, you're actually doing your body some good. And as we were talking earlier, you're going to stay positive. So, so many people go into this negative mindset. If you find that you're lying there and you're like, this sucks, and you can feel your heart rate going up, that's the time to go ahead and get out of bed. Have a specific area in the house, right, where there's a book, there's a light, and you can just relax, chill. And when you start to feel sleepy again, then return to bed.

Yeah. Now, is it— most people think they have a sleep problem because they're not getting 8 hours of sleep.

Yep.

Is 8 hours still the optimal for average human beings?

Absolutely not. No, no, absolutely not.

Should some people be getting less or more depending on their personality, depending on their job, the person, if they're athletes or it has a lot to do with genetics and where they are in their physical stage of life.

Right. So when you're younger, you can get 6.5, 7 hours. When I talk about younger now, I'm talking like early 20s, things like that. When you're much younger, you want to get as much sleep as you can because you've got a developing body. I mean, you're an athlete. You understood this when you were out playing. Yeah, you got your rest.

You need a lot of sleep. You need naps. You need sleep. You need—

Exactly.

10 hours, maybe.

Right. And so in those cases, you might need more sleep. But once you kind of hit adulthood, the— what we're learning is somewhere between 7 and 9 hours seems to be kind of the general average. I'll be honest with you though, I get about 6 and a half. I'm 58 years old, I get 6 and a half. I've had no coffee today, this is my energy level every day, right? So sleep is flexible. That's the thing I want people to really understand. I got so many people out there like, the only way I'm going to optimize is if I get 8 hours. Remember, sleep isn't about quantity, it's also about quality of sleep. And so depth of sleep matters. Are you getting the right stages? How is that going for you? And a lot of people say, okay, well, I've got a tracker, you know, I've got a Ring, I've got a wristband, I've got a watch, I've got something that's tracking.

What do you think about those, those wearables that track your sleep?

Here's what I'll tell you is none of them are fantastic, okay? They're not accurate because here's the problem: we measure depth of sleep from brainwaves. It's hard to get brainwaves from your finger. Right?

Mm-hmm.

So you have to use a proxy. So you have to use heart rate, blood pressure, temperature, and then an algorithm is kind of, kind of guess, okay, Lewis is at this heart rate at this time of night. We're pretty sure he's in this depth of sleep. The biggest problem I think with the trackers out there is people just zone in and they like, it'll hijack your day. I can't count the number of people who walk up to me and they're like, Dr. Bruce, I only got 14 minutes of deep sleep last night. Am I gonna die? You're probably gonna die, but it's not gonna be from sleep loss, right? Because how much did you get the night before? And they'll say, oh, 16 minutes. I go, how about the night before? 18 minutes. I said, well then the tracker's being consistently inaccurate. I can work with that, right? What we're looking for is the delta or the deflection. So if you get 14 minutes every single night, there's no universe you're only getting 14 minutes of sleep. It doesn't work that way, right? It's being consistently inaccurate. But if you get 14 and then you get 407 one night, I want to know what happened that night. Right. Look at the trend at the end of the week. Don't double down on the number because sometimes it becomes a self-fulfilling prophecy. They wake up, they get a crappy sleep score, and then they think, oh, my day is yours. Yeah, right. I'm going to be done for the day. It's not going to work. It's not going to go well and all this stuff. And then it ends up not going well because they've kind of made it up themselves. Right. So use the tracker. As something to guide you in different directions, but you really don't wanna look and say, this is the number because unfortunately we're not there yet. Now I will tell you, probably 18 to 24 months from now we might be.

Mm-hmm.

Some of the AI and the algorithms that I'm seeing out there, I would not be surprised if a lot of these companies are starting to work and getting better and better at, better at the, at the variability and the guessing game. And I think we'll get there over time, but That is very different than, for example, what we do in clinic with a sleep study, right? So a sleep study is where you actually are looking at all of those things. You have FDA-approved medical devices that really are measuring brain waves, measuring the whole thing, and getting you a much better understanding. So if you've got a tracker, use it as a guide, but not the Bible.

Now, as a sleep doctor, you've got— you get around 6.5 hours of sleep.

I do.

You have 2 French Bulldogs in bed with you.

I do.

Snoring and making their noises. Yeah. Moving around and licking your face throughout the night or whatever they're doing. You've got an 80-inch flat-screen TV blaring signals, frequencies. Yeah. And you told me before that you also have sleep apnea.

Yep. So I was recently diagnosed with sleep apnea.

So what does that mean? And do you use a machine for this?

I sure do. So sleep apnea— I'm glad we're talking about this because this is important. right? So it's kind of funny. So I'm the sleep doctor, right? And about a year and a half, 2 years ago, I wasn't feeling up to snuff. My workouts weren't as good, my times weren't as good on the treadmill. So I called my doctor, the woman who takes care of me, Carrie, and I said, Carrie, you know, God, I'm kind of dragging ass. She said, let's do some blood work. Let's see what's going on with you. And I said, okay, great. So she thought maybe I was iron deficient, like I had anemia. Some— maybe there was some kind of deficiency, something was going on. So we got back and my testosterone was around 400. Now, for a guy my age, that's still okay. But she was like, you know, let's put you on testosterone and let's see what happens, right? So she puts me on testosterone. Almost 9 months goes by, no change. All that happened was I lost more hair.

Really?

Yeah. Let me tell you, that was not the side effect I was looking for, brother.

You know, you're like, I wanted to get jacked. I want to get strong. Exactly.

And so then she turned to me and she said, hey, uh, Mr. Sleep Doctor, why don't we do a sleep study on you? And I was like, you know, I hadn't done one in a few years in the clinic when, when I used to be practicing on the regular, I would test out all the new equipment on myself. So I had a pretty good idea what was going on. So I actually, my company, uh, called Sleep Doctor, we actually do home-based sleep tests now. So by the way, since COVID almost nobody really needs to go to the sleep lab if you're, if you're looking at sleep apnea in particular. So I got a machine, a machine comes to the house, you wear it on your wrist with a little thing on your finger. That's it. It, by the way. The whole— that's the whole thing.

Sleep with that.

Sleep with that. Information ports over to an app. The next day you're online talking with the doctor. Turns out I stopped breathing in my sleep 24 times an hour.

Wow.

Right? That's a lot. That's moderate sleep apnea.

How long do you stop sleeping, uh, stop breathing for?

So the definition is anywhere from 30 to 90 seconds.

Come on, for real? You stop breathing for 30 to 90 seconds 24 times an hour?

Correct. That is sleep apnea.

Now I wanna be clear, and you can't hold your breath for 7 seconds, right? Right.

It's a little bit different. It's just so, it's fascinating when you start to kind of look through these ideas. But for everybody out there, obstructive sleep apnea is where there's a blockage somewhere in your throat. Now, a lot of times we think of sleep apnea as a big person's disease. Look at me, dude, I'm 160 pounds soaking wet, right? I'm not, I'm not one of those people, but I've got some level of obstruction that's here in my throat. So I ended up using a CPAP machine. So CPAP stands for continuous positive airway pressure. So literally it's an air compressor with the hose and a mask that sits on my face and pushes air down my lungs and opens the area that has collapsed and sends air to my lungs. And I breathe all night long. Now here's the thing. A lot of people say, I don't want to get sleep tested. I don't want to sleep with the mask on my face, Michael. It's not sexy. There's no way I'm going to do it. I'm claustrophobic. And they come up with every excuse in the book. CPAP's not the only solution, Lewis. Like, there are mouth guards that you can wear with no hose, no mask. There are surgical interventions. Weight loss can help. There is a dramatic number of treatment modalities that we can do for people where you don't necessarily have to wear the mask, but people won't even get tested, right, because they're afraid to wear the mask. If you've got undiagnosed sleep apnea, you are on the road to diabetes, you're on the road to atrial fibrillation, congestive heart failure. Like, It's a mess. Cognitive decline for sure, right? Like, this is a significant medical issue and we want people to at least get tested for it so they know and understand what's going on. I had a question the other day I thought was really interesting. They said, Michael, are GLP-1s the new CPAP? Right? Because, you know, people are losing weight with GLP-1s and that— I think it can be helpful, but I don't think it's the only solution. And by the way, there's a pill now that's in progress. It's in the research trials. I would say 18 months from now to 2 years from now, there's a pill that you'll be able to take that will be able to help you with your sleep. Really? So people need to get tested.

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100%. I think sleep is kind of like the volume knob for greatness, right? When your volume is low, nobody can hear you. You, you can't hear you. You can't perform at the levels that you want to perform. Sleep affects every organ system and every disease state. Literally everything you do, you do better with a good night's sleep. I mean, cancer has a circadian rhythm. I mean, we can actually help people with cancer faster and better if they're sleeping better.

Really?

It's unbelievable. There's now data to show that if you administer chemotherapy at a particular place in someone's circadian rhythm, they get— we need less chemo and it works better. Come on, dude. The research is out there. Wow. Absolutely.

So wait a minute. So you can— if you have cancer, mm-hmm, and you get treatment, if you get chemo at a certain time, in your circadian rhythm, it could potentially—

the research is showing that it helps you recover faster and you need less chemo. Less poison is going into your body. Really? Oh yeah. The research has been around for a little while.

I mean, okay, so tell me about circadian rhythm then. Why is this important for us to understand and what should we know about our own circadian rhythms?

So sleep is basically two separate systems in the brain. One is called your sleep drive. The other is called your sleep rhythm. Sleep drive works a little bit like this. When a cell eats a piece of glucose, something comes out the back end. That thing is usually called adenosine. Adenosine works its way through your system, goes through a very specific receptor area in your brain. As that accumulates, you get sleepier and sleepier and sleepier. That is sleep drive. By the way, as an aside, kind of, I'm kind of a sleep geek, so I, I'm, I'm all into the research. If you look at the molecular structure of caffeine and the molecular structure of adenosine, they're off by one molecule.

What does that mean?

So, I'm going to tell you what it means. I figured out this thing. I call it the Napa Latte. So here's what we do.

Napa Latte.

Yeah, you're going to like this. All right, so if you're dragging ass, you've only got 4 hours, you know, the night before, you got a big presentation, going to be on a podcast, you're going to do something cool and fun, you want to be able to be present and be able to be at your best, here's what I want you to do. Take a cup of drip black coffee, no cream, no sugar, throw 3 ice cubes in it merely to cool it down, slug it as fast as you can, and then take a nap for 25 minutes. You burn through the adenosine, right? And since caffeine and adenosine are off by one molecule, caffeine fits into that place, blocks future adenosine for up to 4 hours.

So what does that mean?

That means you're wide awake and not dragging it for 4 hours.

Really?

Absolutely. I do it with athletes. I do it with CEOs all the time with my entrepreneur set. Don't do an Apple Latte every day. No, right? That's not, that's not what we're looking for.

Once a month if you have, if you didn't get a good night's sleep or something.

Right, exactly. But you can definitely use something like this to your advantage.

So give me an example. You're up all night ruminating, thinking, excited. You can't sleep. Maybe you only get a couple hours.

Yep.

And you got a game, you got an event, you got a speech, you got something the next day, right?

I would say somewhere around 60 minutes before you're gonna go on, right? Do this 25, take the coffee with— cool it down, take the coffee, drink it.

Why not hot coffee?

'Cause you have to drink the whole thing fast.

Okay.

It's merely to cool it down.

Don't sip it for an hour. You have to drink it.

No, that's not the goal. The goal is to put it in and close your eyes.

And what if you can't sleep right away?

Doesn't matter. It still works even if you never actually fall asleep. But be in a room that's quiet, that's dark. Give yourself a good opportunity to be able to do that, right?

And sleep for 25 minutes or so?

25 minutes. You don't want to go over that. You ever taken a nap and felt worse, not better? Yeah. That's 'cause you sleep too long. This is a very subscribed nap, 25 minutes. Right, with the caffeine in front of it, you'll be shocked at how well it works. That's sleep drive. All right, now let's talk about sleep rhythm, 'cause that was the question that you asked me. What is circadian rhythm? Why do we care? This whole cancer idea, what's, what's happening there? So circadian rhythm is kind of my area of expertise. It's one of the areas that I really love because within circadian rhythm are these things called chronotypes. Mm-hmm. Okay. So a circadian rhythm is a lot like hunger. You ever notice that you're hungry around breakfast time, around lunchtime, around dinnertime? That's your circadian rhythm for hunger. For sleep, at least here in North America, most people are sleepy somewhere between 10 and 10:30. You go to Latin America where they take a siesta during the day, they eat at 10:30. I mean, these people are up, up, up, right?

That's crazy.

That's a whole different, you know, ballgame. And we can work with those people. But circadian rhythms are basically your brain is telling you when to go to bed. Melatonin is really the big factor on the circadian rhythm side. Melatonin is a sleep regulator. Not a sleep initiator. Okay. Initiator would affect adenosine. Melatonin affects the circadian rhythm. So I was looking— I had a patient who came in, and if I'm honest with you, dude, I failed. I mean, I failed with her. We were trying everything. We tried— she had terrible insomnia. I tried cognitive behavioral therapy, which is my drug of choice, if you will, for my patients. We tried medication, we tried sleep hygiene, we tried everything. When I have a patient that doesn't do well, I bring them in for free and I just assess, assess, assess, because clearly I must have missed something that's going on here. About halfway through the interview, she turns to me— and this is when I was practicing on the East Coast— she said, Dr. Bruce, she said, if I just lived in California, everything would be great. Like, explain that to me. She said, well, everything there is 3 hours later. She said, if I could just go to work a couple hours later and stay a couple hours, I think it'd be fantastic for me. I said, well, why can't you do that? She said, well, I don't think my boss would like it. My husband probably wouldn't like it. I take care of him and the kids, and, you know, waking up in morning, that kind of stuff. She said, and by the way, I'm not doing well at work. I'm on like probation, like my work product is down. I said, well, can I call your boss and ask him if you can come in 2 hours later? And she said, you can try. So I call up her boss. This was on a Monday, um, and I explained who I was and what I was doing, who I was working with. Of course, I got her permission in order to do all this. And, uh, he said, you want to do what? I said, I want her to come in 2 hours later. So So in this particular job, she had to be there at 8 a.m., right? So I said, I want her to come in at 10 and I want her to leave at 6. I said, can we do that?

She leaving 2 hours later?

Yes.

Okay. So you're still the same work hours, but we're just starting 2 hours later.

Exactly. He said, Michael, you can try whatever you want. I'm firing her on Friday. Wow. I'm like, no pressure. Great.

Wow.

So we run the—

did you tell the client, your client, the patient this?

Like, hey, no, because then she really wouldn't sleep, right?

Right.

Exactly. So I didn't tell her that part. So I call him back on Friday and he picks up the phone. And you know what the first thing he says to me is? I got 3 more employees I want you to talk to. Wow. Okay. This is what's called a chronotype. It's genetic. You don't actually get to pick it, by the way. I got interviewed a couple of weeks ago by the Wall Street Journal, and they said, what do you think of The 5 AM Club? I said, I think it's the second stupidest idea I've ever heard other than mouth tape. Okay. Okay.

Tell me why.

Because 85% of the world can't wake up at 5 a.m., Lewis. 85%. They're going to fail no matter what. Genetically speaking, I can actually look— if you had your genome sequenced, I could look at your 23andMe or your ancestry.com. I can show you where it's an area called the PER3 area. I want to be clear, there's about 30 areas that control this, but PER3 is kind of the big, the big one that we look at. And if you have something called a single nucleotide polymorphism, which is a SNP, which means that the building blocks, if they flip one way, you're an early bird. Now, you've heard of this term before. A lot of people out here have never heard of chronotypes, but they've definitely heard of early birds. If it's flipped another way, you're a night owl. If it's not flipped, you're what we used to call a hummingbird. Okay, so I was looking at this system and I said, now I've heard about this system. I, I was in school, I heard about it. Like, it's kind of a well-known system. I said, but it doesn't encompass this woman I, I was talking with because she also had kind of a strange system. Sometimes it'd be late, sometimes it'd be early. So it turns out that there's a fourth chronotype. Once again, this is genetic.

So this is not just some social construct of just saying, ah, I'm a night owl, I'm an early bird, or— so this is like, if someone's saying that, they're actually— it's their body saying it. It's not— it's not they're just like, ah, well, I just don't want to wake up early.

That's right, it is actually their body. Okay, now I have always been—

you can test this?

Yeah.

Is this through bloodwork you're saying, or is this through—

I've got a quiz online that people can take and look, 30 questions online. It doesn't take you but about 3 or 4 minutes and it's, it's not hard. Like this isn't like some, oh my gosh, I've got to figure all this stuff out. Like you can figure this out reasonably quickly. To be fair, I'm a mammal, not a bird. So I decided to rename the system. So early birds are now lions because who wouldn't want to be the king or queen of the jungle, right? And lions are very interesting people. They make up about 15% of the population, right? And these are the early birds. So these are the people that wake up at 5 o'clock in the morning. They're all chipper. I mean, honestly, the only thing I hate more than mornings are morning people, right? I mean, come on. They're just too, too into the morning scene for me.

Yeah.

Right. They exercise early. These are the people that'll make a list and go from step 1 to step 2 to step 3 during the day. They have a very interesting personality kind of characteristic. Once again, only 15% of people do this. So they're great for The 5 AM Club, but 85% of the rest of the freaking world is not gonna do well at The 5 AM Club. The next group, I call them bears. They're the ones in the middle. These are more solar sleepers. They go to bed around 10, they wake up around 7. And by the way, 50%, 5-0% of the population is a bear. And I gotta be honest with you, dude, I wish I was a bear. Life is built for the 9 to 5 schedule. Works perfect for a bear, right? Absolutely perfect. And these people are a lot of fun. They're really good to work with. And, you know, a lot of times it makes a lot of sense. We've had almost 3.5 million people take my quiz now. And so, yeah, it's amazing. And so what we've discovered is there are actually early birds, early bears and later bears within that category. Right. The next category I call wolves. These are the night owls. This is me. I've been a wolf my entire life. I'm the guy who, like, it was crazy when I first went to college. I took, you know, the classic freshman 8 a.m.

It's the worst.

It's the worst, right? It's awful. Number one, I missed it half the time because I was asleep, right? Like, my body just doesn't work. Then I was labeled lazy, right? I was told that I wasn't intelligent. I was— so all of these different things. And if all I had done is just taken some of those classes later in the day, dude, I would have crushed it.

Mm-hmm.

Right now, what's interesting about my night owls is this is where my creatives are, my CEOs, right? These are my artists, my actors. Yes. My inventors. Cuz who gets an idea at 2 o'clock in the afternoon? Nobody. I get it at 2:00 AM.

Right. They're, why is that? Well, is there something around brain chemistry?

Yes.

Or like the ability to dream or to, to let go, or we can talk about dreams in a second.

That's a slightly different category. But what's interesting is right after or right before REM sleep is when you turn out to be the most creative. Interesting. So, so far, I'll be honest with you, I haven't told you a whole lot you probably didn't already know. You knew about early birds, you knew about night owls, you figured there must be people in between, right? My real kind of the thing I'm most known for is the fourth category, which I call dolphins. Now people always ask, Michael, why, why do you call them dolphins? So it turns out that dolphins sleep unihemispherically. So half of their brain is asleep while the other half is awake and looking for predators.

I thought they don't sleep, right? I mean, they're just swimming in a circle.

Exactly.

Like if you see at the zoo or whatever, just like— exactly, they're swimming 24/7. Exactly.

So half of their brain has to sleep while they're swimming, and then it rotates to the other half. Crazy, right? That is my insomnia groups. That's what this woman was. She was a dolphin. And you know, we did—

what percent is that?

It's about 10 to 15%, man, closer to 10.

What are the wolves?

The wolves are about 15%. So we've got 15% lions, we got about 55% bears, we got another 15% wolves, and about 10% are dolphins, and then some people can float around. Now, I want to be clear about something. The dolphin is interesting because sometimes it's not genetic for a dolphin. Sometimes it's circumstance, right? So if you're a woman and you're going through menopause, you're a dolphin, dude. Yeah, because your hormones are all over the place. This is all based on your melatonin and your cortisol moving up and down. So this is how it works, is if you're a lion, your melatonin turns off at 4:30 in the morning. The cortisol comes up and now you're awake. But if you're a wolf like me, my melatonin doesn't turn off until 7, like a full almost 90 minutes later. So here's where the— where it gets really cool. So my book is called The Power of When, as in when to do something. What I tell people is don't change your chronotype, embrace it. Change your activities to the time when your body will naturally have the hormones that you're looking for.

So how do you know once you go through your quiz and you find out your chronotype?

Yep.

Then you should know when to have sex.

100%.

So you can learn when to have sex based on your chronotype to have the best night's sleep?

Absolutely.

So when is that?

So let's talk about it. Yeah. So everybody always wants to know. So I'm going to give a general recommendation and then I'm going to get some specific recommendations based on people's chronotypes, right? So in order to have sex successfully, you need 5 hormones to be elevated. You need estrogen, progesterone, testosterone, adrenaline, and cortisol all need to be high, and melatonin, the sleep hormone, needs to be low. So when we surveyed people, 75% of people have sex between 10:30 and 11:30 at night. What do you think their hormone profile looks like? It's the opposite. Melatonin is high and all 5 of those things is low. So that's—

you need that to switch.

Exactly.

So you should be having morning sex, not night sex.

So You've already caught on. You're quick. You've already caught on, right? So then the second thing is, if you happen to be having sex with somebody who was born biologically male, what do most men wake up with in the morning? An erection. If that's not Mother Nature telling you when to use that thing, I don't know what is.

Yeah, if you're exhausted at night and you can't get an erection, why force it?

Exactly. It's not, not tonight, I have a headache. It's not tonight, I'm too fucking tired. Like, that's what's really going on here. So Everybody here who's watching and listening has a prescription for with their partner to be able to— if you want to have sex, try it in the morning time. Go to the bathroom, throw in a little mouthwash first, right? Then hop back in bed. Here's what's interesting. We surveyed people when we asked them to do that. Men actually have better performance. They have better erections and they last longer. Women have better emotional connection right now. Here's the question that I get asked all the time, Michael. This all sounds great, but What if I'm a wolf and my wife's a lion? What do we do then? So in the book, I created a matrix.

Sure, sure.

So I've got male on the one side, a female on the other side. And then I also created one for gay and lesbian couples because the hormones are different, right? So we can figure this out, dude. Like, it's not hard to do. I can tell people the best time to have sex, eat a cheeseburger, work out, drink caffeine, have alcohol. All of it runs on these circadian systems based on your chronotype. This is the biggest unlock that anybody could do. Wow.

Okay, so I— so here's the thing. I feel like when I was growing up, I was more of a wolf.

This is such a great question. I know where you're going, right?

Yeah, but then, but then through social conditioning, through sports where we had to wake up at 5 AM for lifting, and it's like, yep, I had to condition myself, essentially go against my nature or the way my brain was working at that season of life. So to try to fit in with you know, high school, college, then pro sports, then—

yeah.

But then I flipped back to being a wolf when I was an entrepreneur.

Yeah.

Because I was like, oh, I'm just up all night thinking, and now I can create and do, and there's— there's— everyone's asleep, so I can actually get some work done.

Yeah.

But then I was like, okay, well, 2 AM every night doesn't work also, because now I'm gaining weight and I'm not— it's like my healthiest.

Yep.

So I feel like I've become more of a bear and probably more of an early bear now.

Yeah.

Just so I can get up and get my workouts in first. And now with twin daughters, I got to spend time with them in the morning. So it's like fitting things in the morning.

So it's called chrono longevity. Okay. So you go through all of the phases in your lifetime.

Yeah. And I'm sure I've been a dolphin in the summer season.

Also, you know, your daughters right now are lions. They go to bed early, they wake up early.

Yeah, right.

Once they hit middle school, they're going to be bears. They're going to go to bed around 7:30. They're going to wake up around 7:30. Then adolescence hits. I don't know an adolescent who doesn't want to stay up until 2 and sleep until 12.

Yeah, that was me.

That was me too, right? Then when you hit about 20 years old, it sets for about 30, 40 years. Really? Yeah. And then it starts to go backwards, right? So if your parents are still alive and you call them up and you said, hey Mom, I want to go out to dinner tonight, you know, she would say, oh great, I'll meet you at 5:30.

Yeah, exactly right. My mom's taking a nap throughout the day multiple times, right?

Because, well, we should talk about that, but What's interesting is your, your chronotype seems to go backwards, so it shifts throughout your lifetime based on stress, based on gender, based on, uh, women if they're going through menopause, men can go through something called andropause.

So there's a whole host, maybe how much daylight you get during the day, all these things.

Such, and I'm so glad you asked that cuz that's such an important factor. Light turns out to be the biggest factor when it comes to sleep in terms of allowing you to sleep because melatonin cannot be produced in the presence of light. Really? Yeah. We call it the darkness hormone or the vampire hormone because it only comes out at night.

So you— your body won't create melatonin if the sun is out?

That's correct.

Or if you see the sun?

Correct. Now, what happens with jet lag? People always ask me this, like, I'm on an airplane, Michael, and my body thinks it's this time and my— that's why we get jet lag is because of this mismatch between our brain and what's going on in our environment.

So how do you never get jet lag?

Believe it or not, there's an app for that.

I've seen that.

It's called Time Shifter.

I've seen that.

Yep. So does it work? Full disclosure, I'm both an investor and developer of Time Shifter.

Okay.

All right. But I'm going to tell you something. The shit works.

It works.

So what we do is we give you a schedule. We know where. So about 15, 20 years ago, they discovered that if they put a specific frequency of light, blue light, in fact, in front of you for a certain period of time, We can shift your circadian rhythm by almost 8 hours. So it turns out jet lag is a math problem, right? So if I know where your circadian rhythm is, let's say you're in LA and you're going to Paris, right? Well, I know what time it is in LA. We know what time it is in Paris, and we know what time your flight is. All we have to do is time when we show you the light that squelches your melatonin, and then we give you a little bit of melatonin when you're supposed to be sleeping on Paris time. And if you can't quite wake up because your melatonin is still trying to come through, we give you a little caffeine, maybe even take a nap, and by the time you get to Paris, I have you on Paris time.

Come on.

Swear to God.

So is the app give you a blue light through the phone? Is that what it is?

Or, um, it doesn't have— no, it doesn't. But what you do is you can just— you can bring a light with you, or you can turn a light on. You can use any one of— like, any light that you want.

Really? A blue light though?

Yeah, yeah. Not, not blue the color. These lights have blue in the frequency. So blue light is a frequency between 460 and 480 nanometers, and you just look at it. Now you don't have to stick it here, like you can have it here while you're eating breakfast or things like that. Like, for— I have a lot of clients who are— live in New York City, right? And you know, during the winter, like, it's dark, dark, right? Also, by the way, we just kind of flipped over to daylight saving time.

That messes you up too.

It's a terrible idea.

Why? I mean, it's a terrible idea. My whole last week was a mess because of this. Yeah.

And by the way, your daughters will actually be lagged behind.

Oh, they were I know, it was rough. It's awful, dude, because it was lighter later, they were going to bed, and I was like— and they were fussier for hours. I was like, why do they keep allowing daylight savings to happen?

They shouldn't. The American Academy of Sleep Medicine has been very clear on this. Standard time is where we should all be. The bottom line, people shouldn't wake up in the dark, okay? Because melatonin still keeps going. So what you have to do is get one of these light boxes. You can buy them on Amazon for like $100. I've Travel with one all the time. Really? Yeah. I put it in my sleep kit. I create my own sleep kits when I travel.

So we shouldn't wake up during the dark?

Absolutely not. It's just your body wasn't designed to do that.

But there are lions that wake up in the dark, right?

They do. They do. Because their melatonin turns off naturally.

Interesting.

Yeah, it's pretty cool. I'm telling you something. This chronotype is an incredible unlock. I had one entrepreneur chronotype his entire company and then schedule meetings based on people's chronotypes. Come on. Think about it. If I know what time of day you're gonna be focused and paying attention, you're gonna be able to be present for the meeting. Like, there's data to now show that, uh, an average, uh, employer loses approximately $3,200 per employee per year based on something called presenteeism, which means the body's there, but the brain ain't there. If you're trying to have creative meetings at 8 o'clock on Monday morning, and most of your creatives are wolves because that's the people who are the creatives, dude, you're never going to get anything done.

What's the best time for a wolf to be creative?

In the evening time. So as an example, when I work with creative agencies like marketing agencies or some of the big brands, what I'll tell them to do is like, don't have your 8 a.m. Monday morning meeting, have it Thursday at 4 o'clock, bring some guacamole, a little, and a little bit of beer, and you're going to get more out of your group than you could possibly imagine because they're there, they're present. That's what greatness is. Wow. It's being present. Yes.

Right, man, that's fascinating. So as a new parent to twin girls, they're gonna be rough, bro. They're gonna be 5 months this week.

Congratulations.

Thank you very much. It's a beautiful journey. Um, it's pretty cool. What advice as a sleep doctor would you have for me to ensure that I get the best sleep possible, my wife gets the best sleep possible.

Yep.

Knowing that things are to keep evolving as they grow.

Yep. So there's a whole host of different things, but my favorite is what I call the on-call system. So here's what's going to happen. So they haven't told you this yet, but teething is right around the corner.

Coming soon.

It's going to be—

they're starting to put everything in their mouth right now. Yeah.

And they're sucking on things and it's really painful. Like the teeth erupt through the gums. Like it is not fun for the baby. Right. And so they're going to be fussy. They're not going to be sleeping well and things like that. So what I always recommend is, for example, you take Monday night, Wednesday night, Friday night. What's your wife's name?

Martha.

Martha takes Tuesday, Thursday, Saturday. You flip a coin for Sundays. And here's the deal, is if the twins get up, it's one person who has to get up with them.

Not both. Not both. Why should both suffer?

Exactly. You know, and if you alternate like that, you can get one good night's sleep and then one crappy, and then one good and one crappy, and then you make it through your day. Wow. And then it's just a matter of time to get through it.

Yeah.

Now here's what's also cool. Is if you're a lion and your wife is a wolf, you could actually do it like that.

Yeah.

Take advantage of the nighttime. Exactly.

That's smart.

Exactly.

Interesting. Now, we mentioned briefly about how different cultures sleep in different ways. You know, I'm, you know, I'm an American. I was raised here and there's a certain standard of living. And when people eat around 6 to 8 p.m., maybe for dinner or whatever. But my wife's from Mexico and they eat at 10 p.m.

Yes.

And on New Year's they eat at 1 a.m.

Yes.

Dinner. And it's like, come on, guys, I'm going to bed. But this, you know, not all Latin cultures, but predominantly Latin cultures have this later evening, later evenings, 10 o'clock start, which to me seems crazy because you're like, don't you want to try to go to bed by 11:30, 12 and actually let yourself rest?

And that's how a lot of those people end up being chronotypes. But it's all shifted because this comes through culturally from hundreds of years of people evolving there. Right. Also, they're closer to the equator, which means they get more light later, right?

So remember, it's still light at 10 PM, right?

And remember, light is the real meter or metric against sleep. You can't make melatonin with light going on. So they've had to adapt from a cultural perspective.

And what happens when you take a 30 to 60 minute nap during the day, a siesta? Does that mess up your nighttime sleep?

So I'm a big fan of the nap. Especially while watching golf, right?

Oh yeah, you can sleep during that.

Rory gets to the tee box, you know, it's like it's all really quiet. And if you fall asleep, you can just catch up on ESPN like that, so it's pretty easy.

You didn't miss anything, right?

But insomniacs should never nap, because what happens is when you nap, you lower that sleep drive, that adenosine we were talking about, makes it much more difficult to sleep.

But naps can be a good thing.

Absolutely. I love a nap.

At 20 minutes, what's the ideal time?

20, 25 minutes is really where I like to see people, because if you nap too long, what ends up happening is you pop over into a deep sleep Man, it's tough to get yourself out of deep sleep. Wow.

Yeah. What is the one or two questions that most people are asking about sleep today?

Well, we went through the whole idea of what do I do to wake up, like waking up in the middle of the night. Um, I think that's really a big one. We talked a little bit about, you know, what are the sleep disorders and undiagnosed sleep apnea. So I think that those are, are kind of some of the big, big, big ones. And I think we were able to cover that. But you know, a lot of people, it's unfortunate because a lot of people don't see a sleep doctor unless they're in their office, right? And they've already been diagnosed with something. They don't really able to get their questions answered. And so what I like to do is I like to give out as much, you know, evidence-based information about what's going on in sleep and how you can use this to your advantage. I'm a very practical guy. Like, I'm not a big theory person. I'm pretty prescriptive. I'm good about telling people exactly what to do. Yeah. So I'd like to, if I can, give people a 5-step plan.

Let's do it.

Right? That they can roll through every single day, which can help them with sleep. So step number 1 is to have one wake-up time 7 days a week.

Same wake-up time.

Same wake-up time. Let me explain why. When you wake up in the morning, sunlight hits your eye and you have a special cell in your eye called a melanopsin cell, right? This cell turns off the melatonin faucet in your head. Okay? And, um, by the way, it sets a timer for approximately 14 hours later. Okay? When your melatonin turns back on. So what I just said was the time that you wake up directly determines when melatonin turns on at night. So if you're waking up at 6, melatonin's gonna turn on about 8, takes 90 minutes for it to get up and in. You start to get tired around 9:30, you go to bed at 10, 10:30, right? But if you wake up at 8, melatonin doesn't start until 10. Mm. And now you've got a different problem on your hands. One, wake up time. If people only get one thing from what I'm talking about today, really do that one.

Not, not the same sleep time.

You will automatically metric yourself, right? If you know you're getting up at 6 on Saturday, you ain't staying up until 1. I can assure you, you'll do it once, maybe twice, and then you'll be done with that one. All right. Step number 2 is to stop caffeine by 2 PM. We really haven't had a chance to talk about caffeine. Caffeine has a half-life of between 6 and 8 hours. Okay. If you stop at 2, 8 hours later is 10, which is roughly when most people are thinking about going to bed, and at least half of the caffeine is out of your system. A lot of people don't realize that they— oh, I can fall asleep, I can drink a cup of coffee for, you know, at dinner and fall right asleep. It's because you're so damn sleep deprived that you're falling asleep, okay? But if I put electrodes on your head and I look at the quality of the sleep you're getting, you're not getting deep sleep if you've got caffeine on board.

I mean, a lot of cultures will have a cappuccino or an espresso after dessert.

I get it.

At dinner time.

I get it.

And they're falling asleep.

It's problematic. Really, it is. Go decaf. It's not going to kill you. You still taste it and you'll be fine. Trust me on this one.

Yeah. Okay.

Number 3 has to do with alcohol. There's a really big difference between going to sleep and passing out, right? Okay. Yeah.

Yeah.

Right. Like we've all been there.

Being unconscious and being unconscious. Right.

Exactly. Right. There's, and because alcohol basically anesthetizes you. Wow. Right. And so I, by the way, I like bourbon. Okay. I like, I have a beer every once in a while. I'm not saying you can't. Drink, right? But what I am saying is you need to be thoughtful about when you drink. So here's the schedule. Let's say you're sitting down for dinner at 6:30, right? Have your first glass of wine, then have a glass of water. You want to always go one for one because you want to be flushing the system out, you know, pretty quickly. Takes the average human approximately 1 hour to digest one alcoholic beverage. Wow. Now you order your second glass of wine. Maybe you finish it, maybe you don't. Then you have your second glass of water. Stop And then 3 hours later, if that's your chronotypical bedtime, you are on the go. It's perfect.

Wow. Wow.

Right? So to limit yourself to 2 drinks, but step number 3 is to stop alcohol 3 hours before bed. Wow.

But there is, there's no nutritional value to having alcohol.

Absolutely none. Here's the crazy thing.

It doesn't help your brain, it doesn't help your sleep, it doesn't help your gut.

Nothing. It does nothing. Okay. During dry January, all of my patients call me up and they're like, Michael, my sleep is so much better. I'm like, No shit. Stop drinking alcohol, right? Exactly. You stop drinking alcohol. Step number 4 has to do with exercise. I know you're a fan of exercise, as am I. I work out every single day. I was in the gym this morning. But if you exercise too close to bedtime, it increases your core body temperature, right? And that makes it hard to sleep. So stop exercise 4 hours before bed.

Stop before—

not—

what about like a brisk walk or even just a slow walk?

Walking after dinner's fine. Zone 2 is Fonka. Okay, but you don't want— you just don't want to break a sweat because that increases your core body temperature. And in fact, walking after dinner has actually been shown in studies to help with digestion, so it's probably a really good idea to do that.

What about like, um, a hot bath, a sauna? Let's talk about hot tub, like things that activate that way.

So thermoregulation is what you're talking about, or the body's ability to change temperatures, and how does that affect It turns out it's very, very important. And here's the one thing that you can control as a consumer. You don't need a drug, you don't need a therapy. You can actually control the temperature. Couple of different ways to do it. With our insomniacs, sometimes 90 minutes before bed, we do have them take a hot bath because what we do is we mimic that core body temperature drop that I was talking about earlier by raising it, by raising it. You can do the same with the sauna, right? Mm-hmm. Sauna, hot bath. 90 minutes to 120 minutes before bed is okay. Absolutely a good idea.

Really?

Absolutely a good—

it's going to help you drop your temperature.

Correct. Now let's talk for half a second about what happens under the covers, right? So here's what's interesting is people always say, well, Michael, I've just— I'm gonna, you know, crank the, the AC on and go to 65 degrees or 68 degrees. The data would say somewhere between 65 and 72 turns out to be about where you want to be. But here's the thing, This unit that we're walking around in for a while runs at 98.6 degrees.

It's a heater.

It is. And when you're under the covers, guess what happens? You create your own little mini sauna, right? You really do, because the heat just bounces off the sheets and comes back and the mattress and what have you. So they now have out there these things called thermoregulatory pads. So it's a topper that you put underneath the sheet that you're lying on top of, has a thin tube that runs through it, and you can run hot water or cold water through it and you can actually cool yourself from beneath. I work with a company called Orion Sleep, and they've developed this technology. And here's the thing, it's great for menopausal women, it's great if you are— if you happen to work out in the evening time, you know, and your core body temperature is, is high, or if you're like me, my body just runs hot.

Me too.

It always has. I don't know why it does, but that's just genetically who I am. So these, these devices like this Orion work really, really well. Really. Step number 5, is for the morning time. And so when you wake up in the morning, there's 3 things I ask people to do. Take a hardback chair, sit outside if it's not too cold out, right? And what I want you to do is I want you to take 15 deep breaths. This is merely to bring yourself present and, and activate your, your lungs and your respiratory system. In between each breath, I want you to drink 1 ounce of water. Most people don't know it, but sleep in and of itself is a dehydrative event. You lose almost a full liter of water every single night. Right. And so we want to replenish that. You want to hydrate before you caffeinate. That's really, really important. And then the other thing you want to do is get 15 minutes of sunshine. Now, people are going to be like, oh, California doctor, he's getting all woo woo on the sunshine on us. The data is incredibly consistent. Number one, the sunshine activates that melanopsin cell I was talking about, turns off the melatonin. So your morning brain fog goes away. 15 minutes is the exact amount of time that it takes your body, generally speaking, to produce vitamin D. Vitamin D is a circadian pacemaker, right? So that's kind of where we want people to be. Now, speaking of vitamin D, people also always ask me all the time— I think another thing that we didn't get to hit on— supplements. Tell me, right? So people are always like, Michael, Michael, should I take melatonin? Absolutely not. Really? There's only 3 instances where I think melatonin is appropriate: jet lag, shift work, and if you have a melatonin deficiency. Okay, melatonin, first of all, is a hormone. Okay, you can't just walk down to the local CVS and buy testosterone, right, and estrogen, and there's a good reason. Hormones affect every system in the body, right? Here's the problem with melatonin that a lot of people don't know. Did you know that melatonin affects birth control?

Really?

Did you know it affects all antidepressant medication, all diabetes medication, and all heart rate medication? It's a circadian pacemaker. It affects your circadian rhythm. This is not something to play around with. And by the way, never use melatonin with kids. Never, ever, ever. There's one group of kids, kids on the autism spectrum, where we have discovered that about 5 or 6 milligrams turns out to be good for them. But by the way, that's kind of a whopping dose. Average dose should be between a half and 1.5 milligrams. Wow. Now here's what I think about supplementation, generally speaking. Go do blood work. Okay? If, if you're supplementing, it's because you're not getting something in your diet and it's a vitamin or a mineral. Like, to be clear, nobody has a deficiency in ashwagandha.

Okay?

Mm-hmm. But you might have one in vitamin D or magnesium or iron or, or melatonin. And those are the 4 that I always have people do blood work on. And let's fix that first. Bring those up to par levels in your body and let's see how your body functions, dude. I would say 10% of the patients that I see, when I just get them to do that, their problem is solved.

They feel better.

Yeah.

I keep coming back to this idea of ruminating, thinking about stress, worry, whether it's big T, little t traumas, uncertainties on what keeps us waking up or staying up and not able to sleep.

And, you know, one of the things we didn't really touch on that I think it falls into this category— nightmares.

Oh, yeah, for sure.

Right.

Nightmares.

Yeah. So one of the things I've been spending the last year and a half working on becoming what's called a dream therapist. I want to be clear, this is not dream interpretation, okay? This is actually using the dream in the therapeutic context. So what I'm talking about are people with PTSD, right? And one of the hallmark signs of PTSD from any kind of trauma, whether you're a first responder, you've had a terrible sexual trauma, you know, military, right? I mean, How many people are committing suicide that are coming back from our— like, I don't take it for granted when somebody puts their self in harm's way for my freedom, right? I want to be able to figure out how we can help these people. And they're all coming back with these terrible, terrible nightmares, and they don't want to go to sleep because they don't want to watch the movies that are playing in their head. No, right? This is where PTSD becomes a really big issue. And dreams are an area of study for me. I haven't quite cracked the code on it yet, I'm going to be honest with you. But what I have discovered is that there's couple of different techniques that can be used to help people move the dream forward. What dreaming turns out to be is what I call emotional metabolism, right? And so you dream for whatever was going on in your day, right? So if you had a joyous day, your daughter's turned 5 months, you're having a party, having a good time, you might have a little bit more REM sleep and you might dream a little bit more. Or the same could hold true if, God forbid, something bad happened in your life. So dreams are a great way to understand emotionally where you are. People also oftentimes have these things called repetitive dreams or stress dreams. I have my own. It's kind of funny. I'm in high school and the bell has rung and I'm running to my locker and it's one of those spin combination lockers. I got to get my books out for the next class and I can't remember the combination.

Really?

Yeah.

You have that dream on repeat?

I do. And if I have that, that's a signal to me that there's something else going on in my life, right? I don't know exactly what it is yet. It still may be filtering around in my unconscious, but it's something to be thoughtful of. A lot of people don't know the purpose of REM sleep. REM sleep is where you move information from your short-term memory to your long-term memory, right? And you create this kind of organizational substructure, like a filing cabinet in your head, but you can retrieve things. But if you can't get it there because you're waking up because you're scared due to a nightmare, it never hits the filing cabinet, and you're just kind of stuck on this repeat and repeat and repeat. So the goal here is to try to get people through that, and there's some different therapeutic techniques that can be done for that. Really? Oh yeah, it's pretty cool.

What about sleep hypnosis?

So sleep hypnosis, generally speaking, is to help people fall asleep if they're having some level of anxiety prior to sleep. Um, and so there's a lot of different things you can do. Me personally, I like breathing techniques there. I think because it's very hard to self-hypnotize. I mean, there are different platforms and there are things that you can look at or listen to that can be helpful. But generally speaking, I think the breathing techniques, the 4-7-8 that we were talking about earlier, I think that has a real, you know, use case right there.

Where does the research lie within spirituality and sleep?

Oh, that's a great question.

Having, you know, faith in God or a bigger purpose or something else, if you've dealt with stress, rumination, anxiety, Sleep tremors, nightmares.

Yeah.

Is there research around faith in God to allow people to sleep better?

There's research around faith in general. I don't know everybody. There's a lot of people have a lot of different forms of what they call a higher power. But here's what I'll tell you is people who are thoughtful in that area oftentimes sleep better. And you can't be spiritual with a bad night's sleep, bro. It doesn't work when you're so exhausted that you can't either read the Bible or look at the Torah or the Koran or whatever it is, whatever your thing is, if you're too tired to be able to get those messages and to be able to have that purpose, it's problematic.

Yeah. But what I'm hearing you say is, is there research that if someone has faith in a higher purpose, they sleep better?

I would agree. Yes.

Yeah. Is there any, like, documentation of this out there? Is this more from your experience?

I would say that's more from my experience. But if I'm fair, I'll look it up and I'll let you know.

Yeah, I'd be curious about that. Yeah. People sleep better if they believe in God or a higher purpose, or if they don't believe in God, do they sleep worse?

I think for the people— this is a guess. I don't have any data on this, but if I had to use my years of experience to kind of figure it out, I think when you don't have a higher purpose, whatever that means for you, it's hard. It's rough.

Life is harder.

It is. Everything is harder. Right? Purpose. I mean, isn't that kind of what defines greatness, right, is purpose? Yeah, right. And so when you're— when you're— and don't get me wrong, people struggle with purpose all the time, and sometimes you don't always know your purpose, or your purpose can change over time. I think as long as you're in the pursuit of purpose, I think that's really where sleep plays a good role.

When you work with those patients that have sleep insomnia or that are dolphins for seasons, right? How many of those have a belief in God or a higher purpose versus don't?

You know, if I'm honest with you, it's not a question that I usually kind of run through with them. But if I was going to guesstimate, I would say that the people that are having the more difficult time might be the ones that don't have a well-defined purpose. Interesting.

That's interesting to know. Yeah. The ones that sleep the best, the ones that have followed your routines and the practices and the principles we've talked about, and they've gone from either bad sleep to now consistently good sleep over years. Right. What are the things they're thinking and doing differently? And do you feel like they've healed a certain past trauma?

Oh, it's an interesting question. I think that happens a lot. So, you know, here's the thing is when you've got a past trauma, when you get home and you get in bed and nobody's talking to you, and maybe the TV's not on or the bulldogs aren't in the bed, all the thoughts come in.

Yes.

Right. And that's hard because there's fear, there's elevation of heart rate, there's anxiety. So if I had to guess, I would say that if you've got all that stuff tucked in and, and dealt with, whether that's through therapy, whether that's through journaling, whether that's through, uh, you know, working with your pastor, who— whatever method that you use that's positive for you, I think that would actually promote good sleep. And I would say I could— I can easily say that looking at my patient population, I've seen that over time.

Really?

Yeah.

How much does I— how much does self-identity impact the way we sleep?

What do you mean by self-identity?

Like, if I identify myself as a bad person, as stupid, as ugly, as not good, as I'm I'm never going to amount to anything in my life versus I'm confident, I'm courageous.

I, I— here's what I'll tell you is the more sleep deprived you are, the more likely you are to have a negative self-image.

Interesting.

There's a lot of data on that.

That is interesting.

The more sleep deprived you are, the more likely you are that the tapes in your head are negative.

Yeah.

The better sleep you get, the more likely it is the tapes in your head are positive.

So what I'm hearing you say so far in this conversation is that when you learn to manage or navigate your mind in an empowering way, yep, and use tools, helpful tools that support you in calming your mind, creating a more empowering self-identity versus a negative self-identity, with discipline and following a couple of those rules we talked about. Like what? Well, I mean, you cannot have a caffeine in the middle of the night, right?

Exactly. Like, you can't do that. You can't have bedtimes all over the place. But if you've that, the things that you're talking about with the discipline, dude, that's a winning combination.

Interesting. So, and it also sounds like you can do all the things right. You can do these 5 steps. You can wake up at the same time every day. You can stop caffeine at 2 PM. You can—

yeah, but if you think you're a pile of you know what, you're not going to sleep well.

None of those— that you could have the darkest room at 62 degrees and the perfect conditions. But if you're thinking, ruminating that I'm a piece crap.

Yep, you won't sleep, more than likely not. What we're talking about here is a little bit into the data on depression and sleep, right? So if you get to that point where those negative tapes have really started to affect you and you become depressed, what happens to your sleep? Yes, pretty interesting. So we act— it seems to bifurcate, and we seem to be two different camps on this. Is one is people have a tendency to not sleep, and then the other is people have a tendency to oversleep, right? So people who, they're so depressed they don't want to be in in the world, right? They want to stay in bed for 9, 10 hours. When somebody comes to me and says, oh, Dr. Bruce, I need 10 hours of sleep a night, big red flag pops for me, right? Unless they're an athlete and they're doing something crazy like that. I, I ask about narcolepsy, and I ask about depression or undiagnosed sleep disorder like apnea. And by the way, undiagnosed sleep disorder can lead to those negative thoughts, which then compounds it. Like, it's such a compelling reason. Like, if you want to have a positive attitude and a positive life, get a sleep study. Like, it's not that hard. Yeah.

What about narcissism? You know, there's a lot of people— there's a lot of information going around that more and more people are becoming narcissistic or having narcissistic tendencies or narcissism.

Yep.

Do narcissists sleep better than those who don't have narcissistic tendencies?

I'm not familiar with the data in that area, but if I was going to like put on my clinical hat and talk about it. If you're a true narcissist, you think you're fantastic, right? And so you're probably— you probably think you're full of purpose. The rest of the world might hate you, but you probably think you're full of purpose. But if you really are, I don't like— you start to identify and you say, wow, I'm kind of a narcissistic ass. Like, I'm kind of not like the nicest person. I think you trail down into slippery. Interesting for sure. Wow.

Now there's a lot of kind of sleep hack trends out there right now.

Yep.

Mouth tape being one of them.

So stupid.

What? No, as a sleep doctor, yes. Does mouth tape work, or why do you think it's stupid?

So here's the thing, there's actually data on this. There was a meta-analysis that was released last year looking at 20 different studies. People have died using mouth tape. Come on, dude. I mean, it's the data. I, I'll send you the study. Wow. Right. And here's the thing, because people are not seeing if they have undiagnosed sleep apnea. If you've got undiagnosed sleep apnea and you tape your mouth shut, it's not a good—

Yeah, you got a stuffy nose and you can't breathe.

And by the way, that's the reason why people use mouth tape or they're mouth breathers, because they've got nasal congestion. Fix your nose. Fix your nose. It's very simple. I think mouth tape kind of falls under the mom test, which is call your mom up and say, hey, Mom, I'm thinking about taping my mouth shut while I sleep. And see what her reaction is. She might say, I'd love it if you did it during the day. Yeah, but it really sounds like a stupid idea at night. It is a stupid idea. Wow.

Okay, so when— before the data came out about this, you know, and it started being big maybe 4 or 5 years ago, the mouth taping, as a sleep doctor, did you think, oh, maybe this is a— you know, I guess if you have your mouth open the whole time and you're not like—

I never thought it was a good idea.

Really?

Biologically, it doesn't make sense. I— 90-something percent of people, their mouth will naturally close while they sleep. The question becomes, why is there a group of people out there that this isn't occurring? It's the nose.

Really?

Look, it's all about nasal congestion. By the way, it's not that hard to fix your nasal congestion. You can use a saline spray. There's that device, I think it's called the Navage or something like that, that rolls, you know, you know, hot water through there, right? You can use Flonase, you know, which is, uh, over-the-counter now. They can squirt up your nose and be able to to reduce that tissue. Like, here's the thing, when you're taking in air through the mouth, right, it's like leaded gas going into the tank, right? There's no cilia, there's no filter, there's nothing that's pulling those particulates out. So I get it why we want our mouth closed, and I understand that there are people out there who are like, look, it's the only way it's going to work for me. I don't think so. Go call an ENT, have your nose looked at, and let's figure out what's going on.

Interesting. Why is it important for us to sleep Uh, why is it important for us to breathe through the nose when we sleep and not through the mouth?

Again, you're not getting good air, right? The air that you're getting when you breathe through the mouth, when you breathe through the mouth, because it's— there's no— all the particulates are going straight into your lungs, right? The, the purpose of the nose, like, you've got two nostrils, you've got one mouth. Noses are for breathing, mouths are for eating. Like, that's really how it was, uh, you know, however the big guy upstairs, you know, planned it all out. That's pretty much—

we should be— how much should we be breathing through our nose throughout the day and night versus through the mouth? Because when you're— when you're speaking, you're going to breathe through the mouth.

Absolutely. So in my, uh, fifth book, it was called Sleep, Drink, Breathe: Wellness Is Too Complicated. These are some of the most important habits. We've talked a lot about sleep, but let's talk about breathing. And then of course, hydration is the other one. People always say, like, why did you write a book about things your body naturally does? It's like, well, because our body is— we're kind of putting hurdles in front of ourselves to do some of this stuff. And so what we need to think about here is getting clean air in, humidified clean air in, actually is better for oxygen exchange, right? Most people are shallow breathers, right? They're not— right? And so what ends up happening is when you're a shallow breather, your heart has to beat twice as fast in order to distribute oxygen in an effective manner, right? So this 4-7-8 breathing Right? It's perfect cuz you slowly breathe in, you hold and use all your oxygen, create your carbon dioxide, and then you push it all out. Your heart is more efficient, which lowers the load on your heart, right? We don't need our hearts beating any faster than they need to be beating. We need efficient hearts. And, and breathing in through your nose is one of the best ways to do that.

Gotcha. So how often, or how much of the time should we be breathing through our nose?

While we're sleeping?

Throughout the day and night.

All the time.

The night, the whole night.

Well, I mean, generally speaking, 90%. Yeah, something like that would make sense to me. Sure.

I guess if you're speaking part-time and you're breathing throughout your mouth, it's different.

Yeah. I mean, look, I'm a public speaker. You're a public speaker. Like when I'm on stage, what's happening? I'm— I actually pace myself. Like, I actually know when my breathing is off when I'm on stage because I'm, I'm, I'm out of air at the end of a sentence. Right. You know, and when you're on— I mean, like, I mean, I speak in front of— you do too, like big crowds. Like, you know, one time I was on stage for Tony Robbins, 12,000 people in the audience, right? And you know, your heart starts beating fast 'cause it's exciting and it's a lot of fun. You gotta chill yourself out. I do 4-7-8 breathing before I go on stage. Chills me right out. Not 20 cycles 'cause I don't wanna fall asleep, right? I do about 5, 6 cycles, chills me out. And now my body is being efficient. Then I don't have to worry about my body. My brain can do what it needs to do to educate.

So I've heard you say mouth taping is stupid. It is. And what about kind of the nose strips the opening the airways.

Yeah, yeah, yeah. Let's talk about those. And so I like those, right? So anything you can do to open up the pipe is going to be a good idea. I will be honest with you, for me personally, whenever I've tried those nose strips— I have slightly oily skin— they have a tendency to migrate, and also it's like across my eye, and I'm like waking up like, you know, what's going on? They now make internal nasal dilators, right? These, these little, like, almost like a little stent that you put right here inside your nose. I use one called a Mute, and it's like, turn the mute button on. My wife always says, like, if you had any whiskey tonight, put in that nose thingy, because here's what happens. Alcohol causes inflammation inside your nose. Congestion.

Yeah.

Why do you think people snore when they, when they drink alcohol? This is the reason, right? So internal nasal dilators, I think. Well, don't get me wrong, there's nothing wrong with the strips. I just personally, they just don't work great for me.

Sure. So what I'm hearing you say is don't fix your mouth, fix your nose.

Yes. Can't breathe. Absolutely.

Try to expand the nose, try to find ways to enhance it, reduce inflammation. Yeah.

Before shutting your mouth with a piece of tape.

With a piece of tape.

Yeah.

Your mouth should close.

It should naturally get there for you.

Keep your mouth shut.

Right.

But not like trap your mouth.

Exactly. Exactly. Now, we've talked about, you know, one of the things we haven't touched on is noise at night. Snoring. Right. It's a big one.

Yeah.

So a lot of people are thinking about like noise at night and what's going on here. Like, we want people to snore. By the way, if you sleep next to a snoring bed partner, you lose approximately 1 hour of sleep a night.

Do you say we want people to snore?

No, snoring is bad. Yeah, right. Snoring means that there's some kind of disruption in your airway. Snoring is like on the way to apnea.

Now, to be clear, snoring related to the nose or the throat?

Great question. So you can have snoring in 3 different places. There's a nasopharynx, an oropharynx, or a hypopharynx. And so anywhere— so let me back up. You ever been in the garden and you stick your thumb over the end of the hose and the water squirts out faster?

Yes.

Right. Your nose is the hose in this analogy. So air is coming in anywhere that you close the aperture, like putting your thumb on here makes the air move faster, causes a vibration, causes a cadence, causes a snore. So anything we can do to open up the pipe works better. So that's why that mute thing works really, really well. Sometimes there are oral appliances where you can slowly move the jaw forward open up the oropharynx, or there are surgical interventions for the hypopharynx.

Yeah, surgery is probably the last thing you want to do.

Absolutely. Last, last, last case scenario.

Yes.

Yeah. But noise in general is kind of interesting. They're now making earbuds that— made to sleep in, like, so they don't hurt the auricular canal. Um, and there's one on the market, it's called NexSense, which is really cool. And what they do is they measure your EEG, they measure your brain waves, because it's so close to the brain, they figured out a way to do it. Don't ask don't ask me how because I haven't figured it out, but, uh, it's pretty cool. And then they know when you're moving into a lighter stage of sleep, they can send in a frequency to help you move back to a deep—

that's crazy, dude.

The tech is cool.

So how important is it to keep things quiet when you sleep then?

I mean, dude, I sleep with the television on all night long. You can adapt to almost anything.

Does it disrupt your sleep?

It does, absolutely. So that's why I have those NextSense things.

You put them in—

yeah, I got my CPAP on, I got my NextSense in, I'm golden.

Do you sleep alone or do you sleep—

No, my wife's there and the two French Bulldogs are right next to us.

So is she losing an hour of sleep because of the noise and the dogs? And this is such a good question of the machine.

I have tried to convince her that she is, but here's what's interesting. There's actually data to show that, um, people feel safer with animals in the room, and she grew up with animals in her bed in the room. Now, you know, when we first met, she She told me, Michael, if we ever have a sleepover, right, I need to let you know that I sleep with the TV on. And she said this, she said this to me. And I said, you know, hey, honey, I'm becoming a sleep doctor. I'm going to fix that. Right.

I don't know, was this like 30 years ago or something?

Yeah, we've been married for 26 years. So you ever try to fix something in your bed partner? Doesn't go particularly well, right? Ever.

So you've always slept with the TV on since you've been with her?

Absolutely. So I studied her to understand why. Because if you live in my house, the sleep doctor is going to take a look at you, right? And here's what I discovered is she's not watching TV. She's listening to it kind of out of what I call the corner of her ear. It's a distraction technique for her from monkey mind. So you know what I do? I set the timer, right? So the timer goes off 90 minutes later, she falls asleep half the time. She never wakes up again. And, and the TV's off all night long. The only thing I hear is the bulldogs. Now the bulldogs are an interesting story. So we used to have an older bulldog and, um, my wife went to back east to visit her family and I was taking in charge of the dogs. We had a younger one and an older one. And with the older one, she turned to me and she said— his name was Hugo— she said— he passed away now— she said, "If Hugo is not snoring, it's a problem," right? So it changed the emotional valence of the sound to me.

So it created a sense when she heard snoring, she felt emotionally safe and allowed her to sleep better.

Exactly.

Even though snoring, based on the data, correct, makes you lose an hour of sleep a night in the partner.

This is the difference between a sleep expert and a sleep doctor.

Interesting, right?

There's data and then there's practicality. Yeah, right. People can sleep through almost anything depending upon what's going on. If you, if you understand the emotion that's attached to whatever the sound is, it makes a lot more sense and you can really do pretty well with it.

It's the, it's the way we interpret the emotions of everything in our life. Exactly. Which allows you to either sleep better in horrible conditions.

Correct.

Or bad in perfect conditions, right?

Talk to somebody in the military, right? They can rack out anywhere— on the middle of a B-52, in a tank, in a submarine. It doesn't matter how loud it is down there or any of those places for those guys. Why? Because they know they're safe.

Well, somewhat safe. I mean, it's like, yeah, and you have to sleep also at some point. You can't just be up 5 nights, you know?

Correct. Your body will exactly crash out.

Now what about kids? Because there's a lot of different parents online that say— that swear by sleeping with your kids. And other ones are like, this is the worst thing you could ever do. Put them in the crib in a separate room and you never see them. Let them, like, sleep on their own.

Yep.

As a sleep doctor, not a sleep expert, right? What would you recommend? Should parents— or what are the benefits, the pros and cons of sleeping with kids in the same bed versus not sleeping with your kids?

Depends on the child and depends on the age of the child. Right? If you have a special needs child that has got something else going on, you probably want them close by. Okay, let's just be fair, right? If you've got a child who's got RSV, who's got major medical situations going on, who's got autism— you know, God forbid any of these things happen to a child— you're going to feel better, you're going to not worry nearly as much if the child is in the room with you. Now, there's a difference between being in the room with you and being in the bed with you. Right? And so children in the bed can be highly problematic, especially if there's alcohol involved or if you have big fluffy pillows and covers, right? When babies are born, when you go home tonight and you look at your daughters, they do not have protruding noses. Their noses are actually pretty flat because their noses haven't had a chance to grow yet. So if they go over on their face, whoosh, they can suffocate, right? What you want for the first 3 to 4 months, we had what's called the Moses basket. So it was in between my wife and I. We put my son in there, and if she was— if he woke up and was hungry, she'd scoop him up, she'd put him on, she'd take him off, she'd put him back, you know, in, in the basket, and everything was fine. Over the course of time, maybe 4 to 6 months, we started rotating him— the bassinet in there, rotating him out— finally got him into his own room. I would argue that you really want to get your kids figuring out how to fall asleep on their own.

Why?

Because they— it's a skill that they need to learn. Okay, if you put a child down every single time and they're out cold, here's what happens is there's, there's this idea called object permanence, right? And so it doesn't really kick into gear until like year like 1 or 2. And so here's what happens is when the baby goes to sleep and you go away, they think you're gone forever. But if you put the child down while they're awake and they see you, and then you start moving out and they know that they're okay and safe, maybe you've got a monitor so you can talk to them, maybe sing them a song, read them a poem, Bible verse, whatever, whatever your thing is, you know, say your prayers, whatever, that actually has a tendency to work a lot better. Now, the age of the child also becomes a big determining factor. I mean, I had one patient who turned to me and she said, you know, she had her 7 or 8-year-old son sleeping in bed with her. And I hate to say it this way, but the moms are like, it's so cute and it's so cuddly and I'm going to miss it. What happens when the young boy starts to have erections when he wakes up in the morning and he's sitting next to mom? Them. That's pretty inappropriate, right? So you need to be thoughtful about the biology that's going on, but I would say generally speaking, it's probably a good idea to get them out. Now, to be fair, there's some cultures where the family bed is where everybody sleeps. I think that's a whole different ball game. But here in the United States, I would say generally you really want your child to have their own room, their own bed, and put them down awake.

Now, what about— I mean, what happened, I don't know, thousands of years ago?

It was pretty different thousands of years ago, but generally speaking, everybody lived in the cave, you know, and, and they sat around the fire and that's how they did it. As we've gotten bigger and bigger, things change a whole lot. I would argue that sleep really changed when that idiot Thomas Edison invented that thing called the light bulb. I think that screwed up everybody's sleep pretty bad because it used to be when we were an agrarian society, right, we'd go to bed when the sun went down. Right? Then we'd wake up halfway through the night, have a meal, have sex, have whatever, then go back for the second sleep. Really? Yeah, this is well documented.

We used to wake up in the middle of the night and have meals?

Why? Yeah, you were hungry. Ah, right. And then you'd wake up at dawn and then plow the fields and do that. When old, you know, Tom came around and everybody could have light at night, everything started to change. I don't know this as a fact, but my guess is we probably didn't have insomnia before light bulb.

Yeah, I'm sure people went to bed. Yeah. Like maybe within an hour or two after it got dark.

Exactly.

Start to wind things down and—

Exactly. Yeah.

Got a little lamp on maybe, or—

Yeah, you know, right? Abraham Lincoln supposedly, you know, wrote with— by candlelight. So I think that society has evolved from back those days to where we are now. But I'm gonna be honest with you, I think some of the evolution is not going in the right direction. I mean, the phones before bed, you know, and by the way, It's not the blue light that's keeping you up. It's this. If you're trying to get your heart rate on Candy Crush, you ain't trying to go to bed.

Okay.

Like, trust me on this one.

Oh, man. So, yeah. Do you think— I mean, people probably had a lot less depression or insomnia, you know, hundreds of years ago.

I would guess so. Yeah. Or at least it wasn't recognized. Yeah.

Now let's talk about phones.

Yes.

Since you brought it up. Sure. That's also something we didn't have 20 years ago.

Thankfully.

You know, I just saw this video online yesterday. Who's the guy who wrote The Anxious Generation? Jonathan—

Yeah, yeah, yeah.

Jonathan something, something.

Yeah, exactly. Great book, by the way.

Yeah, yeah.

He really talks a lot about anxiety and what's going on.

He had a video. It's kind of funny because it was on the phone, but in class about not having phones. But he had a video go out on social media of like an AI video from back in the '90s of like kids when they were 8, 9, 10 in the '90s reenacting. They're like, wait, so you, you had a a box that would like call people. You didn't just like go to your home phone and like pick it up and make a call.

Yeah.

Wait, you, you didn't stay out till like the lights went on, you know, and then come back home.

Right.

Well, you're just on a phone all day. Like, yeah.

I mean, when I was growing up, you know, here's how it worked. You were, you got home from school, you played out, you went outside, you played all day, and then your mom yelled from the porch. Dinner, dinner time, dinner time. And if, and if your mom— if you didn't hear your mom, you know what you did? You just went with your friends to their house and had dinner at their house because everybody's mom was having dinner at a particular time. And you know, then you'd get in the house and the mom would call your mom and say, hey, you know, Lewis Howes is over here, right? We got him for dinner tonight, you take him, you know, my son tomorrow night. Now it was just kind of how it worked, was it? Yeah, very different.

And with phones if someone is on their phone first thing in the morning and last thing at night, it's not good. It's not easy to sleep, probably.

Yeah, well, I mean, it's just so much stimulation. Like, here's the thing is you can, you can do all the things we've been talking about today. You can follow all the 5 steps, you can figure out your chronotype, but if, if you're causing a significant level of autonomic, of brain arousal, you— it's really hard to overcome that, right? So if you're watching videos and all of a sudden, you know, something comes on about the con— a conflict or something comes on about, you know, an award show or something, you know, whatever it is, and it piques your interest, it dials up your cortisol, it dials up your heart rate, and now you really haven't done yourself any favors. Read a book, okay? Read one of your books, okay? Like, this isn't tough. Like, keep, you know, Greatness right by the bedside and read it. You'll be surprised at how you'll— number one, you'll retain the information, but number two, it really helps ease you in. You need runway to land the plane.

Yeah. Oh, man. This has been powerful. I want people to get your book, The Power of When: Discover Your Chronotype and Learn the Best Time to Eat Lunch, Ask for a Raise, Have Sex, Write a Novel, Take Your Meds, and More. This is really inspiring. So I want people to get this book. You have a lot of other books as well.

Yep.

They can check out your website, thesleepdoctor.com, The Sleep Doctor on social media as well.

Oh, and we actually created a special landing page for all of your viewers.

Okay.

What is it? So if people go to sleepdoctor.com/greatness.

Perfect. They can check it out.

Yeah, they can check out the book. They can take the quiz.

Quiz.

They can hear some of the products we were talking about. Whole thing.

And there's a home sleep apnea test as well, right?

Yeah. And so that's one of the things that our company does. And again, I was trying to tell people, don't be afraid of the test. Let's figure it out. It's less than $200. Okay, it comes to your door. You don't have to go see a doctor and then a doctor interprets it. It's all done online. It makes life much, much easier.

That's cool. Uh, Michael, I got a couple final questions for you.

Sure.

Um, before I ask them, is there anything else that you're seeing online that could be harmful for people to start believing is good around sleep or sleep practices that is actually potentially harmful?

Well, I'm going to be honest with you, even though I do have my own TikTok channel where I'm trying to give people don't get your information from social media about sleep. You know, like, for a while there was this thing going around called the Sleepy Girl Mocktail, right, where you would have 2 scoops of magnesium, uh, fizzy water, cran— uh, tart cherry juice. And again, the practicality of this is like, you shouldn't be drinking large volumes of water before bed because you're going to have to get up and pee. By the way, too much magnesium and it's going to give you gas. And make you go to the bathroom. And then that fizzy water is also gonna give you gas. So like really, if you're gonna get your sleep information, get it from somebody who's well-versed, who has an educational background that's gonna be important for you to understand. Like vet your sources. 'Cause nowadays anybody can seem to be talking about stuff and they really don't know what they're talking about.

Yeah. Or get it from Michael's book, The Power of When, or one of your other books as well. Um, this question is called the Three Truths. So you shared a lot of advice today. You have tons of great books, you have a lot of great content.

Thanks.

But let's, uh, create a scenario far in the future. You get to live as long as you want on this Earth, but then it's eventually the last day on Earth for you.

Okay.

And you get to create and accomplish everything you want and experience all of life's magic, and you see your kids grow up and all the great things happen, but it's your last day on Earth.

Okay.

Far in the future.

Okay.

And for whatever reason, we don't have access to any of your content anymore. So this episode is gone. Your books are gone. Nothing is around anymore. Hypothetical.

Okay.

But you get to leave behind 3 truths, 3 things that you know to be true from all of your experiences that you would share as lessons to the world. And we would get to keep those. What would those truths be for you?

I think the first one that comes to mind is sleep matters. It's important. People take it for granted all the time. Oh, I'll sleep when I'm dead. I can't count the number of times people have said something like that to me. Okay, sleep matters. It's important. It's something you need to be thoughtful about. And, and if you're not thinking about it, that's okay, but do yourself the favor, take a few minutes and, and think about your sleep, because I think sleep matters. Um, number 2, be present. Right? Be a present husband, be a present father, be a present employer. Be there. Be able to help people in whatever way, shape, or form that you can. And by the way, you can't do that without good sleep, right? I think those two are the two that definitely hit me, hit me kind of hard. I think the final one is probably be open, right? Be open to other people. Be resilient. You know, listen to what other people have to say. They— everybody's got some good ideas, right? Be open to the new ideas and see if you can, you know, make them part of your life.

That's beautiful. I want to acknowledge you, Dr. Michael Breus, for being a leader in this space, because I think, I think for me, sleep definitely has given me a better life when I'm consistently sleeping well.

Right.

And you feel it specifically having, you know, twins now. I can feel, feel it when I don't sleep well. My wife can feel it when she doesn't sleep well. And it impacts everything you do that day or for potentially days. Oh, you don't get a good night's sleep. And so I want to acknowledge you for being a leading voice and researching these things and constantly learning about what is going to support your quality of sleep, what's not going to support your quality of sleep. And I think also reminding people that you don't need medication, that to sleep better. I think I get really worried when doctors come on and they prescribe medication first rather than— no, that should be the last result.

Last result.

Do all these other things. Heal, create peace, learn breathing, meditate, you know, find purpose, all these other things, you know, mend your relationships, all these things that cause stress, anxiety, and worry first. And then, okay, last resort, have some pill that maybe can help you next.

And maybe it's just temporary.

Temporary, yes, right?

Pills are really good on the temporary when we're talking about sleep, not on the regular.

Exactly. So I want to acknowledge you for all the work you're doing.

Thank you.

And the final question I have is, what's your definition of greatness?

My definition of greatness, I think, I think it's about being present. I really do. I'm going to go back to that one. It's about being able to be in the moment. You know, I saw a great interview with Michael Jordan. And one of the things he said is he said the second his foot touched the court, he was present. He was there. Don't be someplace else. Be here, because here is really the best place to be.

Absolutely. Thanks for coming.

Thanks, Patrick.

Thank you very much.

Appreciate it.

Powerful.

Your brain is designed to ask all the big why questions on the right and then to solve how-to and what questions on the left. And the reason people are depressed today is because they're avoiding the big right side questions. The whole culture of technology and hustle and grind, online—