The Truth About Sleep: Myths, Tips, and Longevity Secrets with Dr. Rebecca Robbins

22:10So when people come to us and say, oh, you know, I'm getting three or four hours of sleep at night or five and I, you know, I feel okay, but, you know, I think I'm doing all right. And you might feel okay, but you're virtually robbing yourself of your potential because rapid eye movement sleep is where we get so many benefits cognitively from our sleep, memory consolidation, etc. And that period is predominating right before we wake up if we're getting seven to nine hours. REM sleep is the consolidation of memory.

22:41Dr. Gabrielle Lyon:These software updates, however you want to call it, software, hardware updates of the brain, do they happen in other stages? Is it as bifurcated as it sounds? Well, if you think about it, that's kind of a difficult study to do to really isolate each unique stage. But we do see the more rapid eye movement sleep you get, the more likely you are to achieve insights. If I teach you something before you fall asleep and then quiz you on it the next day, the more rapid eye movement sleep you get, the stronger those connections and the better your performance the next day on cognitive tests. The gold standard of measurement of sleep is polysomnography.

23:15But I do think that there's an important qualitative piece to sleep that sometimes we forget. And now the development of sleep trackers gives us such an amazing insight into the quantitative component of our sleep. How long did you sleep? How long did it take you to fall asleep? Did you wake up? Did you spend much time in deep sleep or rapid eye movement sleep? This is amazing information that a typical consumer didn't have access to, you know, five, you know, 10 years ago. But I think that the quantitative piece is ideally coupled with a qualitative evaluation of our sleep. Quite simply asking yourself, how do I feel in the morning?

23:50Tired.

23:52Dr. Gabrielle Lyon:Do I feel restored? And then if that's the answer, you know, truly, you know, we need to add a little bit more time. And I hope that, you know, you call me after and you're like, Rebecca, we did it. I got more sleep. I feel great. How much sleep do children need? So our sleep duration need does ebb and flow across the lifespan. Very little babies need virtually to be sleeping almost all day long, as you remember. And then as children age, they need a little bit less. And up until the kind of school age period or time of a child's life, they need somewhere between six and 12 hours of sleep. But there are a lot of individual differences.

24:29Some kids will do well on that lower end of the spectrum and other kids will do well on the higher end. And this is where I love to think about end of one experiments. What works for you for your kid after a night of eight hours of sleep? Do you find that they are bright eyed and bushy tailed as the saying goes when they wake up? Or do you find that they're dragging and maybe in the car in the afternoon? Do they fall asleep? Those would be signs that they're just not getting quite enough. And then maybe start that next night and try to start the bedtime process a little bit earlier and the bedtime routine a little bit earlier.

25:01Do you think there is a time that is universally good for kids? And what do I mean by this? Meaning we talked a little bit about this

25:10Dr. Gabrielle Lyon:circadian rhythm, which is this 24 hour cycle. Here in Texas, the sun goes down, let's say six o 'clock. Let's say the sun goes down in Boston or New York. I'm just making this up at eight o 'clock. Does the location dictate the time we should begin to think about putting our children to sleep? Because listen, mine didn't come with a manual. It would be so much easier, wouldn't it? So much easier. But perhaps if at 6 p.m. when the sun is going down, even though it's not convenient, maybe that's the time that we begin to wind them down. Do you know what I'm saying in terms of like, what if we're kind of doing it wrong?

25:51Dr. Gabrielle Lyon:It's not our children. They can't regulate. They don't. My kid, she'll want to stay up and read princess books. And literally one eye is falling asleep, you know? Well, I love that. I love it. Sounds like a great bedtime routine. But young kids are very susceptible to light is one thing to keep in mind. So make sure, and this does not have to be expensive for everyone listening. You can get great blackout shades at Target for very little. But do make sure your children have sleep-proofed environment. and an environment, you just showed me your daughter's bedroom. It's so amazing and so cozy and so fabulous.

26:27You want children just like all of us to walk in and feel soothed, have elements that comfort them, their favorite stuffy, their favorite lovey, and the book that helps them also feel at peace and safe. And that's going to change as they grow, of course. But I think this is where kind of back to the end of one experiments, thinking about workshopping your kids sleep until you find the sweet spot. and whether that's a 6 p.m. fall asleep time or if that's a 9 p.m. fall asleep time. And one of the key things is your children are young, but what might be happening is all of us have, in large part, genetically predetermined preferences for chronotypes.

27:03Now, this is a term that refers to each of our personal preference for being alert or asleep within a 24-hour day. What is yours? I am a very severe morning type. How about you? Same. Same, right? I was at the gym by seven. I love it. So that is kind of part of this equation also. And your children, those types might be presenting themselves.

27:30Dr. Gabrielle Lyon:What are the other types? There is a morning person. We generally model it on a spectrum from what we call morningness to eveningness. And the biggest question, the best question for figuring out where you are within that spectrum is when do you do your best work? And if you would probably tell me first thing in the morning, right? Would you say? Interesting. How would you answer that question? I'm hoping that in a month I can tell you that. Okay. Because I don't sleep well. I have the two little kids, you know, whether my husband is on call or not. But I'm hoping once I finish this episode, I can call you and I'm going to implement same sleep wake cycle, blackout shades.

28:07Dr. Gabrielle Lyon:I'm not exactly sure what I'm doing with my kids. But then I'm going to call you and tell you. I can't wait. And let's text along the way until you get there. because all of this is really all about workshopping and finding the sweet spot for you, for your kids, for your partner, and factoring in also your professional obligations, your personal obligations, and maybe also unwinding yourself as a mom because we do stuff for everyone around us all day long as moms. The fascinating thing that you said is there is a genetic predetermination for amount and chronotype. how much movement can we make when people have dysregulated sleep from a nutritional science standpoint again we see people all the time in our clinic that have abnormal lipids abnormal blood pressure glucose partially because they're either doing shift work or it's so interesting how this appears in blood work yes oh what's that oh that's uh my heart how many of you miss that over caffeinated feeling of your heart pounding out of your chest or you maybe you're on another caffeine detox maybe you miss feeling really tired I'm so grateful to mud water one of the sponsors of the show and I have two little kids therefore I don't have a perfectly structured morning routine sometimes I need something that supports focus clarity and energy without wrecking my nervous system that's where mud water comes in it's not coffee it is something different and it makes me feel great throughout the day.

29:37Dr. Gabrielle Lyon:I use it in the afternoon so I get good sleep. Mud water is made from functional mushrooms. Nope, not that kind. Adaptogenic and organic ingredients like cacao and turmeric. No sugar, no artificial junk, just clean focused energy. It gives me that mental lift without the crash. I love that it supports my mood, immunity, and focus. But what I really appreciate is that I'm not... Is that my pulse at 200? Almost everyone has experienced too much caffeine. Go to mudwater.com if only you are interested in cutting back your caffeine and want something that works. And use the code Dr. Lion to get up to, you guessed it, 43 % off your starter kit.

30:24Dr. Gabrielle Lyon:Mudwater.com, code Dr. Lion. And you'll feel the difference. When do we consider jet lag? Is it a two hour time difference? Three hours? Would there be a time that we say, okay, this is jet lag? When you're traveling, one of the big questions is how long is the trip going to be? If you're going to London for a 24 hour trip and coming back, I don't know that you have to adjust. I'd say just rip off the bandaid, do your best. But if it's a longer period of time and you want to really align, then the best thing to do is in the week before you travel, and it's really more than three, maybe three time zones away.

30:55But look, New York to California can be difficult. Yeah, it is. And if you have a big, important meeting, I'd say consider these protocols. And the way you do that is in the week leading up to your trip, you think about where you're traveling and you start to move. You fall asleep and wake up times in the direction of that new time zone, just 15 minutes. So if you're going to London, push your bedtime, you know, just 15 minutes later, the first night in the week before, and then another 15 and then another 15. So that'll get you just over an hour.

31:22Dr. Gabrielle Lyon:What about New York to California? you are flying back you're going to go there you're going to be there for a week would you move up bedtime from 8 to 8 15 or you move it the opposite 7 45 well when you're moving to the you know backward to california new york to california you're going to try to push your schedules to be a little bit later so i'd wear sunglasses in the morning if you live in new york city and you're going for a big work trip to california in the week beforehand you're trying to move small increments 15 minutes in the direction of your new time zone and that's sleep times and wake times but it's also meals so maybe try to push your dinner to be a little bit later if you're taking a red eye for instance from new york to london they're going to be i try to avoid them but there are situations where every time i book a red eye i think of you I'm just like, oh, I know this isn't good.

32:20If you have the luxury or the ability to choose, flying during the day is ideal. And then getting to your new destination. And when you're there, do, you know, again, live, eat and sleep on your new destination time zone and realize that sleep is not going to be perfect. I don't have a cure for jet lag. I wouldn't be a professor if I had a cure for jet lag. But so you might experience some sleep difficulties. So when you're on your new destination, you land and maybe you experience some insomnia. You wake up at two, three o 'clock in the morning. The protocol is the same if we experience that in the US, in our home time zone.

32:53Take it in stride. Try not to beat yourself up. It's so easy to look at the alarm clock and just be like, no, I'm up. But try to have, I think self-talk is actually really important here. You know, no big deal. I'm up, but it's okay. Of course I'm up. It makes sense. Do something that will hopefully make you sleepy. Reading a book, some gentle yoga poses. The best use case for melatonin is travel and combating jet lag. So we do recommend melatonin for that specific use case and taking it as you prepare for your trip could be a good idea to facilitate the transition of melatonin in the direction of your new time zone.

33:28And when you land at your new destination, do keep a couple things in mind as it comes to melatonin. Number one, if you can find it, pharmaceutical grade melatonin is critical. There have been research studies that decompose melatonin tablets that you can find that are not regulated in the nutraceutical category in drugstores. and they found that what's stated on the label varies up to 300 % than what's actually in the supplement. So keep in mind that purity varies widely. So pharmaceutical grade will allow you to be confident that what you're getting is pure and it is not more the better. So look for something

34:02Dr. Gabrielle Lyon:that's 500 micrograms. Oh my goodness, no, we got to stop that. Sorry, tell her. I'm just calling you out. So 500 micrograms or one to two milligrams, but not much more. And lastly, taken before bedtime in advance. It's not right before bedtime, but it's kind of when sun is setting in your new environment is when you should be taking melatonin a couple hours before you want to be falling asleep. I didn't realize it was a few hours before. What you're saying is you don't take melatonin right before you, okay, I'm going to pop my melatonin and go to sleep. You want to plan in advance. and facilitate that internal secretion of melatonin and adjustment to your new time zone.

34:43Dr. Gabrielle Lyon:I am only aware of one thing that suppresses melatonin and that would be light. Is there something else? Does cortisol suppress melatonin? Are there other, do we know? The two things that have the biggest impact on our circadian rhythm are number one, blue light, blue daylight spectrum light. And that is the strongest, what we call life giver or zeitgeber to our circadian system. So light comes in through the eyeballs and it travels along the optic chiasm to a tiny region of the brain called the suprachiasmatic nucleus. And that's the circadian rhythm home in the brain. And then that kind of fires the secretion of melatonin if the eyes detect absence of blue daylight spectrum light.

35:23But if bedtime approaches and you open up a computer screen that has full brightness, you're going to be giving yourself a physiological cue to become alert and awake because the eyeballs will receive blue daylight spectrum light from that screen and think it's time to become alert and awake. And so we're virtually shooting ourselves in the foot when we use blue light emitting devices before bedtime. There's a free software called Flux, F dot L-U-X, and it's free, widely available. I'm not affiliated with them, but I personally use the technology. You do. Amazing. And what that will do is it will take away the blue from a computer screen.

36:00So if you must be working before bedtime, do consider Flux. And what's nice is you can set it up so that it just goes on automatically. And as the sun sets in your time on your laptop or your tablet, then the screen will become warmer. So blue daylight spectrum light is the strongest input to our circadian system. And exposure to blue light at inappropriate times will disrupt the flow of melatonin. The second is meal timing. A meal consumed too late will disrupt the circadian system and could make it difficult to fall asleep that night and experience consolidated restorative sleep.

36:34Dr. Gabrielle Lyon:That would make a lot of sense. And we do see a lot of dysregulated eating in general. I think not only do we have a ton of extra light exposure, I don't know, is fluorescent also blue? I mean, there's light pollution everywhere. Everywhere. And it takes a lot of effort in there. I think there's also a lot of confusion because there are a lot of devices that say there are circadian lights or there are sleep-promoting lights. which also are quite bright. And then maybe someone's using that before bedtime. So the best thing for your bedroom is to go to a department store or a drugstore and buy a sleep-friendly light bulb and put that into your light.

37:13Is that a red light? Almost a red. On your nightstand, yes. It's a red spectrum. Red, colors are measured in temperature. So it's a warm light. It's reds, it's maybe oranges. Those are kind of sleep-inducing colors. And use that in your bedroom if you're reading before bedtime. and then if when you wake up in the morning do you need one of these circadian lights i don't know but i think that you know generally is if you have one and love it amazing um but getting outside into the natural blue daylight spectrum light kind of as soon as possible is great for helping our

37:45Dr. Gabrielle Lyon:helping align our internal circadian rhythms i do that with the kids uh every day i don't know if you think about do you do that too with your kids right outside yeah okay all right guys let's go Also just getting them out of the house is sometimes the best. Bye. I agree with you though. Do we know the impact of exercise and the types of exercise on sleep quality? This is a great question. For so long in sleep, we would discourage exercise at night. Now, I think the research is still emerging, but what we've found is that generally, if you're getting exercise, that's the most important predictor of good sleep quality.

38:23We really care less when you get it. There have been a couple studies, one in vigorous activity, for instance, doing a very vigorous, you know, high intensity workout before bedtime is ill-advised. That does, you know, have some negative impact on sleep. But by and large, just making time for exercise, I'm really not worried about when you do it as long as you get it in. And this question is related to our circadian rhythm preference, our chronotype. Because if you're a true morning person, one of the other questions I'd like to ask that's a great predictor of where you are on the spectrum from morningness to eveningness is when you do your best work and when you want to work out.

38:59A true morning person will say, oh, you know, the morning. Or an evening person will say, I love to get a workout in after work.

39:06Dr. Gabrielle Lyon:I don't think I've ever, a handful of times, have you ever worked out after work? Oh my God, it's very hard. I need a lot of motivation. I already know it's not going to happen. I'm exhausted. I'd rather get up at four to train than I would rather train at 5 p.m. I also think, you know, our poor evening people in our society, I feel like I want to advocate for true evening types because there's so many things in society that privilege a morning person. Even our figures of speech, the early bird gets the worm. And there's so many people, the true evening types, the idea of a 9 a.m. wake up is very stressful.

39:40And then think about a commute to get to a nine to five office job for a young professional who's a true evening type. It's really hard. I dream of a workplace where the quality of our work will be the biggest predictor of schedules. If you're doing enough, I don't really care where you are or when you're doing it, as long as you're able to get the sleep that you need. And that's the biggest, most important question employers should be asking. How can we set our employees up for success? I think there's such a focus on being at the office. But the hours aren't ideal for many, many millions of Americans.

40:15Dr. Gabrielle Lyon:Do you think that the environment matters in the way that if we are exposed all the time to blue light under fluorescent light, do we wear, we use flux in the evening, do we wear red light glasses, blue light blocking glasses? Should we be spending four hours or more of our time outside to combat this light? This is a great question. I think sometimes we can get too in our head about things. And I think the bottom line is more fresh air, the better and natural fresh air. What comes with that often during the daytime, at least is exposure to blue daylight spectrum light, getting more fresh air, more sunlight exposure over the course of the day, the better.

40:58So think about ways to build that into your daily routine. So you can kind of behavioral economics can fall into place and you can just reap the benefits. If that means, you know, if you're like, look, I work in an office building. I don't have a lot of opportunity to get outside. One simple way to get a little bit more fresh air is to, if you live in a city, walk one extra subway stop or park your car far away from the entrance and walk for five minutes. Take a call that you can off video and go outside. So I'm really, the more the better. And in the morning is terrific, but sunlight exposure in the afternoon is also great.

41:31So many people are reaching for a coffee or, you know, a sugary sweetened beverage in the afternoon. And I get it. We all experience a little bit of dip and alertness. But if we combated that with either a power nap, if you're really tired, or simply going outside and walking around the block and getting exposure to sunlight can have the energizing benefits of caffeine without the jitters or the adverse implications for your sleep that night.

41:58Dr. Gabrielle Lyon:Hydration isn't just about drinking Coke Zero or other sugar-free sweetened beverages like Red Bull. Now I'm saying this for a friend. Or it's not even about drinking more water. It's about keeping the right balance of electrolytes and fluids. During life's most demanding season, like, I don't know, parenting, maybe pregnancy or postpartum, your body is going through massive changes. Blood volume increases, hormones shift, breastfeeding demands, you know, all those things. All of these life transitions, you probably need more and better hydration. And you need electrolytes like sodium, magnesium, and potassium.

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43:33Dr. Gabrielle Lyon:The power nap is interesting. Does it have to be 20 minutes? If you're tired enough, could you fall asleep for 10? What's so interesting about naps is maybe even less is beneficial and in a little bit of a different way. Research from MIT just revealed that brief naps, I'm talking seconds, moments of sleep over the course of the day, allow you a tiny bit of what we call hypnagogia sleep. It's that way station from sleep to wakefulness or the other way. It's that way station between wakefulness and sleep. And we're finding the research is showing that moments, seconds in hypnagogia sleep is associated with bursts and creativity and the ability to come up with solutions to complex problems.

44:17And what I love about that research is it really lowers the stakes. So many people say, oh, I can't nap. I see the research. I wish I could, but I can't. And what that says is don't worry. If you can get a couple minutes, you are in great shape to crush the rest of your day. It doesn't matter when you do it. The ideal time for a nap is in the dip in our circadian rhythm in the afternoon, which we all experience, whether you're a true evening person or a true morning person, we all simply experience a dip in our alertness in the afternoon. Why? Because we've been up for so many hours so far in the day, we've consumed a lot of information, there's a small drop in our core body temperature in the afternoon.

44:58So it's kind of the perfect storm for a nap. And that's also a really good litmus test for whether you're getting enough sleep. How do you feel in the afternoon? Are you exhausted? Are you like, listen, I need something to get me through. That's a really good barometer for whether you're getting enough sleep at night. 20 minutes is considered a power nap. So moments are, have been shown to be beneficial. And then what we call a power nap is generally, Can you just go under the bed?

45:24Dr. Gabrielle Lyon:Can you imagine? All right, guys, just give me a second. And my husband would do it. He could fall asleep right here for two minutes. I love it. I love it. But he needs a lot more sleep. He will get it once he's done with his residency. Yes, he needs a lot more. And he's doing such an amazing job. And remember, these periods of life are fortunately short-lived for many of us. The reality is most of us are not getting enough sleep. And I don't want anyone to feel bad as they're listening to this going, oh, I wish I could get more sleep. Is there a way to recover? And I don't just mean in the short term, the brain function, the executive function, you know, from years of lack of sleep, of doing all of the things, I don't know, from being in high school.

46:07All of the research is showing that sleep, the quantity and quality of our sleep at night is a significant predictor of our health, our well-being today, tomorrow, and well into the future. but importantly sleep is not going to be perfect every night and that's because sleep is part of the fabric of the human condition and stress is all around us i think now more than ever and if you've been experiencing stress you're you could have done everything else right but you go into your bedroom and you slip into in between the sheets and you toss and turn and it could be because of something a co-worker said or maybe stress that you weren't managing over the course of the day or some negative experience as you approach bedtime, you know, a scary Netflix show, the list goes on.

46:50But I don't definitely don't watch those. Yeah, sometimes there are things that are out of our control.

46:54Dr. Gabrielle Lyon:Do you have tips or tricks? I mean, I want to share mine because I have a handful that I think will solve everybody's sleep problems. It doesn't include alcohol. Number one, sheets. I know that sounds ridiculous, but the sheets have to be cool and they have to be really silky. Again, maybe it's a personal preference. It just makes if you are physically so comfortable, that's incredible. I couldn't agree more. And you want your bedroom to be the place that you look forward to. I can tell that you love your sheets and what a beautiful hack. Like that's one thing that's easy to change. Sometimes it's hard for all of us to go out and get a new mattress.

47:31But by the way, we should be sleeping on a mattress for maybe seven, maybe eight, maybe nine years, but not much longer than that. But we did some research recently and we found that one in three Americans have had their mattress for far too long, but a mattress is expensive. And I think some of the other elements of your bedroom environment, your pillows, your sheets, you can upgrade and they don't have to be expensive, but I do encourage go to whatever store, find sheets that you love, just like you love yours. And you want to look at your bed and want so badly to get in and look forward to sleep.

48:05Dr. Gabrielle Lyon:Does it matter the kind of mattress? Does it matter if it's firm or not firm? Is there any data that would support people sleep better with X or at a 5 % incline on a pillow? We are actually doing some of these studies right now to look at the best sleep surfaces and the components of an ideal mattress. Springs, you know, what is the topper, those types of questions. So stay tuned. But bottom line, there is a lot of individual preference. However, if you're talking about a really plush surface versus a, you know, a really firm surface, there is a lot of individual difference. And some people, you know, really look forward to a plush, you know, would love a plush experience, meaning something very soft.

48:47Others much prefer a firm surface. And I do think that your sleep position matters. So if you're a side sleeper, imagine your body on its side on the mattress. Are you a side sleeper? I am a stomach sleeper. Are you? Amazing. You're part of the minority. There aren't a lot of stomach sleepers.

49:04Dr. Gabrielle Lyon:I don't even know how that is possible. No, I think it's cool. I think it's fascinating that we all have these preferences that we just move into. I'm a side sleeper. And specifically, I kind of curl into the fetal position. Covered by pillows. My husband gives me such a hard time for it. He sleeps with one and I have like 16 on my side. Wait, then what about the kisser? Then what position is this? That is, it's so funny. There's actually scientific research on this. One of my favorite studies looked at different sleeper positions and had all these cute names for all the different types. And that is called the starfish pose.

49:33Dr. Gabrielle Lyon:My kids are 100 % starfish pose. Is Shane also? No, my husband doesn't move. He is a back sleeper. Okay. Interesting. And you have two starfish. That's so interesting. And this research was, it was interesting. They delivered the big five personality assessment and then asked questions about your sleeper position. They found that extroverts were associated. The starfish pose was you're more likely to be an extrovert if you slept as a starfish. So there you go. You have two extroverts maybe on your hands. And then what about the rest? I have to go back to the paper for all the other. I think you're more introverted if you sleep like I do, actually, which is true.

50:09I think I'm an extroverted introverted, I'd say. But the fetal position, you're a little bit more introverted. No, I'm face down. Nobody touch me. I'm just in my silky sheets. I love it.

50:22Dr. Gabrielle Lyon:So wear an eye mask and earplugs. I love that. Only wax earplugs when Shane is out. I love that so much because that is your routine. And what you've actually done is you've classically conditioned yourself to put in your earplugs, put on your eye mask, slip into your sheets, assume your position and go to sleep. And these little things make such a difference. And what I also love about that routine is you can take it with you on the road. I do. It's already packed. There we go. It stays packed. It's beautiful. And then you can have some protection because you never can guarantee a quiet bedroom when you're traveling, the light environment.

50:58So many even really nice hotels often have that sliver of light. What about air quality? We do see a strong association between the quality of our environment and our sleep. So if there's poor air quality, if it's stuffy, if there are allergens, we do see that that does interrupt our sleep. So buying an air purifier that can promote good air flow and air quality can be useful. Do you usually use an air filter? I do. I do like, and that's part of my sleep routine. I also do earplugs and I mask every night. I have brands that I love and I know that I can, they're my go-to things and I take those with me when I travel.

51:34I also do like a little bit of background noise. And so that is one nice thing that an air purifier provides is a little bit of background noise to attenuate any interruptions, a siren, even a town over you can sometimes hear in the country or if you're in an urban environment, there are definitely going to be noises.

51:51Dr. Gabrielle Lyon:Is there any data that would support and enhance his sleep or does something to the brain while the brain is going through its cognitive processes or consolidation? There is some research to show that pink noise, which are generally kind of natural sounds, can be associated with memory consolidation, believe it or not. What's the difference between pink and white noise? Basically a different frequency of sound. White noise tends to be a little bit more of a static or mechanic noise, whereas pink noise is typically a natural sound. It does make sense because white noise is a little jarring. Yes.

52:22So one of the biggest differences is that pink noise has more power at lower frequencies. It's typically natural sounds, rain or a babbling brook. And research has shown associations between the use of pink noise and memory consolidation, believe it or not.

52:36Dr. Gabrielle Lyon:You have talked a lot in the past about cognitive health, Alzheimer's, sleep, mortality. Are there sleep biomarkers that we would be able to look for? Sleep is a really rich process. And I think we often kind of hyper-focus on duration. Getting enough duration is a really important part of the equation. For the vast majority of adults, that's between seven and nine hours. And finding where you are on that spectrum, and ideally meeting it as many nights of the week as possible, realizing not every night is going to be perfect, but doing your best. Now, in addition to getting enough sleep is consistent sleep.

53:12That is another vitally important thumbprint of what constitutes good sleep health. Consistent sleep meaning falling asleep at the same time and waking up at the same time as many nights of the week as possible and keeping those times as close together as possible, varying by maybe 15 minutes here, 30 minutes there, an hour, but really no longer than that. Now, in addition, I want you to wake up and I want you to feel good from sleep. I want you to tell me that you feel restorative. Now, in addition to duration, to the consistency of our sleep, to being satisfied with our sleep, consolidated sleep is also vitally important.

53:50Sleeping as much as possible in one consolidated period of sleep that's not interrupted by multiple prolonged awakenings. Waking up from time to time is not a problem. As long as you keep the lights low, it's typically to use the bathroom and come back to bed as soon as you can. Those are the four markers of what we call a good night's sleep. and doing your best to meet those as many nights of the week as possible. But I think one of the things that we do is we kind of will hyper focus on duration and we'll talk about all of the dangerous and scary things that happen if you don't meet those things.

54:24But the truth is sleep is not going to be perfect every night. But the key is getting back on track as quickly as possible towards those four components. Now, those are kind of the manifestations of a good night's sleep. But the interesting thing about sleep as health behavior is it's also intimately related to a constellation of other things. I mean, I like to say that good sleep really starts when you wake up and getting plenty of blue light, natural sunlight exposure over the course of the day, the timing of your meals, this is your work, the composition of your meals, managing your stress over the course of the day.

54:59I think one of the most powerful tools that is really not widely understood is meditation and mindfulness. And those tools allow you to find

55:08Dr. Gabrielle Lyon:peace in a moment. Do you meditate before sleep? I do. I have a very regimented. What's your pre sleep routine? Well, after the kids are asleep, I do the whole wash my face. I use this essential oil. Yes, I do. And sometimes I use the wax ear plug. Sometimes I don't. I only use it when my husband is home does he snore is that why yeah we love him no he actually has sleep apnea really yes okay yes oh that's a whole other it is a whole i mean he has i don't know his neck is like 18 inches but i does he pop well yes he does amazing uh every which way it's very romantic always hasn't he's got like the sleep mask but i love that that's great news yeah the other aspect is i'll put on a meditation before you go to sleep.

56:00Dr. Gabrielle Lyon:I love that. 15-20 minutes. The same one do you use? No. I'll switch it up or that or some kind of noise. Not white noise, but some kind of. What's so beautiful about that is that it's your routine. And you've classically conditioned yourself to wash your face, to start your meditation, to put on your eye mask. And then your brain starts to understand that what follows is sleep. And I think sometimes we're, I mean, look, we have busy days now more than ever filled with information and all of this stuff. And then our day comes to a screeching halt at night. And I think that whole bedtime procrastination trend emerged because especially younger generations who are being told to do things all day long.

56:40And then they finally have some agency at night and they kind of push back on the idea of needing to sleep or needing to keep a bedtime. But a good night's rest is the strongest predictor of so many aspects of our waking success. Better productivity, better mental health, better mood, better exercise. When you exercise, you're going to get more out of your sleep if you're well rested. So many positive things when you can put sleep first. But our days are busy and then they come to a screeching halt. And I think that the time between, you know, you send the last email and for us as moms putting our kids to bed, it's so easy to think, you know, oh, I'd love to have a, you know, watch a show or, you know, but then unfortunately, what can happen is a lot of times that the next show will start and suddenly there's not a lot of awareness about your bedtime for many people.

57:28I don't watch shows for that reason. It's so dangerous. It's a risky game, right? Because then you want to know what happens next. Nope, I do not. If it's a show, I'm out.

57:36Dr. Gabrielle Lyon:Nope. I love that. And finding ways to relax and kind of fuel your soul and prepare you for sleep so that you can get the rest that your body needs. If an individual is sleeping, is there a way to see if there's an improvement in brain function? Would that be on an EEG? Again, that's probably outside of what would happen at sleep. But assuming that you can see the health of the brain while it's sleeping, is that? This is a great question. Now, of course, we need to be measuring brain activity to really know without a shadow of a doubt where you are in terms of light sleep, deep sleep. rapid eye movement sleep.

58:17Now, as it relates to brain health and function and structure, what I think the response I'd make is kind of twofold. First, if you take someone who has maybe what we call yo-yo sleep schedules, which are keeping one bedtime one night, falling asleep at 10 p.m. one night, 2 a.m. the next night, waking up at 10 a.m. one morning, 6 a.m. the next morning. So all over the map, which is quite common. So an irregular sleep schedule or maybe not getting enough sleep. So if you take someone who is maintaining a schedule like that, kind of sleep and wake times all over the map, sleep duration all over the map, and you move them into a regimented sleep schedule.

58:56During sleep, what's going to change is the structure is going to improve so that we're going to see a healthy cycling in and out of all the stages at the times that we would expect to see those stages. Again, deep sleep predominating in the first half of the night and rapid eye movement sleep in the second half of the night. So the structure of your brain activity over the course of the night will become more regulated and you're going to get more out of your sleep also. If you move someone from even someone getting enough sleep, but keeping that what we call yo-yo sleep schedule, falling asleep at different times all over the week, waking up at different times all over the week.

59:31We take someone like that who's getting enough sleep, but we look at the structure of their sleep, it's going to be all over the map. And if we move that person even to a slightly shorter sleep schedule, but a consistent one, so many things improve and their brain starts to understand oh this is when i'm going to fall asleep and then it can align itself within that period in a much more efficient way so that sleeper is going to move even if they're getting a little less sleep into a schedule that's more consistent and more regulated and wake up and probably have more energy than the person who is maybe even getting more sleep but sleeping all over the map is there any data and this might be

1:00:07Dr. Gabrielle Lyon:very hard to study, but that glymphatic system cleanage, the cellular turnover, do we know if it's more effective that mirrors that regular consistent sleep? What we do know is in lab studies, and these have been done in rodents because we can inject the brains of rodents. You don't want to do that to humans? So not quite, no. But what those, and what's so interesting is these findings were developed by a neuroscientist who wasn't necessarily a sleep scientist, but had this amazing finding. And in rodents, they found that the brains of these rodents in their studies that were sleep deprived compared to well rested, there was an accelerated clearance of toxic particles, which are observed, of course, in greater deposition in humans with Alzheimer's disease and related dementia as compared to healthy controls.

1:00:55So there is this increased clearance of these neural toxins in the rodents that were allowed to sleep to the tune of 60 % greater clearance in the well-rested rodents as compared to the sleep-deprived. Isn't that fascinating? It is. And mechanistically, what's happening there is there's this fluid. I like to think of it as like Drano. It's washing through the networks of our brain. And the glial cells expand when we're sleeping, allowing for accelerated clearance of those toxic particles. And that accelerated removal then results in better brain health over time. And we've looked at this in humans and we've found that in cohorts of older adults, we've published several papers on this where individuals enter the cohort at age 65 and we monitor them over time.

1:01:38And those individuals that are maintaining poor sleep schedules, they're struggling to get good sleep, maintaining inconsistent sleep schedules. They're at a marked increased risk for dementia as compared to the individuals who are getting consistent and regular healthy sleep.

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1:03:16Dr. Gabrielle Lyon:But as a sleep scientist, do you have concerns about their utility? This is a great question. And there are many millions of Americans who are using sleep medications. And there is a time and a place for medication. And for some patients, it is a lifeline. If someone is really struggling with sleep and has been for many years, So the first answer is talk to your healthcare provider and create a plan that works for you. Some of the research shows in the longer term, it is advantageous to move on to a behavioral change regime. But what is interesting in individuals who have the option and think they might be open to behavioral intervention or medication, the research that pits those two treatments head-to-head, pharmacological intervention and behavior change, specifically cognitive behavioral change for better sleep.

1:04:02We refer to this as cognitive behavioral therapy for insomnia or CBTI. When we take that treatment and we compare it to pharmacological intervention, those two patients suffers of insomnia and we compare them over time, the behavioral treatment wins out in the short and especially in the longer term. The unfortunate thing is we have a dearth of sleep providers that can provide this treatment. So that's one of the interesting and exciting applications of artificial intelligence for the future to think about providing some of these behavioral treatments.

1:04:33Dr. Gabrielle Lyon:I was going to ask you, you're very involved in sleep, sleep nationally, sleep globally. Where do you think that the future is going in terms of tracking, improving outcomes, testing? What is on the forefront of sleep? I am really excited about the intersection of some of the new technologies we're seeing and sleep. And specifically in my work, which is behavioral interventions, one of my areas of expertise is designing interventions to nudge and navigate patients and populations towards better sleep. And I am so excited at the idea of developing an avatar that could deliver tailored, personalized recommendations.

1:05:12It could help you make sense and act on your information from your wearable device. I mean, how exciting to take the problem, which is a dearth of sleep providers, and think about sleep interventions at scale. I also think the trend towards sleep tracking is incredibly exciting. These devices are increasingly relied upon by many millions of Americans. We published data in 2019 to show that one in three Americans were tracking their sleep with some sort of wearable technology. And I think that that number has only increased since that time. And so ensuring that these devices are increasingly accurate, increasingly small, and increasingly scalable.

1:05:51And soon, I hope also able to detect signs and signals for sleep disorders that people might not even be aware they have and might be limiting their sleep quality.

1:06:01Dr. Gabrielle Lyon:What would be one of those disorders? There are more than 80 differentially diagnosable sleep disorders, but a couple of the big ones are insomnia. Number one, it impacts anywhere between 30 and 40 % of the population, depending on how we're measuring it and studying it and in what population. But it's a condition that is debilitating for many. It is characterized by a chronic experience of difficulty falling asleep. So taking longer than 30, 45 minutes night in and night out. Difficulty maintaining sleep. So maybe being able to fall asleep, but then waking up and fighting, struggling to get back to sleep.

1:06:36Waking up too early in the morning and not being able to fall back asleep. And those are typically also accompanied with feelings of exhaustion during the day. Individuals who suffer from insomnia will tell us that they are absolutely exhausted. And the frontline treatment for sleep for insomnia is cognitive behavioral therapy for insomnia when available or pharmacological intervention and then kind of titrating to get onto a behavioral regime. Often with insomnia, we're trying to do away with maladaptive cognitions about sleep. Someone with insomnia will walk into their bedroom and their cortisol will spike, which we know interrupts your ability to relax and prepare for sleep.

1:07:18The second most concerning sleep disorder is obstructive sleep apnea. And that is, you know, is a condition marked by often loud snoring, loud raucous snoring, but also interruptions or pauses in breath. It's very scary. Yes. Yes, as a spouse. And so if those symptoms sound familiar to anyone listening, there are treatments. It's imminently treatable, which is the good news. And there are a range of options. but do find a sleep professional to coach you on the available options for your personal needs. And treatment is a significant predictor of better quality of life, better sleep, of course, better heart health.

1:07:57Often in patients with untreated sleep apnea, blood pressure can become uncontrolled. Many issues start to snowball when you're not getting proper treatment for obstructive sleep apnea.

1:08:08Dr. Gabrielle Lyon:That's absolutely true. Blood pressure, hemoglobin hematocrit, people they just don't feel well low testosterone do you guys use the upworth sleep score or no we do that you know the good news is there are a lot of you know very easy to deliver questionnaires that are very sensitive for your risk for these things so you don't often even have to go into a sleep lab just to get a sense of if you're at risk for someone for some of these conditions the upworth sleepiness um scale the insomnia severity index for any providers or clinicians listening, the Berlin questionnaire, the Stop Bang questionnaire are all widely used validated questionnaires that can give you, for instance, if you're a primary care provider, could give you a really good sense of whether a patient you're seeing is at risk for any of these disorders.

1:08:54Dr. Gabrielle Lyon:I want to close out this podcast with some common sleep myths. What is your top three myths that you here. Number one is this belief that there's some people out there somewhere somehow that do well on less than seven hours. And there might be, they're very poorly studied if they are out there, people who truly, truly need less than seven hours and they have a kind of appropriate health profile. But we do find there are several notable figures. Thomas Edison was one and there have been others across history, people who brag about not getting enough sleep. But Thomas Edison, And yes, he probably slept around four hours at night, but he had a cot in his office and he was known for taking protracted naps.

1:09:39So it is not in fact true that he was only sleeping for four hours a day. He simply wore that on his shoulder as a valor of honor somehow, despite all of the health concerns, but was in fact likely sleeping closer to seven. So really duration, we can't, there's no cure. There's no silver bullet. We do need to spend the time sleeping. But the secret is if you can combine a healthy duration of sleep with consistent sleep, you start to maybe need a little bit less sleep overall because your sleep will become so consolidated and so efficient within the time that we're provided. The idea of bedtime routines and the time before sleep, we don't often factor that in, but it is a vitally important part of a sleep routine.

1:10:22We're really not made to fall asleep immediately, quickly, right away, but we need to set ourselves up for success. And just knowing that can be helpful. And then creating a relaxing bedtime ritual, whether that's doing a couple breathing exercises, reading a couple pages in a book. One simple thing that I love to talk about is just one good thing from your day. I think sometimes at nighttime, all the bad stuff can snowball. But if you close your eyes and breathe and focus on one person that touched you in some way, you know, touched your heart, was kind to you, was thoughtful, one nice thing that you did can also sometimes make us feel good ourselves.

1:10:57that can just put you in the right headspace to drift off to sleep. And then number two, I'd say is this myth that falling asleep quickly is a sign of good sleep. So often people say, oh, you know, I'm such a bad sleeper. It takes me 15, 20 minutes. I'm like, you whoo. It takes a healthy sleeper 15 to 20 minutes to fall asleep. But I think that that some people think of that is, you know, what's wrong with me. So falling asleep quickly, just as if you were underfed and you were presented with a buffet and you helped yourself to a ton, you know, ate, you know, ton of food right away and you're, you're, you're starved for food.

1:11:32So similarly, if you're falling asleep right away, you're probably starved for sleep. And the third myth is snoozing. So many people at dinner parties or, you know, wherever will open their phone and show me a dozen snooze alarms and they're like, look at me, I get all this extra sleep. And that is another myth that hitting the snooze alarm will give you more sleep. What the vast majority of us are doing if we're using the snooze alarm is you're looking at your schedule. So you have to get up at seven o 'clock for work. And that's a non-negotiable to commute, to get ready, to do all of your things.

1:12:05So what people are typically doing is setting their first alarm for 630 and then for 640 and then 645. And I'm like, guys, let's just set it for seven and find the latest possible time. Set your alarm. And then it's going to be tough. You've got to get your butt out of bed. But just commit. Say, you know, I'm going to maximize my sleep and maybe put my phone on the other side of the room. So I'm not tempted to hit the snooze.

1:12:30Dr. Gabrielle Lyon:Again, it's genius. We're all inspired to sleep more. And you know what? You don't make it sound painful. Oh, thank you. That means so much to me. It's just important. You're really on this mission to improve cognition through sleep and just better life. And if we can get ahead of it, then we can get ahead of it for our children. Absolutely. And set them up for a more resilient life. If we can do that, it's the biggest gift as parents, giving them a good sleep. Think about it. When they are dysregulated, it's oftentimes when they're tired. 100%. Dr. Rebecca Robbins, you're just a joy. And it's so fun to be able to sit down with my friends and people that I just respect and admire the work that they're doing in the world.

1:13:13Dr. Gabrielle Lyon:So to this, I would say good day, but I'm going to say good night. Good night. And can we add sweet rums?