What Your Chronotype Reveals About Your Hormones, Sleep, and Energy | Dr. Elisa Sacal

30:05And I will say the wearables now or even like your phone, you can set prompts. So my watch, I've set it so that it knows when I wake up and it's like this lovely little bell and it's like, you need to stop and you need to take some time to meditate. And I'm like, yes, I do. Thank you very much. But I think, you know, as a mom, I definitely need those cues, but also because we can jumpstart the day thinking, I've got it, like I have all this to do. And then at the end of the night, I think we sometimes get in bed and we just think like, okay, I'm in bed, like I should just fall asleep. But we need exactly what you're saying.

30:41Some of that parasympathetic system priming. I know. I've heard Matthew Walker, this sleep expert, said that you won't get to the table and wait there until you're hungry. You won't go to bed until you're sleepy. So we need to prepare ourselves to activate those hormones switch that we need to prepare for sleep. And you were saying, you were talking about how your melatonin rises at a certain time, but we know that there's different chronotypes. We know that certain neurodivergent people have delayed sleep phase syndrome where their melatonin doesn't get up until like 1 a.m. in the morning. So I'd like to talk a little bit about chronotypes because I think some people are going to hear the sleep stuff that we were just talking about and they're going to be like, sure, that sounds great, but that doesn't fit who I am.

31:34So can you first start by explaining what a chronotype is? Yeah, that's a great question. I love it because chronotypes are like our sleep personality. We have different blood types, different eye colors, and we have different chronotypes, which is the sleep propensity.

31:53It's like our internal clock timing, Our preference to wake up at some times and go to sleep at a different time. And traditionally, we have morning people that are the ones that you go to the gym and everyone, and they're talking to everyone and they are really energized at mornings. And then we have, by the way, 30 % of the people are morning larks. And then we have intermediate chronotype, which is 40 % of people comes here. And they just go by the sun. And then we have night owls, which have more energy at nights. They tend to be more creative at nights as well. And they probably will be fine sleeping around 11 or 12 at night.

32:43And this chronotype is really important for us to make our sleep schedule and to take advantage of that, to be energized in the morning, to set meetings by the time we know we're going to be better and more alert. It's determined genetically, specifically per 3 gene has that information, for example, and then hormone and age, because you said neurodivergent people might have delayed sleep phase and also teens. So it's pretty common for teens to go to sleep at 12, 1 or at least have that sleep drive at that hour and then wake up at 9 or 10. So they're not lazy. They just have a sleep delay phase.

33:38On the contrary, for kids, for example, that they have advanced delay phase and they tend to go to sleep at 6, 7, 8 and they tend to wake up at 7. That's why I see a lot of children and moms with children that tell me, couldn't I just take him to sleep at 10 and he'll wake up at 10 if they need to sleep 12 hours? Let's just move that. And no, because their circadian clock, their chronotype makes them sleep early and wake up early. So we need to align our circadian clock, our chronotype to our sleep schedule in order to have our best energy. eczema is unpredictable but you can flare less with ebglyss a once monthly treatment for moderate to severe eczema after an initial four month or longer dosing phase about four in ten people taking ebglyss achieved itch relief and clear or almost clear skin at 16 weeks and most of those people maintain skin that's still more clear at one year with monthly dosing ebglyss lebrikizumab lbkz a 250 milligram per two milliliter injection is a prescription medicine used to treat adults and children 12 years of age and older who weigh at least 88 pounds or 40 kilograms with moderate to severe eczema.

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35:19Real weak. Yeah, we're having this conversation right now. Last night, my son just said to me, he's like, all my friends at school think it's weird I go to bed at 8 because they all don't go to sleep until 10. And I was like, he's going to be 13 soon. Yeah. And he's like, they all think it's weird. And his kids in the class are like 11, 12. And I'm like, yeah, well, I bet not all of their parents are doctors who actually understand hormones and how significant sleep is on the brain. And I always tell him, like, if you eat food and you're full of poop, would you like, would you skip going to the bathroom and just be full of it?

35:54And he's like, no, I'm like, then why would you do that to your brain? Which we'll talk about today, guys, why I say weird things to my kids. It will make sense. And also, we've seen on research that schools that tend to start later. for teens, they tend to see better score grades. So it's really important to try to align our culture, our activities to that biological clock. Yeah. I think about that. I think about that research. And even the American Academy of Pediatrics is like, school should not be starting before 8 a.m. Like this should not be a thing. And in high school, I was in leadership classes.

36:30I don't know why. It got me nowhere in life. It was completely, someone tell my 15-year-old self It was dumb because I was getting up at like five something in the morning. And some nights I wasn't going to bed until like close to midnight. And it's, you know how people are always like, what would you say to like your younger self? I'm like sleep. I would have said sleep because I love it so much. And I really, I missed my opportunity there. Yeah. Whenever I was a medical student, I did the same. I was up all night to study for an exam that I actually needed sleep. Yeah. Because sleep is going to be better for us than any study that you want.

37:05Because for cognitive performance, the best you can do is sleep at least seven or eight hours a night. Totally. But this is the thing about medical school, right? In the first two years, we're not getting any sleep and we're staying up and we're doing all this studying. And then it's like after those two years where they start teaching you about memory consolidation. And then you're like, wait a minute. I needed to sleep to actually consolidate my memory. To actually have better cognitive performance. We didn't have creatine research back then. So 20 years ago, it wasn't downing creatine and doing all of that.

37:36But yeah, it's kind of the irony of medical school. I know. It's also like when you go through medical school, the way that they expect you to live is incongruent with what makes you healthy. They're like, we're going to set you up for the worst health outcome scenario. I know. Just see how you do. I know. I sometimes feel like medical school is setting you up to learn everything about illness and nothing about health. And building health, actually, because all those pillars of lifestyle will bring out the best of you. So, yeah, if you don't build your health on sleep as much as diet or exercise, you are building your health on zen.

38:20There's actually a research that I like, many researchers, that compare two groups, both of them with the same diet and exercise, but one of those groups, they limit their sleep time to five and a half hours of sleep, and then the other one let them sleep eight and a half hours. And by having the same exercise and diet routine, only because of this sleep difference, the group that have sleep deprivation compared to the group that had enough sleep, the ones that sleep good, that had enough sufficient sleep, they burned between 30 and 50 percent more fat. And they were able to build more muscle just because of sleep time, sleep hours.

39:15So it's really important. And we usually tend to not put enough attention. Yeah. And I think that's important in the metabolic conversation because especially as it applies to women, when we have stressors, which can be many things, but lack of sleep can be one of them, we will see our hormones shift towards survival. So we've got the HPA activation you talked about before, and then you've got, we're going to consolidate fat, right? I mean, I would argue body, like we should keep muscle, but the body's like, that's expensive. And fat is a great reserve. Like fat is going to give me more than that muscle is ever going to give me if like, you know, I'm in a famine.

39:55So I think it's really important for women to hear that because sometimes they're like, exactly what you just said. I'm exercising like the same, I'm eating the same, but I'm not building muscle and I'm building fat. What's going on? Examining your sleep. I want to bring it back to the chronotypes because I'm fascinated by this conversation. Let's help people right now. How can they know their chronotype? How can they identify it? Because most of us are living in an artificial sleep scenario that's imposed on us and it isn't true to what our nature is. So how can you identify what's your chronotype?

40:32Okay, well, it's pretty intuitive. If you think about yourself in vacation mode for a month or so, think what will be your sleep schedule? What are your tendency to go to sleep at, let's say, 9, 10, 11 p.m., and what will be your best wake-up time with no alarm? Other than that, we can go online and do the morningness, eveningness questioner, which is a questioner that will ask those questions are, at what time do you feel more alert or you want to go to sleep? And that will tell you your best sleep schedule and your chronotype. And also you can look at your parents. What are their preferred time for sleep?

41:18Because it's pretty genetically driven. And yeah, you were saying something about chronotypes and... Yeah, well, I'm glad because I want to go a little bit deeper here because what you said just prompted me to ask the question, a lark. So what would be the ideal waking time for a lark? The ideal meeting time? So like actually when would you schedule like your meeting? Whether it is like the parent-teacher conference or it is like, you know, your big presentation at work. So I'd like to go through like based on the chronotypes, what's an ideal way to structure your life? Yeah, I will say for sleep schedule, for morning larks, nine to five sleep time will be okay.

42:00They can be on the 5 a.m. club. Not everyone should be in. And I have a ton of patients that want to be at the 5 a.m. club and wake up at five and meditate and do a lot of things before their children wake up. And if you're not a morning chronotype, you're going to just mess with your sleep, with your biological clock. So nine to five for morning larynx. And I will say 11 to 12 till 7, 8 a.m. for night owls. And then for intermediate, anywhere between 10 and 11 and 6 or 7 a.m. to wake up. And for morning persons, it's okay to have a meeting at mornings, probably 9, 8, 9 a.m. And for night owls, it's better for them to take decisions and do their creativity work at evenings.

42:56Okay. And then the intermediates, do they get more flexibility in terms of like? Yes, they do. They can do it anywhere in between. They just follow the sun. And then we also have Michael Brio's chronotype idea. He's a sleep expert and he matches with animals, the animal energy. So lions are the morning types. Bears are like intermediate. They follow the sun. And then we have wolves, which are the night owls. And he adds an extra one, which is a dolphin. And the dolphin, it's a light sleeper and they tend to get more insomnia. The dolphin, so you and I were talking, I think this was last week off camera, And you were like, the dolphin's pretty controversial.

43:40I know. Why is it controversial? I'm not sure if it's the way they're wired or it's their habits, their sleep hygiene. So I feel like sometimes I'm a dolphin because I'm aware all night I'm alert. But I feel like it's because our HPA axis is more activated. We are moms. we might skip routines and things like that. And that might exacerbate our dolphin profile. Yeah. Does your aura ring tell you you're a dolphin? Yeah, sometimes. Yeah. Mine tells me I'm a dolphin as well, but I actually, people on the internet are like, who is getting eight to 10 hours of sleep? I like to go to bed at nine or 10 and I wake up just naturally at seven, usually in my luteal phase.

44:33So my later luteal phase, I have to go to bed earlier. I'm just naturally tired earlier, which my youngest is like a night owl. He drives me nuts because I'm like, sometimes I'm just like, we're reading stories. I fall asleep. I end up taking a nap. And then I wake back up and he's still awake. And I'm like, what are you doing? But I noticed that in my late luteal phase, I have to go to bed earlier, but I'll wake up usually like 6.30 and they will still work for me. So my question for you is these chronotypes, you said like it changes with teenagers. So you said it's genetic, but does it change through your life cycle?

45:13Okay, say more about that. You tend to go more advanced early phase. I mean, you tend to go to bed early as you age. So after menopause, you tend to go at 10 or 9 and you become an early bird. And it's a good idea to switch, to change your sleep schedule so that it matches an early bird. Most of them. Yeah, that's very interesting. Yeah, my speculation of why that switches for me in the luteal phase is because of progesterone and GABA. and then I just think I have this GABA in the evening that's just like, we're just super, super calm out. And I think it also is that in some ways when progesterone is right, the parasympathetic activities I engage in actually have a better effect.

46:04Like it actually feels more meaningful in terms of like, oh, I'm actually getting something out of this. Whereas I feel like other times in my cycle, you know, when estrogen is high and testosterone is that I'm doing these activities, but I already feel more stress resilient. So it doesn't feel like it's having that same kind of benefit for me. Yes. And I feel like we need to improve our melatonin secretion, especially in those stages of life, because we tend to think, okay, what should I take and think supplements while lifestyle, it's the main, the specific that you need to put your attention on in order to produce more of your own melatonin naturally.

46:48And melatonin is a darkness hormone. So it's really sensitive to light, especially blue light. And I feel like most of the people find really hard to stop using their cell phone or screens or TV or anything. And we know that we need to stop at least an hour before heading bedtime. and that and also change the color of light. We said dimming lights, but also red light or maybe filters, blue light filtering glasses, screen filters in the phone and curfews for digital or do a digital detox at least an hour before bed. That's the main recommendation that I would do. And I know that's the most difficult to do.

47:33Yeah. Because it feels like you need to sleep with your soul right next to you, but you don't. And it's better if you leave it in the bathroom or in another room for it not to be like something that is distracting. Yeah. We had a podcast guest that her plane got delayed and she asked me, can we just like do it tonight? And it was, she wanted to start the podcast at like 6 p.m. And as you sit in this room right now, I'm like, no, no, no, no, no. Like I will not. My sleep will be awful. Like I can't do that. Yeah, we need to treasure our sleep. That's the best thing we can do for our health. And I feel like if you wake up feeling tired or you get tired often early in the evening or so, we need to think about what's going on with our sleep quality and quantity.

48:23Because I was seeing yesterday a video on Instagram, a lot of celebrities saying they were sleeping. Most of them, average, said that they were sleeping six hours a night. like if it was normal. And I feel like we need to know that below seven, it's going to have some impact in our health. It's going to increase our chances of getting a chronic disease like cardiovascular disease, diabetes, insulin resistant, obesity, or things like that. So we need to have it in mind. Do you hear that? Sounds like breakfast is ready. Because Quaker's coming in hot with morning nutrition, 100 % whole grain oats, and a good source of fiber to fuel the rhythm of your morning and kickstart your day.

49:16And that sounds absolutely delicious. Fuel to start whatever's next. Quaker, official sponsor of FIFA World Cup 26. I think that's so important for you to know because there's a glorification of getting little sleep. Like it's interesting to me because I will share about getting good sleep on the internet and people will say to me because I talk about how I'm trying to get nine to 10 hours. Like I have multiple autoimmune diseases. I have endometriosis. Like I need more restorative time. And people are like, well, you're missing out on so much life. Like you're not even living. your full life.

49:56I'm like, actually, I am getting so much done in the day. I am enjoying this full life because I'm not dragging cognitively. I'm not exhausted. You don't catch me yawning all the time. And I'm actually functioning my body and explaining that to people and people being like, wait a minute. Yeah, I'm just going through the motions instead of actually being present because my brain is so tired. Can we talk about what is happening when you sleep to your brain? Yes, it's really important because a lot of people don't get that while you sleep, you're actually boosting up your life, your awareness, your cognitive performance.

50:33We know when we sleep, our brain shrinks at night. Okay, that sounds scary. To people, explain why it's not bad. It springs a little bit. The neurons tend to be close together. So cerebrospinal fluid just go through neurons and flushes out metabolic waste. That is normal waste, beta-amyloid, tau protein, and things that accumulate and builds up only for being awake. So without enough sleep, that will accumulate and increase our chances of having brain aging and neurodegenerative diseases such as Alzheimer's, Parkinson's, dementia. So it's really important, right? And also in REM stage, which is our cognitive performance stage, the one that is going to help us with learning and memory and everything.

51:29If we don't get enough sleep, our emotional balance is going to get disrupted. And we know that we are more able to solve a problem, three times more able to solve a problem, and our reaction times as well. So a lot of time we tend to prevent our children to drive drunk, right? Yeah, yeah. And we wouldn't let them drive drunk. That's in Mexico have like a chosen... Designated driver. Yes, designated driver. The designated driver. And we will be very proud if our kid is the designated driver. But how often do we ask them how tired are they or ourselves when we are at the wheel? It's very important because we know after 17 hours awake, our cognitive performance will drop down and we will have 50 % less reaction time.

52:31So the chances of having a car accident increases after 19 hours or so, four to five times. And after 24 hours awake, it will increase by 11 times. So we should pay attention to that. And I think that our best tool for cognitive performance is sleep. In the United States, they do daylight savings and they like to take away sleep from people. I am like, I am seriously the mouthiest person on the internet about this. I'm like, stop doing this. We stopped like a couple of years ago here. Yeah. In Mexico, they stopped. A lot of places are stopping because they're like, not only is it bad for productivity.

53:10So, right. The government's like bottom line, the money, this is a problem. Right. But it's so bad for your health. And we see the car accident spike, heart attacks spike, like the first day back to suicide, like so many problems. And I think that this is a non-consensual experiment that is being done, right, year after year after year. We've got the data and the evidence that anyone listening, like, revolt, just revolt. And it's something that, like, you know, with us, like, we have people in our company that work all over the world. And when the time zones are switching, like, I don't live in places that switch the time zone.

53:50And I'm just like, stay what you're doing. Keep doing what you're doing. And, you know, we work it out because I'm like, there's no reason for you to like go losing an hour of sleep. I know. That's why I like to talk also about social jet lag. Because social jet lag can be detrimental to our health because sometimes you might lose an hour every week. So let me just say that's life in Mexico. Like I have finally got my friend circle to stop making dinner reservations at nine. And I'm like, can you move it up to eight? I understood when I made dinner reservations at six for everybody, we were all trying to meet, but then we were all stuck in traffic for 90 minutes.

54:29I was like, oh, this is why, this is why it's later. But it is something. I lived in Spain for a bit and I could not, I was like, I cannot permanently live here because this entire start your night at 10 p.m. I can't do it. I know. The social jet lag is like this misaligning between our biological clock and the social clock. And we tend to go to sleep, let's say, to wake up at 6 a.m. on weekdays and then to wake up at 9 on weekends. And that difference is like if you're having jet lag, if you're traveling different time zones within the same city every week. So that brings us inflammation that will lead us to a lot of sleep problems.

55:15And that's why also it's very difficult for us to go to sleep on Sundays because you know you have to go to sleep again early. And then on Monday, you couldn't go to sleep at the same time on Sunday, but you will wake up at the same time on Monday. And that's why everyone's miserable on Mondays because they tend to sleep an hour less. Well, I think there's also revenge, bedtime procrastination that happens where you're just like, my work is about to steal my time. So I'm going to steal it back and like stay up and like enjoy myself. I know I've caught myself in that. A lot of patients experience that.

55:52It's well documented in the research that I always say we're just perpetual toddlers. Like you think that you grow out of being a toddler, but you're really a toddler for life in a lot of ways. Especially moms. Whenever you put your children to sleep, it's like, now it's me time. Yeah. I'm going to take advantage of that till 12. So I want to ask you though, so people, we know community is so good for your health, right? Like one of the, like when we look at the blue zones, we're like, it's not so much their diet. Like look at how they live in community. Look at how they move. So with that in mind, there's people who are going to be like, no, but I want to have a girl's night out.

56:26I want to be able to spend time with my friends. What do you recommend to safeguard their sleep? And kind of like, you know, it's harm reduction, right? There's things that we're going to do that are not the best idea for our health, but it's part of living the full human experience. So how can we reduce the impact? Yeah, I like to use blue light filtering glasses and put in my car whenever I'm going back from dinner with friends. I will put them on so I can start my melatonin production and it doesn't take me a while to fall asleep. I will not drink for at least an hour or two before bed. I think those are good tips.

57:05I have to say there's this trick I have done my entire life, which is I order soda water and a lime and I'll ask for a salt rim. And then in Mexico, it's suero. Everybody is drinking that. I can't be as tricky, but in the US, so I would be out, you know, there's sometimes conferences and parties and people are drinking and people, because if you don't drink, everyone's like, why are you not drinking? Like it's such a thing. and so I would order that and people would think I was drinking a margarita all the time that was like I'm just drinking water and then here in Mexico is like this normal thing so I'm like well people know what I'm up to here like they're well aware but I think um the hydrating is super important I love that I love your your tip of blue light blocking glasses sometimes I will just wear those if I'm out at dinner with people because I'm one of those people that when I leave the social interaction I know I have like an hour of wind down when I get home like I have a hard time.

58:01So I'm like, if I can just wear those blue light blocking glasses. It's a better idea than screen time. I feel like a lot of people to wind down, they think they are helping themselves with a screen or with social media, and that will probably activate you more. It will increase your cortisol levels. So it's not a good idea. I know you feel like you're winding down and you're at least directing your thoughts, but it's not a great idea biologically speaking. That's why reading is a better idea than that when you're listening to a podcast. Yeah, and it's interesting the research showing that people who read before bed actually have better HPA access, so stress system response, and they have lower cortisol levels.

58:48So it's that two for one right there. And like I said, I fall asleep all the time when I'm reading. It's like my go-to. And the other thing that I do, like if I'm going out at night, is I will actually, so I have an Adrenal Calm supplement, which has things that are like L-theanine, pro-gaba supplements. So not GABA itself, but things that actually help with your own GABA generation and utilization. And that I will take like, you know, it's the end of dinner, dessert is coming. I will take that. I will take that as well. Yeah. And so it just starts priming my body because again, I'm just like, once I end a social interaction, I feel like my default mode network in my brain is like, we have so much to process now.

59:27And I'm like, we do. And I just go to sleep. I know. I sometimes use a sleep aid as a supplement or a nerve oil as well. I love L-theanine. A lot of people tend to think that melatonin is a good idea. I don't think for this is a good example because melatonin is a hormone and it tends to interact with other hormones in our systems. And it is actually a chronobiotic. It won't help you stay asleep. It's just going to cue your brain into sleep mode. But L-theanine is going to increase. GABA is going to act as an anxiolytic. I love to take 200, 400 milligrams of L-theanine. Some adaptogens might help us also with this HPA axis regulation.

1:00:15And I love ashwagandha, like reishi, and a mixture of things is a good idea. I like chamomile, chamomile tea. But yeah, I see what you mean. And I need as well something that cues my brain into this rest mode. Yeah. Well, I appreciate you saying that about melatonin because I think people go to that first. And it's something that I'm, especially with women who are postpartum, they are in perimenopause or where they're having luteal phase sleep problems. I'm like, it's a GABA problem. If you, you can fall asleep, but you don't stay asleep, that's most women's problem. And so it's like you take melatonin, sure, that's going to get you to sleep, but that won't sustain you through sleep.

1:00:57And so what you were saying, L-theanine, I also like passionflower for that as well. I'm a big fat. Pash of flora. Holy basil. Holy basil is a great one too. I love it. And valerian root. I think for GABA, the best idea in perimenopause is progesterone. If it's indicated, I think that nothing is going to beat that. And what I'm afraid most is people using more melatonin gummies for kids. That has increased a ton. We know that poison control has received over 500 % more calls regarding ingestion of melatonin. And there's research from last year, 2024, that said that melatonin gummies, 88 % of them are not adequately labeled.

1:01:45So they tend to have three times more than it used to, especially gummies. And some of them even have CBD without saying that clearly on the label. So it's really important to take caution of that, especially in kids. We know it will interact with their hormones. It might delay puberty. And there's no chronic studies, especially in children with melatonin, And especially not with that amount, we know our brain tends to release about 0.1 to 0.3 milligrams of melatonin. And these preparations tend to have between 3 to even 10. So it's 10, 30 times more than our physiological dose. We need to take caution of that.

1:02:37I appreciate you giving caution around that. So I have a supplement company and we do a lot of manufacturing. Gummies are really hot. Everybody loves gummies, except all my dental friends are like, please don't do gummies. So bad for your teeth. And I've considered certain things. So people were like, oh, how about a prenatal? When you look into it, so two things people need to know. They're incredibly unstable. That means the nutrients that are in there, the second they go in, they're degrading rapidly. So because of that, you have to put more ingredients in there. So if you're, let's say you're using like B12, you're going to put way more B12 in there, which is like fine, right?

1:03:17You pee that one out. We don't worry about that one. But what the label says is what you're trying to catch with the degradation, the actual breakdown of it. So it's the same with melatonin. They're overshooting it because they're like, well, once it sits on the shelf for two years, it's going to be at that level. Like that's where it's going to be at. And so one, you're getting oftentimes, you don't know what you're getting when you take a gummy. It's very, it's because it's so unstable and the way manufacturing practices are, sometimes it's way more, sometimes, and prenatals, way less fully.

1:03:50No, I'm like, no, no, no. We would never, I would never mess with that. So I think that you're right to caution people about melatonin gummies. And I think especially when it comes to children, and it's a common, you know, it's, it's one of those things where like a lot of parents would be like, oh, my kid's going to fly. So I will give them Benadryl. Okay. That's not great. Right. And so they were like, okay, doctors now say don't use that. I'm going to switch over to melatonin and a gummy. Of course, a kid's going to love a gummy, but there's actually liquids out there that are standardized, that are third party tested that will work well.

1:04:24So if you do, if you are someone listening to this, that you're like, okay, but what if like, it's just like an overnight flight or things like that is fine, We need to go to microdosing of melatonin, especially in kids. I will never go up over 0.5 or maybe 1 milligram. Even for adults, I feel like that's a better idea for the brain to actually speak his language regarding hormones. And before thinking about these kind of supplements, I think we need to rule out nutrition deficiencies, which are everywhere nowadays. Pandora jewelry brings the sparkle to your summer. Now with even better prices.

1:05:05Enjoy up to 50 % off select styles. From personalized pieces to must-have favorites made for the summer. Timeless designs that shine with you through every moment, wherever the summer takes you. Shop in-store or online. Now through July 6th. Terms and conditions apply. Visit Pandora.net for details. especially iron for example for for menstruating women it's very important to rule out iron deficiency ferritin low levels of ferritin because it's associated with restless restless leg syndrome so it's pretty simple to to to level back and it's really impactful on sleep Also, V vitamins, really important.

1:05:52D3, vitamin D, important to check out. And hormone levels. I feel like we need to check hormone levels, thyroid, progesterone, and check that will actually impact sleep. Yeah. So we have talked about chronotypes, sleep hygiene, nutrient deficiencies, hormones. If someone's having trouble sleeping and they're like, okay, listen, I'm doing all the sleep hygiene, it's still not working. What other things should they investigate? I think they, besides hormone, they need to check glucose balance. It's really important to check A1C, insulin, basal insulin, fasting insulin to check if they're on the right levels and they can jump into supplements.

1:06:41I feel like it's a better idea to start with supplements and sleep hygiene before heading to sleep medication. So you can start magnesium. Most of the people, 50 % of the people are depleted in magnesium or at least are not sufficient. Magnesium is It's a mineral implicated in a ton of functions for the body and for cell health. And the thing with magnesium is you need to find the right kind of it. At least in Mexico, it's not that easy. We know that most of the forms of magnesium won't get absorbed. So glycinate, pheonate, which is difficult to have. But glycinate is a good idea. Side rate, if you're having some constipation problems, might help too.

1:07:30Yeah, I think that's important to know that not all magnesiums are created equal. And then I'm wondering, at what point with your patients do you consider doing a sleep study, investigating sleep apnea? Yeah, if you've done everything related to sleep hygiene, which we have talked about, environmentally speaking, your sleep environment is good. You did your wind down routine. You stop eating two or three hours before bed. you're exercising at morning and you're taking care of light and everything, and you're still waking up more than three times a week for more than three months, you probably have insomnia.

1:08:10And it's a good idea to check with a nighttime polysopnography if you're having any other problem, because sometimes it might be obstructive sleep apnea or Lesteg syndrome, which in a nighttime polysorchnography might come out. I want to talk about the specific sleep phases because you've mentioned REM sleep, but we didn't talk about, you know, slow wave. And I think these terms get thrown around a lot. So if you could just break that down for us and like, what is ideal? Right. So we don't have like a passive state. We have different states on our sleep architecture. And we have two main stages, non-REM sleep and REM sleep.

1:08:59In non-REM sleep, which is the part of our sleep that will help tissue repair, hormone balance and everything, it's divided itself in three. N1, which is like a light stage of sleep, is the transitional stage actually, and you will easily be waking up. Then we go into N2, which is light sleep. And most of our cycles, most of our nights, we tend to go into sleep. And this is where our heart rate, breathing, blood pressure will start to drop. And here we're going to have sleep spindles, K-complexes, which are important for memory processing. And also they will help us, they will prevent us to wake up from external stimuli.

1:09:52Then we have N3. N3 in non-REM, it's where our deep sleep is going to be. And we're going to have delta waves. And here is where our growth hormone will spike. And it's really important for kids to grow, but for adults, for muscle repair, We're going to have our hormones reset. We're going to have our immune system also reset. And it's like housekeeping for our brain, especially, and cognitive performance. This is going to represent around 15 to 20 % of our night. And it tends to be more at the beginning, the first part of the night. Then we're having REM sleep. REM sleep is our rapid eye movement.

1:10:42We're going to be paralyzed in the body except for the diaphragm and eye muscles. We tend to have our dreams here. 80 % of our most vivid dreams is going to happen here. We're going to have emotional balance. We're going to keep our memories and learning. It's really important. It's often called paradoxical sleep because our brain is, as active as if we are awake almost. And yeah, it's really important. We tend to have 15 to 20 minutes at the beginning of the night and it gradually increases throughout the night. So by the last part of our night, we're having more REM sleep. That's why we remember most of our dreams if we wake up and REM.

1:11:31And why is REM sleep so important? Because you're like, the brain is really active. And I think people often think like, no, but sleep is when our brain is supposed to like power down and supposed to get cleaned out. And, but why is REM sleep so important for us? Especially for, for cognitive performance, for learning, for memory, for attention, for emotional wellbeing. It's like, some say that it's like therapy for us because we tend to edit our, I love that. You know, therapy every night. I know. It's like, that's why they say sleep on it because you tend to go to sleep and reframe things and see things in other perspective.

1:12:10I actually never knew why they said sleep on it. I thought they was like, just take some space from it. But like that makes sense. So there are women listening to this right now. And they're like, yes, everyone and their mother and their brother on the internet is like, women need to gain muscle, build muscle, do this like strength training. But sleep is so important for that. So how can women get into that phase of sleep to help them build their muscle? Okay. I always say that we have three things. We need three things to build muscle. First, we need enough protein. I know we need protein from our diet, clean protein enough.

1:12:49And then we need to do some weights. We need to challenge our muscles in order for it to build up. And then we need to sleep. and we need enough and three phases. So if that's the first part of your night, the best thing you can do is go to sleep early, early for your chronotype. But when you tend to go later to sleep, you cap that specific phase when you're building up your muscle. Okay. And to review the chronotypes, to make sure I got this right. So if you are the morning person, nine to 10 is when you need to get to bed. If you are the intermediate, you're following more of the sun. 10 to 11.

1:13:30Okay. And then if you're the night owl, that might be more like 11 to 12? Yeah, I wouldn't go over 12 because we are diurnal animals and our circadian rhythm will dictate that we need to sleep before 12 in order to have enough melatonin. That's the best time to have high melatonin in our brains. And yeah, so before midnight. Before midnight. Well, I like that anyways, because it's like you want to go to bed before the next day. You should be sleeping, hopefully, at the end of that. Yeah, and I would put attention on waking up at the same time every time because regularity is key to sleep and it's key to sleep hygiene.

1:14:10That would help us set our circadian clock and keep it in place. So you really highlighted the short-term consequences of not sleeping. So less reaction time, more car accidents. Mood swings. Mood swings. Yes. I think about that with like, oh, if you have teenagers right now, check their sleep. If their moods are swinging. But we don't. I mean, as women, if we don't get a, I think we've all been postpartum in that phase and recognized ourselves in that, like for the bombs, we all have been. And then for others, you know, there's always been that like one night you stayed up too late and you feel that you're more emotionally vulnerable.

1:14:56And I think in a lot of ways, we sometimes pathologize that, right? And we're like, you're just being too sensitive. But if you consider that your brain is running at a lower capacity, it is more vulnerable, right? Your reaction time is reduced. Actually, your amygdala, is it called like that? Yeah, so your amygdala amplifies everything. It said that 60 % of the activity of the amygdala is going to be amplified once you're not getting enough sleep. So you're going to take everything personal. You're going to see everything through a gray, like a gray lens or so. So it's really important to not take that serious things after a bad night of sleep.

1:15:40You're less capable of solving a problem. You're not a good team member, you know, when you don't have your best sleep. Yeah. And so that was going to be my question is like, what is the long term impact here? So we're not talking about like, you know, three months of a newborn baby not getting good sleep. But what happens when it is just month after month and there's no end to it? The thing is, when we don't get enough sleep, we tend to activate our alert mode. And for a couple of weeks, it is okay. It is actually helpful to turn on our alert mode, our fight or flight system. But if you keep doing it, it will start to burn out our systems, our organs.

1:16:28So for the heart, for example, you tend to keep your blood pressure up. you won't have that dip that we need at night, so it will increase your chances of having high blood pressure for your liver. It is okay to release more glucose for a couple of weeks if you need it, if you haven't slept well. But in long term, you're going to be more prone to have insulin resistance, to have prediabetes or diabetes, as well as cardiovascular disease, and neurodegenerative diseases like Alzheimer's, Parkinson's, dementia, obesity, dyslipidemia. I mean, every chronic disease is going to... If you don't want it, that's what you're going to get, right?

1:17:13And for people listening to dyslipidemia, that's cholesterol levels that are unfavorable and not compatible with like live long and prosper mantra there. I just think that's important for people to hear because it's not often that people are choosing not. So, okay, two things. People don't often choose not to get good sleep. There are two things that happen. One is physiologically something is going on that's disrupting it. Or socially, there's this pressure of you like sleep when you're dead. Hustle culture. Go, go, go. Yeah, these misconceptions are, yeah. Yeah. And I think it's something that like, I think this is the most unfair thing of being a human is all the decisions we make in our 20s have the impact for our 40s, 50s, 60s and beyond, right?

1:18:02So we think about like bone consolidation and building your muscle mass, like that gets talked about a lot. But brain health and cognitive outcomes and the way that we slept or didn't sleep in those decades of life can have a major impact. So with all that said, and it sounds really scary, what can people do right now? So we've talked about the sleep stuff, but if they're like, I want to prevent that, I want to keep my brain healthy, what can they be doing right now? Because we're plastic. We are always able to undo what we did in our youth to a degree. I know. The best time to set our sleep habits is now, whenever you're listening to this, because we can always improve.

1:18:43It's like a sport that you just sign in. You need to train for it. You need to perfection it. And there's many things we can do. Sleep hygiene will be the first things. Sleep regularity is very important to set your schedule, to leave lights off, to actually to do your morning routine. because sometimes night, I mean sleep, starts with morning routines. Yeah. Wake up and expose yourself to light, natural light, external, preferably the first hour or so. It's a good idea. That's why if you exercise at morning, you just hit, in Spanish we will say to hit two birds at once. I don't know if that exists.

1:19:27Yeah, two birds with one stone. Yeah. That one. So, yeah, we'll do exercise and you expose yourself to light at morning. It will set your circadian clock and stop stimulants. Caffeine is really important. It's the most consumed stimulant globally. So 80 % of the people also consume it. And the thing with caffeine is most people tend to use it too late. Okay. So that's my question. Are you a caffeine hater or is it just a too late problem? I do love my coffee. I need to confess that I am not a coffee person. I'm a slow metabolizer. Actually, I did my genetic testing and I know I'm a slow metabolizer from years and from my sibling as well, because we know that if we drink coffee, I will get anxiety and palpitations.

1:20:16And so I like the taste of it, but I don't consume it. The thing is, if we use it too late, it will affect our sleep quality. Even if it doesn't prevent you to fall asleep and you could fall asleep, the first hours are going to be driven by that small amount of caffeine. It might alter sleep architecture and the deepness of sleep. So wait, that makes me connect that if we are consuming caffeine too late in the day, which is for a lot of people after 12 p.m., but we know definitely 3 p.m. is like bad news. A lot of people take their coffee after lunch, which in Mexico, it's at 3 p.m. So they tend to have their last coffee at 3 or 4, and I think it is too late for your sleep.

1:21:09Absolutely. But you just said it's going to negatively impact deep sleep, which is the exact sleep we were talking about for repairing your muscles. So building muscle for helping, you know, your brain do its detoxification. Like all of these benefits of deep sleep. I'm like, I just realized that I want to underscore for everybody, your coffee too late in the day may prevent you from building your muscle mass. Yes, because also we've talked a lot about circadian rhythm, which is like part of the two processes that regulates sleep. We have two processes, process C, which is circadian clock and circadian rhythm.

1:21:43And we know it's genetically determined and we need light and everything that we've talked about. But we have process S, which is like the homostatic drive, the homostatic system. And it's ruled by adenosine, which is like a product of ATP degradation. And caffeine, then when we wake up, we start going through our day. and adenosine accumulates. So it will help us feel sleepy. And when we go to sleep, that adenosine is going to be washed out and we're going to reset that. Caffeine, it is actually an antagonist of this adenosine. It will sit on the same receptors of the adenosine. So it's half-life.

1:22:30It's going to be between six to eight hours or so. And that means that if you take a cup of coffee at 4 p.m. By 10 p.m., you might have half of that caffeine, which is like 50 milligrams or so. And that could be enough to pull you out of that or prevent that you go into that deep sleep that we need to feel repaired, at least physically. That adenosine sleep pressure, so that's what it's called, it gets built up. But there's a big problem when we miss the window of when adenosine builds up and it's like, go to bed. Talk to us about what happens when you ignore that signal. Yeah. The thing is, if you ignore that signal or you took coffee, actually it won't make you feel energized.

1:23:17The only thing is that you won't feel that tiredness. So when that caffeine washes out, your adenosine is going to come back like a tsunami, helping you feel tired and you're going to crash. And it's not the best way to fall asleep in that state. It's better to transition softly. So you need to have your process C and your process S coordinated. And as long as they fall into the same path, you're going to have the best sleep quality that you can. So you need to pair your chronotype with your adenosine, with your sleep drive, and find your best time to fall asleep. So, you know, the other thing I think that if you have toddlers, you've seen the second wind come on, right?

1:24:03They're tired, they're tired, they're tired. Some of us have mistakenly been like, maybe if they skip their nap, they'll get better sleep. It doesn't happen that way. Explain why that second wind, like what is happening with the second wind? Why is it so hard for people to get sleep? Right. I love to say with kids that sleep begets sleep. because once you miss that sleep window, cortisol is going to spike and it's going to kick in just to help them feel like they can go through that time that they're awake and they're not supposed to. So if you miss that window with them or with you, which is actually about around for adults, 12 to 16 hours, if you pass that time, you will probably activate your alarm system, which is going to kick in with cortisol, you're going to release more glucose, that will make you feel alert.

1:24:58So you can go through that couple of hours or so. But if you go to sleep, actually, at that time, your sleep is going to be driven by cortisol, which is going to make your sleep more superficial and you're going to have more fragmented sleep. You're going to wake up and it might be difficult to fall back asleep and to prepare that cycles that we need in order to have good sleep quality and the whole eight hours with good hygiene, for example. And how long does it take to recover? Like if you have a bad night of sleep, how long is it taking the body to recover from that? I feel like everyone's different and it might take a couple of days, but if you add alcohol, you add substances and things like that, it's going to be difficult for your liver to flush out everything.

1:25:58Some might say that for every hour that you lose sleep or you go late to sleep, it might take a couple of days, two days to recover from that hour of sleep. So do the math. If you go to sleep three hours late, you need six days to repair for that. But I think that Everyone's different and you need like to build that sleep resiliency or sleep fitness in order to be capable to have a late sleep night every once in a while. There has been research saying that like once you lose sleep, like you can't get it back and also that you can't bank sleep. So you can't be like, oh, I know I have this bad flight scheduled and it's just the way it is.

1:26:48So I'm going to sleep 10 hours tonight and I'll sleep six hours tomorrow. Yeah, I feel like we don't have a bank account of sleep, but you do have resiliency. Your heart rate variability, for example, can tell you how resilient you are to these late nights. And yes, you will have cell damage and inflammation for not going to sleep at the time you need to. But I feel like that is done, that damage is done regarding cells. But regarding HPA axis and autonomous SNA, ANS, I'm sorry. Autonomic nervous system. Autonomic nervous system. You can build that resiliency, especially if you know how to hack your vagus nerve and to activate it more often.

1:27:38I think that will help a little bit with sleep deprivation. Now everybody wants to know how can you hack your vagus nerve. I know. Vagus nerve, we know we can sort of train our vagus nerve into being activated more often. We used to think that it was completely like autonomous, independent, but we can actually drive it towards activating more often. So we can gargle, for example, because the vagus nerve will go through our throats and we can gargle, we can sing, we can say mantras, for example, for activating it. And we can, at mornings, we can use cold water in our face. We can, yeah, you know what I'm talking about.

1:28:30I wouldn't do the whole cold plunge at mornings because I hate it. But we can do our face. and what else we can do a massage every once in a while and i i love gargles because you just brush your teeth and gargle for two minutes or three minutes or so everything walk barefoot for 10 or 15 minutes every day we know it's more important for everything to do it um how do you say, consistently than a ton of time. Yeah. Yeah. So consistency beats like the amount of time that you're doing. I was going to ask you, so can one bad night of sleep kind of throw your hormones off for days? You've talked a bit about the HPA access, but I think for women listening, they would like to know like, how does this affect my ovarian hormones and maybe even thyroid as well, because we know that can be connected.

1:29:31Yes, I know thyroid can be affected because we need to convert T4, which is the inactive form, to T3. And when we're stressed, which means that you didn't sleep, for example, when we're stressed, we're going to alter that conversion from T4 to T3, and we might feel a lot of symptoms. I don't know if it will be for one night, But chronically, it definitely will alter thyroid hormones. It might alter all hormones by one night, but we have some hormone resiliency. But chronically, you're going to deplete our sex hormones because cortisol is going to steal everything. The same, how would you say, like in Spanish, it's materia prima.

1:30:23The precursor, the metabolite? Yeah, not precursor, but the material that you use to build hormones, cortisol, which is cholesterol, is going to drive everything to do cortisol. Because if you're telling your system that you need to be in fire or flight, that's a priority. And cortisol, it's above sex hormones, really, talking about priorities and survival. So if you favor cortisol, that will deplete estrogen, progesterone, testosterone, and also the HEA. So yeah, we can check cortisol at AM or do a curve, salivary cortisol curve to check how is that still going on. And if cortisol is stealing everything from this material, we need to build sex hormone.

1:31:21Yeah. And earlier in this conversation, you also pointed out insulin as well. So we want to remind people of that, that you talked about cortisol. We talked about insulin, sex hormones, so estrogen, progesterone. Certainly testosterone can be affected. You said DHEA, which is coming from the adrenal gland. So the takeaway is no hormone is untouched by poor sleep. So I want to ask you, some people have said that poor sleep is silently aging the brain as fast as smoking is. Why would people say that? Do you believe there's truth to that? I think it's truth. Oxidative stress that accumulates after a night of being awake, it could damage our cells.

1:32:02It will liberate more radicals. Oh, free radicals. Free radicals, yes. Thank you. So we will have morphine radicals attaching to our tissues and aging them. Also, we know that over 700 genes are being or not being activated at night. And those are genes that tend to increase inflammation, chronic disease, oxidative stress. So also for longevity, it's not only brain aging and tissue aging, but for longevity, it's really important to keep those seven to nine hours of good sleep. Yeah. Well, thank you so much for this conversation. This has been fantastic. You've given us so many practical tools.

1:32:47So I really appreciate you sharing your expertise and having the uncomfortable conversation people don't want to hear is that you need to go to bed. I know. Thank you. Thank you so much for inviting me, having me here. I love to share this this information. Spring just slid into your DMs. Grab that boho look for that rooftop dinner, those sandals that can keep up with you, and hang some string lights to give your patio a glow up. Spring's calling. Ross, work your magic.

1:33:19Turn it up. Storm has zero sugar and 200 milligrams of caffeine, so you can turn that workout up a notch. Good energy in, good energy out. Energy for life.