71. Dr. Michael Breus: Why "Feeling Fine" Doesn't Mean You're Sleeping Well

What if your exhaustion, brain fog, or cravings aren't a motivation problem—but a sleep problem no one's diagnosed yet? In this episode of Extend, I'm joined by Dr. Michael Breuss, a sleep specialist, and we dig into why so many high performers are chronically under-recovered, why sleep disorders go undetected for years, and how wearables are both helping and hurting. We talk about why 8 hours might be the wrong goal, how your chronotype should determine your schedule, why snoring isn't harmless, and the link between GLP-1s and sleep apnea. You'll also learn how mouth tape works, the surprising truth about blue light, and why most hydration habits fail. Dr. Michael Breus is a clinical psychologist, board-certified sleep specialist, and the author of five books on sleep. He's worked with Olympic athletes, celebrities, and CEOs—and in this conversation, he's bringing you the same level of clarity and insight. We Also Discuss: Why Sleep Disorders Go Undiagnosed for Years The Truth About Sleep Trackers and Deep Sleep Scores Is Your Bedroom Air Ruining Your Sleep? Mouth Tape: Helpful or Harmful? GLP-1s for Sleep Apnea? Here's What the Science Says Your Sleep Needs Change With Your Period Morning Breathwork That Replaces Coffee Sip vs Gulp: Are You Drinking Water Wrong? Thank You To Our Sponsors: TruNiagen: Whether you are looking to stay sharp, feel more energized or simple age better, go to https://www.truniagen.com/ IFit: If you are looking to elevate your home gym fitness experience with the best in fitness tech, choose IFIT. Go to https://www.ifit.com/NextHealth: Your destination for cutting-edge health optimization—from IV therapy to hormone balancing. Explore at https://www.next-health.com/Vitaboom: For supplements you can trust and wellness solutions tailored to your health, visit https://vitaboom.com/ Learn more about Dr. Shah: Website: https://www.drshah.com/ Clinic: https://www.next-health.com/ Instagram: https://www.instagram.com/darshanshahmd/ Learn more about Dr. Michael Breus Instagram: @thesleepdoctor https://www.instagram.com/thesleepdoctor/Website: https://sleepdoctor.com https://sleepdoctor.com/pages/dr-michael-breus

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:03Dr. Darshan Shah?

  Welcome to Extend with me, Dr. Darshan Shah, a podcast dedicated to cutting-edge science, research, tools, and protocols designed to help you extend your health span. Having become one of the youngest doctors in the country at the age of 21, and trained and board-certified at the Mayo Clinic, I've accumulated three decades of practice as a board-certified surgeon and longevity expert. Over that time, I've discovered that a mere 20% of health knowledge yields 80% of the results when it comes to your health span. We're living in a new era where we are creating a new healthcare system, no longer focused on disease management, but achieving optimal health and vitality. Join me as I interview world-renowned experts, offering you a step-by-step guide to proactively avoid disease, and most importantly, extend your health span.

• 0:49Dr. Darshan Shah?

  Did you know that all of us have a different sleep type or personality? And many of us are struggling with sleep because we do not respect these genetically programmed traits. In this episode of Extend, I'm going to sit down with Dr. Michael Bruce. He's commonly known globally as the Sleep Doctor, and that's because he's able to unpack how sleep, hydration, and breath are the overlooked foundations of longevity and sleep. We're going to be cutting through all of the noise in this episode and getting back to the basics that most experts skip over when they're talking about sleep. You're going to learn how to optimize your circadian rhythm, whether eight hours is actually necessary, and why mouth taping might actually backfire. We're going to talk about the surprising connection between poor sleep and chronic disease,

• 1:31Dr. Darshan Shah?

  and hot topics like GLP-1s, snoring solutions that actually work, and why your mattress might be aging you. There's a lot packed into this episode. I can't wait for you to hear it. Dr. Michael Bruce is a clinical psychologist. He's a board-certified sleep specialist, and one of very few people in the country that is actually an MD and certified in sleep. He has written many books on sleep that are New York Times bestsellers. He's worked with Olympic athletes, celebrities, and CEOs. And in this conversation, he's going to be bringing you the same level of clarity and insight that I've seen him put on stage multiple times. He's one of my closest friends in the longevity space, so I cannot wait for you to hear from him in this episode of Extend.

• 2:16Dr. Darshan Shah?

  Dr. Bruce, I'm so excited you're finally here on the podcast.

• 2:19Speaker 01

  I know, we're here. I'm stoked.

• 2:21Dr. Darshan Shah?

  We've talked so much over the years. We've known each other for a long time.

• 2:24Speaker 01

  We're friends. Everybody should know. We're friends. We hang out. We like each other, the whole thing.

• 2:29Dr. Darshan Shah?

  Yeah, and I love it. And I love also just, you know, we've shared the stage many times at many different venues. And we're going to be here in Barcelona pretty soon.

• 2:37Speaker 01

  I know, I'm pretty excited about that. That's gonna be a lot of fun. And we're going to Utah soon.

• 2:41Dr. Darshan Shah?

  Yes, yes. Oh, yeah, I forgot. Next weekend.

• 2:43Speaker 01

  I know.

• 2:44Dr. Darshan Shah?

  And I wanted to ask you, we're actually doing a Next Health Wellness Conference in our new location, which we just opened in Nashville. It'll be in April.

• 2:51Speaker 01

  I love Nashville. Nash Vegas, baby.

• 2:54Dr. Darshan Shah?

  You're invited to come and talk.

• 2:55Speaker 01

  Oh, I'd love to. Let's do it.

• 2:56Dr. Darshan Shah?

  I'd love for you to come to our first, it's our first Next Health Wellness Conference. It's gonna be in Nashville.

• 3:01Speaker 01

  Amazing.

• 3:02Dr. Darshan Shah?

  It's gonna be a full day of every topic in health, wellness, and longevity, and I'd love to have you there.

• 3:07Speaker 01

  Consider it done.

• 3:08Dr. Darshan Shah?

  All right. Well, we're, consider it done. Well, today's conversation that I wanted to have with you is on your latest book, these three incredibly huge topics. I'm glad they're like spelled out there. Sleep, drink, and breathe.

• 3:23Speaker 01

  Yep. So it's been interesting for me because I think wellness has gotten too complicated.

• 3:28Dr. Darshan Shah?

  Yeah.

• 3:28Speaker 01

  Right? Like, I'm at the gym. Tell me if you have this experience. I go to the gym and people are just kind of walking around. Like, do I go get a green drink? Do I get into the cold plunge? What do I do? Right? And, and it's not that complicated. I was listening to one of your other guests, Dr. Andy Galpin, on one of your former pods, and you know, he said, just do something, right? It's like, we're in the, we're in the habit of starting habits. Like, that's what you and I do, is we try to get people to do positive habits towards their health, right? And so that's where I think this gets interesting because it's just so complicated out there. But I'm saying all you have to do is sleep, hydrate, and breathe. Like, that is the beginning of anybody's wellness journey, right?

• 4:09Speaker 01

  And here's the thing, most people don't do them well enough to understand some of the benefits that you can get, right? So if you get crappy sleep all the time, you're not gonna feel so great, right? If you're not drinking enough water, you're not gonna feel so great. You might drink enough water to sustain your health. To sustain life, but having energy and being able to spend time with your friends and family and having purpose in your life. All of that comes from being having a well hydrated brain and body. Right? Same holds true with breathing, right? You can't really go very long without breathing, but if you don't do it the right way. You're not going to get the benefits from it. And that took me a while to figure out, by the way. But I started to notice like when I go for a run, right? How am I breathing before I run?

• 4:50Speaker 01

  In one pattern, then as I start to run, my breathing pattern changes. And then when I'm at a full gate, my, my breathing has changed as well. So. I started to realize that there are different times of breathing and different types of breathing and different ways. To breathe that can have tremendous, tremendous effects on your overall life. So. Sleep, drink, breathe, like wellness is too freaking complicated.

• 5:10Dr. Darshan Shah?

  Yeah, I, I love it. How you break it down and totally simplify it. Um, you've been talking about sleep. I mean, you're the sleep doctor.

• 5:17Speaker 01

  I am.

• 5:17Dr. Darshan Shah?

  You. You've been talking about sleep for a long time. I've learned a lot. From you about sleep. I've learned about, you know, having a good sleep routine.

• 5:25Speaker 01

  Absolutely.

• 5:25Dr. Darshan Shah?

  Fixing your environment to get optimal sleep.

• 5:28Speaker 01

  Yeah.

• 5:29Dr. Darshan Shah?

  And, you know, I'm really understanding what optimal sleep means. We've had a lot of talk about.

• 5:34Speaker 01

  Yes.

• 5:34Dr. Darshan Shah?

  Wearable devices and deep sleep versus REM sleep and these kinds of things. And. And you've written many books on sleep.

• 5:40Speaker 01

  Yeah, this is my fifth.

• 5:41Dr. Darshan Shah?

  Fifth book on, so.

• 5:43Speaker 01

  You'd think I'd run out of things to say, right?

• 5:46Dr. Darshan Shah?

  But what I love about it is every book I learn something new. So. I would love for you to kind of dive into a little bit of just on primer on sleep from your vantage point of being. You know, one of the most educated, knowledgeable speakers on sleep. Kind of, can you, can we do a little primer and then kind of some of the new things that we'll learn when we read this book?

• 6:06Speaker 01

  Absolutely. So. The basics, things that people need to know and understand about how does sleep work, right? So. The basics are inside your brain, there are two specific systems for sleep. One is called sleep drive. The other is called sleep rhythm. Okay. Very, very basic. Right? So when a cell eats a piece of glucose, something comes out the back end. One of those things is called adenosine. Works its way through your system, accumulates, makes you feel sleepy. That's sleep drive. Sleep rhythm is your circadian rhythm. Now you and I have many discussions about. circadian rhythms because my third book, The Power of When I created a circadian rhythm, sort of sleep animal for people to figure out called your chronotype. Now, I did not invent the term chronotype. I want to be super duper clear about that. We've known about chronotypes forever. So folks in the audience, you might be saying, what is this guy talking about?

• 6:50Speaker 01

  I'm talking about if you're an early bird or a night owl. Those are chronotypes. And those are specific patterns that are actually genetic, right? So I was talking with one of your staff and she said to me, she said, I gotta get up at four o'clock in the morning because I got stuff to do. I'm like, well, I hope your chronotype is aligned with something like that. Otherwise, it's gonna be pretty tough to do those things. So what people need to understand is you actually have a genetically pre-programmed sleep schedule and it's in your body. Believe it or not, you can actually find it on 23andme or ancestry.com if you want to. They have reports on morningness, eveningness, things like that. If people want to learn an easy way to do it, swing on over to my website, thesledoctor.com. You can go to chrono quiz and you can take my quiz.

• 7:33Speaker 01

  In about four minutes, you're gonna figure out which one of these you actually are. Now, it turns out what I'm famous for is I found a fourth chronotype. So we used to know that early birds, night owls, people in the middle, right? I discovered that there was a fourth one that's an irregular sleep pattern. Dolphin, right? Dolphin, exactly. And it makes up right 10% of the population, right? We have 350 million people here in the United States. That's 35 million people. That's a lot of people who've got disrupted sleep. And so number one, know your chronotype because it tells you what your bedtime should be. The second biggest thing that people can do is wake up at the same time seven days a week. Now, you're gonna say to yourself, what, Michael, I want to sleep in on the weekends. I want to catch up like this. Come on, can we do this?

• 8:18Speaker 01

  Let me explain why this just turns out to not be the best idea. You will catch up on some sleep, don't get me wrong, but at the end of the day, this is not gonna produce for you the type of sleep that you're looking for, right? So as an example, if you're on a diet, you don't just eat salads five days a week and chocolate cake two days a week, right? That's not how that works, right? Otherwise, you ain't gonna lose any weight. You got it. You gotta follow the consistency throughout. And also, I think you and Galpin were, I keep harping on him, but a lot of the- Things that you find out in fitness actually work really well in sleep.

• 8:47Dr. Darshan Shah?

  Right.

• 8:47Speaker 01

  So like, you know, if you can have that repetitive nature to it and have that consistency, your body knows what to do. So what I've discovered is if you can wake up at the same time every day, it actually helps you fall asleep better at night. Let me explain the biology. You already know this, but for the audience.

• 9:03Dr. Darshan Shah?

  No, please.

• 9:03Speaker 01

  Here's what's interesting is your core body temperature rises, rises, rises throughout the night. And it hits a peak around 10:30 and then begins to drop. That's a signal to your brain to release melatonin, let you start to go to sleep. Then your core body temperature drops, drops, drops, drops, drops. Okay? At some point in time, if it doesn't increase, you go hypothermic. That ain't good, right? It happens somewhere between one and three in the, in the morning. That's when most people have a tendency to wake up from sleep, right? So number one, if you're waking up from sleep in the middle of the night, it's not your fault. It's biology. Your but here's the thing, most people, they're gonna err, ah, ah, and they roll over and they fall back asleep. Or they get up, they go pee and they come back to bed and they go sleep, right?

• 9:44Speaker 01

  What ends up happening then is they fall back asleep and then you wake up the next morning, right? Seems like a pretty interesting process, very biological, no big problems here. I left out one step. When you wake up in the morning and sunlight hits your eyes and melatonin stops, your brain sets a timer for exactly 14 hours later.

• 10:01Dr. Darshan Shah?

  14 hours, right?

• 10:02Speaker 01

  Right. So it's called the melatonin phase response curve, right? And so here's what happens. If you're waking up at six during the week, 14 hours later is 8:00 PM. That's when melatonin kicks off, takes about 90 minutes to kick in there. You start to feel sleepy around 9:30, 10 o'clock. And now you're falling to bed, right? But if you've been at six and now you wake up at eight, you sleep in to that grand number of 8:00 AM.

• 10:24Dr. Darshan Shah?

  Yes.

• 10:25Speaker 01

  Guess what? Your melatonin doesn't kick off for an extra two hours. So instead of kicking off at eight, it kicks off at 10, takes even longer. If you do this for two days in a row, your entire body wants to shift to the new schedule. That's called social jet lag and that sucks.

• 10:39Dr. Darshan Shah?

  Yeah.

• 10:39Speaker 01

  So if you can just keep your sleep, wake up at the same time every day, set an alarm to wake up at the same time every single day, based on your chronotype, preferably, you will absolutely see a thirty to forty percent improvement in your sleep in three weeks.

• 10:55Dr. Darshan Shah?

  Yeah.

• 10:55Speaker 01

  No question about it.

• 10:56Dr. Darshan Shah?

  That's probably why people that use their weekends to sleep in have such horrible Mondays.

• 11:01Speaker 01

  Exactly.

• 11:02Dr. Darshan Shah?

  Right?

• 11:02Speaker 01

  That's why Mondays suck, right? Because you stay up late on Friday, sleep in on Saturday, stay up late on Saturday, sleep in on Sunday. What do you think your body wants to do on Sunday?

• 11:09Dr. Darshan Shah?

  On Monday.

• 11:10Speaker 01

  Right, it wants to sleep in.

• 11:11Dr. Darshan Shah?

  Exactly.

• 11:11Speaker 01

  It's a mess.

• 11:12Dr. Darshan Shah?

  I love that. So figuring out your chronotype.

• 11:15Speaker 01

  Figuring out your chronotype.

• 11:16Dr. Darshan Shah?

  Chronoquiz.com.

• 11:17Speaker 01

  Absolutely. Then also waking up at the same time every single day. And then I think the third big thing that's important out there that we need to think through is sleep disorders don't just go away.

• 11:27Dr. Darshan Shah?

  Hmm.

• 11:28Speaker 01

  So many people say to me things like, oh, of course I'm exhausted, I've got four kids.

• 11:32Dr. Darshan Shah?

  Yeah.

• 11:33Speaker 01

  You know, or, oh, I, I used to have sleep apnea, I, I lost five pounds and it went away. Bullshit, okay? Like, I'm here to tell you, like, that's not how it works.

• 11:41Dr. Darshan Shah?

  Right.

• 11:41Speaker 01

  Right? Like, if you've got a sleep disorder, it isn't going to magically disappear. And also, there's one thing that I've noticed, is there's really two things that go on with sleep. Either you have a sleep disorder, or you have messed up sleep and it's a window to something else.

• 11:55Dr. Darshan Shah?

  Mm-hmm.

• 11:56Speaker 01

  Right? So when you wake up and you feel unrefreshed, that's not how it's supposed to work. Something else is potentially going on.

• 12:03Dr. Darshan Shah?

  Something's going on, right.

• 12:04Speaker 01

  In this unit here, that you need to potentially investigate. Sleep sometimes can be that early warning signal of like, hey, something's not going well here. You know, like, I need you to focus on this. And that can have, apnea does that very easily. Most people don't even know that sleep apnea, I mean, between twelve and eighteen percent of the entire population has sleep apnea.

• 12:24Dr. Darshan Shah?

  Yeah. And most people don't even know they have sleep apnea.

• 12:27Speaker 01

  One in five. Like, think about that for a second. Like, you hang out with five people, one person there's probably got sleep apnea.

• 12:32Dr. Darshan Shah?

  Yeah.

• 12:33Speaker 01

  So it's very interesting when you start to think through and look at some of these idea sets. And so, very first thing I do with people is I screen them for sleep disorders. Right? And I think that's a valuable tool for everybody out there. And now, the real question is, oh my gosh, well- Do I have to go to a sleep lab now? Do I have to find a sleep doctor? Like, do I have to go to the hospital? Like, what does all that look like, right? So here's the good news. Since COVID, that has changed.

• 12:56Dr. Darshan Shah?

  Yeah.

• 12:56Speaker 01

  Everything is now home testing.

• 12:58Dr. Darshan Shah?

  Sure.

• 12:58Speaker 01

  I can send a Ring home with you. I can send a wrist unit home with you, or I can just push a button, have it sent to your house. You do the whole thing through telemedicine.

• 13:06Dr. Darshan Shah?

  Yeah.

• 13:07Speaker 01

  And by the way, it's only 200 bucks.

• 13:09Dr. Darshan Shah?

  Yeah, yeah.

• 13:10Speaker 01

  Right? So like, we do that on my website. Andy Galpin does that as well. So it's like, it's getting assessment is accessible.

• 13:17Dr. Darshan Shah?

  Right.

• 13:17Speaker 01

  And it's cheap.

• 13:18Dr. Darshan Shah?

  Yeah.

• 13:19Speaker 01

  Because nobody wants to be in a lab where somebody else slept the night before since COVID.

• 13:22Dr. Darshan Shah?

  Exactly, exactly, right. And, you know, I feel like for most people, in our clinic here especially, I would say about half the people get some sort of sleep evaluation done. Because a lot of them, even though they don't particularly know they are having disordered sleep, they, they exhibit signs of it, like you said, like they're, you know, they're tired early in, early in the morning, or they're unable to stay up through the, out the entire day. And there's a lot of problems that are occurring in people's lives is related to sleep. And, but they've never tracked their sleep, so they have no idea.

• 13:52Speaker 01

  Right.

• 13:52Dr. Darshan Shah?

  And we encourage people to do at least one or one week of sleep tracking. And so, you know, you introduced me to the folks at Happy Ring.

• 14:00Speaker 01

  Yeah.

• 14:01Dr. Darshan Shah?

  I'm really happy with that product.

• 14:02Speaker 01

  It is a great product.

• 14:03Dr. Darshan Shah?

  Yeah.

• 14:03Speaker 01

  So let's talk about tracking for a half a second. Is that okay?

• 14:06Dr. Darshan Shah?

  I would love to.

• 14:06Speaker 01

  Let's talk about tracking for a half a second, because number one, there are a lot of types of trackers out there, and we need to be thoughtful when we look at these data.

• 14:13Dr. Darshan Shah?

  Mm-hmm.

• 14:14Speaker 01

  Okay? Because number one, accuracy is an issue.

• 14:16Dr. Darshan Shah?

  Sure.

• 14:17Speaker 01

  All right? So like, you see me, I'm wearing the Aura Ring. I, I use the Happy Ring sometimes. Um, there's also another unit that you can wear on your wrist.

• 14:25Dr. Darshan Shah?

  Right.

• 14:25Speaker 01

  I want to be very, very clear. There are only certain trackers have been FDA approved to treat sleep disorders.

• 14:31Dr. Darshan Shah?

  Right.

• 14:32Speaker 01

  Happy Ring is an example of one of those. An Aura Ring is not diagnostic in nature. It is a tracker, meaning all it does is it feeds you back the data that it is collecting. So let's talk about that data that it collects for a half a second. So Aura is probably the best.

• 14:46Dr. Darshan Shah?

  Yep.

• 14:47Speaker 01

  Out there, but to be fair, it's probably 80 to 85% accurate.

• 14:50Dr. Darshan Shah?

  Mm-hmm.

• 14:51Speaker 01

  And when you look at the studies, it's good at telling you when you fall asleep and when you wake up. What it's not good at is Going into the depth of sleep. Dude, I can't count the number of people. You've seen it happen. When we've had parties, people walk up to me with their phone and they say, here's my score. What does it mean? Like, I only got 14 minutes of deep sleep, Michael. Like, what's going on with me? Right? So here's what I tell people all the time. Don't look at the data point. Look for the trend.

• 15:14Dr. Darshan Shah?

  Right.

• 15:15Speaker 01

  Right? You want to know about the delta. So if every day, your, your, your ring says that you got 14 minutes of deep sleep, I don't think I care. But if it says 14 minutes one day, 407 the next, and 632 the next, I want to know what happened on those days.

• 15:29Dr. Darshan Shah?

  Right, right.

• 15:30Speaker 01

  Right? Because it's okay that it's not accurate, as long as it's being consistently not accurate. I'll also tell you that there are some people that get kind of obsessed with the metrics.

• 15:39Dr. Darshan Shah?

  Sure.

• 15:40Speaker 01

  Right? Like, so many people are like, I'm, I'm really trying and I'm only getting seven hours and 43 minutes. And I'm like, dude, you have lost your marbles. Like, sleep is flexible.

• 15:50Dr. Darshan Shah?

  Yeah.

• 15:50Speaker 01

  Right? Like, people need to understand something. Like, let me give you a basic principle that I don't, I don't think people really can appreciate. Is just before you go to bed, your body basically kind of scans itself. And by the way, it's been doing it all day. And it looks at what kind of physical pressures did you put on yourself? And what kind of emotional pressures did you put on yourself? And by the way, then it determines how much of each stage of sleep you need. So remember, stage three, four is physical restoration. So if you go on a three-hour hike, you're gonna get more deep sleep.

• 16:20Dr. Darshan Shah?

  So interesting.

• 16:20Speaker 01

  Right? If you have an incredibly emotional day, you're gonna get more REM sleep because that's where more emotion comes through, right? And so your body kind of knows this. So what I'm trying to get people to think about is they need to trust their body.

• 16:34Dr. Darshan Shah?

  Yeah.

• 16:34Speaker 01

  You know, like, uh, Mark Hyman said something the other day I thought was great. He said, you're the best doctor in the room, yourself, right? Like, you know your body better than anybody out there. And I mean, you've seen this in your patients. You know, everybody's different.

• 16:47Dr. Darshan Shah?

  Everyone's so different.

• 16:48Speaker 01

  Even if they look exactly the same physiologically, they're still different.

• 16:51Dr. Darshan Shah?

  Yeah.

• 16:51Speaker 01

  Right? And so I think that's the thing that people have to remember is sleep is flexible. There is no one number for sleep, right? So there are a lot of experts out there who are gonna say, oh, you have to get, you know, seven to nine hours of sleep. You know, there's, uh, there's an expert that says eight is the great, you know, you've got to do that. Yeah, well, to be fair, I've been seeing patients for 26 years.

• 17:11Dr. Darshan Shah?

  Yeah.

• 17:11Speaker 01

  Okay? Very few people get eight hours of sleep.

• 17:14Dr. Darshan Shah?

  Yeah, very few.

• 17:15Speaker 01

  And by the way, I don't. Okay, I get about six hours and fifteen, sometimes forty-five minutes of sleep.

• 17:20Dr. Darshan Shah?

  Right.

• 17:20Speaker 01

  I've had no caffeine today. This is how much energy I have and it's ten o'clock in the morning.

• 17:24Dr. Darshan Shah?

  That's awesome.

• 17:24Speaker 01

  I've already worked out, right? I've already hit the sauna, like I've already run and here I am. So it's like, it's very, very possible to have a very nice lifestyle on less sleep. But again, it's individualized. And by the way, that can change.

• 17:39Dr. Darshan Shah?

  Right.

• 17:39Speaker 01

  Right? So with my female patients, as an example, sometimes I give them different bedtimes based on where they are in their menstruation.

• 17:44Dr. Darshan Shah?

  Sure.

• 17:45Speaker 01

  Right? So prior to their period, they're exhausted, so they go to bed earlier. After their period, they're the Energizer Bunny and so I, they can go to bed later.

• 17:52Dr. Darshan Shah?

  Got it.

• 17:52Speaker 01

  Be flexible.

• 17:53Dr. Darshan Shah?

  Yeah. So with the trackers, if the rings are not that good at telling you how much deep sleep you have or REM sleep, are there other methods that are better?

• 18:03Speaker 01

  So to be honest with you, no, there aren't. So here's the thing, you, when you wake up in the morning, how you feel physically, that gives you a very good indication.

• 18:12Dr. Darshan Shah?

  That's the best indication.

• 18:13Speaker 01

  Absolutely. You are your best thermometer, I swear. And so what I tell people all the time is, again, look at the tracker data once a week. Look at the trend of it, see which direction you might be going in. I'm also one of those guys, like I weigh myself once a week.

• 18:28Dr. Darshan Shah?

  Yeah.

• 18:28Speaker 01

  Right? Just to be on point.

• 18:30Dr. Darshan Shah?

  Sure.

• 18:30Speaker 01

  Because what I don't want things to do is creep in the wrong direction.

• 18:33Dr. Darshan Shah?

  For months and months, right?

• 18:34Speaker 01

  Exactly. Same holds true with sleep. That's how I would utilize the trackers there. I wouldn't use them to be diagnostic.

• 18:40Dr. Darshan Shah?

  Right.

• 18:40Speaker 01

  A lot of people are like, well, I have to get this much sleep because I read that this happens here. Dude, you are out the window on this one. Like, trust me on this, I've been doing this for twenty-six years. It's not how sleep works.

• 18:49Dr. Darshan Shah?

  Yeah, yeah. So I guess what you're saying, just overarching principle, is as long as you're maintaining good sleep routines and you're feeling refreshed the next day and you feel like you have energy, that's good.

• 19:03Speaker 01

  You're probably in great shape and I don't care how much you sleep. If you tell me that you go to bed on the regular, wake up on the regular and feel good, I don't ever want to see you in my office.

• 19:14Dr. Darshan Shah?

  Yeah. Yeah, and you're right. Some of the people that have the trackers, they're feeling great, but they're super concerned that they're getting thirty minutes of deep sleep according to their tracker.

• 19:24Speaker 01

  I, so I, I do a group. Sleep coaching now. So I just started this with a YPO, actually. We're doing this group sleep coaching where I've got seven people and I'm coaching them all at the same time. And half the people are like, well, what are you saying, Dr. Bruce? Are you saying I don't need eight hours of sleep? And I'm like, that's exactly what I'm saying, right? And they're and and it's almost like I'm having to pull them out of this old vernacular. This old idea in their head. So like, remember the food pyramid?

• 19:51Dr. Darshan Shah?

  Yes.

• 19:51Speaker 01

  Right. And you remember how terrible that was? That's eight hours of sleep. Yeah, exactly. Eight hours is exactly falls into that food pyramid universe.

• 19:58Dr. Darshan Shah?

  Got it, got it. That's that's super interesting to know because I think that a lot of people also like having numbers that they can follow and optimize along. But I think it's important to know it's sleep. It's really so individualized depending on your chronotype, first of all.

• 20:13Speaker 01

  Absolutely.

• 20:13Dr. Darshan Shah?

  And there, like you said, that, you know, I just want to highlight there's specific genes that have been identified.

• 20:18Speaker 01

  Oh, yes.

• 20:18Dr. Darshan Shah?

  Based on.

• 20:19Speaker 01

  So if you go into the P E R three area, a single nucleotide polymorphism and you look at P E R three. By the way, there's about sixty different markers that can do circadian rhythmicity, but that one is appears to be one of the biggest. That's where you start to see these differences of the early bird, the night owl, people in the middle, and then people that are all messed up.

• 20:36Dr. Darshan Shah?

  Got it, got it. And there's certain tips that you've also given people around their environment of sleep, right?

• 20:43Speaker 01

  Absolutely.

• 20:43Dr. Darshan Shah?

  So, you know, can you give me just some quick? Two or three things or maybe five things that people can do to optimize their sleep environment?

• 20:51Speaker 01

  Sure. So when we're looking at sleep environment, I would say, and I'm going to give you some unfamiliar ones, things that people may not already know. So I think the number one thing I would say, first of all, buy an air filter. Okay, and air purifier, air filter and put it in your bedroom. Why? It's the room you spend the most time in in your house, right? We want that air to be nice and clean.

• 21:10Dr. Darshan Shah?

  Right.

• 21:10Speaker 01

  Right? And so number one, I think the air becomes an issue. And so and that's across the board. Everybody out thirty bucks and on Amazon, buy yourself an air filter for your bedroom. Okay, good. That's number one thing.

• 21:22Dr. Darshan Shah?

  Does the air quality affect the quality of your sleep?

• 21:24Speaker 01

  Absolutely, it does, right? So, uh, so we're here in Los Angeles, right? And there was the devastation wildfires that came through here.

• 21:31Dr. Darshan Shah?

  That's what I'm asking.

• 21:32Speaker 01

  Right, right. Well, let's, well, let's do a double tap. Let's talk about that for a second, right? So when we start to look at air quality, does air quality affect your sleep? You bet it does. So when my, my daughter did an exchange program and lived in Beijing for six months. And when she, she would call me and she'd say, Dad, the AQI is high. And I'd say, what's an AQI? And she'd say, the air quality index. I didn't even know what it was, right? And so fast forward four years later, five years later, now we have these wildfires that are going on here in Los Angeles and the surrounding area. And then so we start to think about, how is that affecting sleep? So number one area I think it's affecting sleep in is air quality. No question about it. It's certainly something that we're thinking about. So the next question is, how is air quality affecting sleep, Michael?

• 22:17Speaker 01

  So number one, when your air quality is low, it means you don't have as much oxygen in your air, right? There's other constituents in there. That's the air quality issue, right? And so when that's going into your lungs, your lungs are now having to deal with whatever that new particulate is, whatever that new substance is. And so it's trying to look at and understand what it is. So the gas exchange slows down, right? Because just not as much air. There's other stuff in there, like it's kind of going on. And so when you start to see things like that, you start to see people's respiratory rate and depth change. And when your respiratory rate and depth change, it changes your sleep.

• 22:51Dr. Darshan Shah?

  Oh, got it.

• 22:52Speaker 01

  Right?

• 22:53Dr. Darshan Shah?

  Yes.

• 22:53Speaker 01

  So when you change your respiratory rate and you speed it up, you can't be in a deep stage of sleep.

• 22:57Dr. Darshan Shah?

  Makes total sense, right?

• 22:58Speaker 01

  Right? It pushes you into a lighter stage of sleep. So now you're breathing bad air and you're in a lighter stage of sleep, right? So it's not good for you. But I also want to say that I think something else is going on with the wildfires here in Los Angeles. I think it's fear.

• 23:12Dr. Darshan Shah?

  Yeah.

• 23:12Speaker 01

  I think.

• 23:12Dr. Darshan Shah?

  People don't feel safe when they're sleeping.

• 23:14Speaker 01

  I think that when you wake up one morning and you walk out your door and your neighbor, who you may or may not like, but you know who it is, who's walking the dog at seven o'clock that barks in the morning?

• 23:28Dr. Darshan Shah?

  Yep.

• 23:28Speaker 01

  Is gone.

• 23:29Dr. Darshan Shah?

  Right?

• 23:29Speaker 01

  Your church, your synagogue, your mosque is gone, right? Your dry cleaner and your school is gone. Everything that is fundamental to your feeling safe and grounded is left. Including, by the way, all of your possessions, more than. than likely and you probably had a grand total of twenty thirty minutes before you had to get out of your house after you got the alert. That's some scary shit.

• 23:53Dr. Darshan Shah?

  Yeah.

• 23:53Speaker 01

  Right, so fundamentally, I don't think people can sleep when they're scared.

• 23:58Dr. Darshan Shah?

  Right.

• 23:59Speaker 01

  It's the most vulnerable position you could possibly be in, right?

• 24:01Dr. Darshan Shah?

  Probably biologically wired not to sleep during those times.

• 24:04Speaker 01

  Exactly, so what I think is really going on here is I think a lot of people are having massive problems with safety. And when you're not feeling safe, you don't sleep.

• 24:14Dr. Darshan Shah?

  Yeah.

• 24:14Speaker 01

  So I think that's where a lot of this is coming from. And so I want to be super duper clear, I didn't mean to interrupt you, but I want to be super duper clear. Everybody who is affected by the fires in any way, shape or form, whether you live here or you don't live here, you're not supposed to be sleeping well right now. To be clear, that is a normal reaction to what's going on.

• 24:31Dr. Darshan Shah?

  And does this take time to just resolve itself or there's things people can do?

• 24:35Speaker 01

  Great question. So we're talking about environment, we're talking about sleep environment here. And so number one, people need to get into an environment that is safe. So I was talking about air quality as an environmental issue. Safety is an environmental issue, okay? You must feel safe. And what does it mean to do that? So I'm going to tell you about something that's kind of unique that happens at my house. So my wife, you you know my wife Lauren, right? So here's what goes on with her. When we go to bed at night, there's a big screen TV on all night long and there are two French Bulldogs in the bed right next to us. All night. I'm the sleep doctor, dude, right?

• 25:12Speaker 01

  She feels safe with the dogs there.

• 25:15Dr. Darshan Shah?

  Yeah, for sure. It's like an alarm system.

• 25:17Speaker 01

  Absolutely, it is. And let's be clear, they're French Bulldogs. They're, what are they gonna do, lick somebody to death? Like, it's not like we've got, you know, Dobermans and Shepherds and, you know, all kinds of guard dogs going around. But people, and there's data to support this, by the way, people feel safer, specifically women, when there's an animal either in the room or in the bed. So, right, so like, if you like to sleep with your animal, I don't think I care. Now, to be fair, if it's a Great Dane, it might be problematic. You might need a double king sized bed or something like that. But as long as you've got space and are not disrupted, I think that can be okay. A biggest factor, though, I think that's that goes on in environment is temperature.

• 25:53Dr. Darshan Shah?

  Yeah.

• 25:53Speaker 01

  Right? Temperature seems to be the big one. I gotta be honest with you, dude. I've saved more marriages as a sleep doctor than I ever would have as a marital therapist, dealing with temperature issues and snoring issues i- for couples in sleep. Temperature is key. Remember, sleep follows the core body temperature cycle. So as your temperature waxes and wanes, you're going to feel better or worse when it comes to sleep and you're going to get deeper or worse sleep. So the ambient temperature turns out to be important in the room, but there's a microclimate under the covers.

• 26:23Dr. Darshan Shah?

  Sure, absolutely. And that's the issue for most people.

• 26:26Speaker 01

  And that's the issue for most people, exactly. And so what ends up happening is also people don't really think a lot about the materials that are surrounding them. If you're lying in a memory foam bed, newsflash, you are going to insulate yourself and you are just going to get hotter and hotter and hotter. And I'm not talking sexy hot. I'm talking heat hot, right? Your body gets hot because you get depressed inside the foam and there's no place for the heat to escape, right? So you become insulated and now your body just heats up and heats up. And we know that your core body temperature has to drop for melatonin production. So being hot in the temperature sense.

• 26:56Dr. Darshan Shah?

  So popular then.

• 26:57Speaker 01

  So it's very, very interesting. I think what happens is, is the memory foam types of beds are popular. And by the way, I had one for years. What's great about them is they form to your body and they create a level of support and comfort. That's really, really good. Here's the, the big issue is America's getting fat, right? Like we're getting bigger and bigger and bigger. And so when you take a larger weighted person and you stick them on one of these, the depression is significantly more. So when you're a big person, it's probably not a great idea to have a memory, solid memory foam bed. Number one, it's hard to get out of it, right? But now they make hybrid beds. So there's springs on the bottom with memory foam on the top. I recommend those for my larger patients all the time because it makes more sense for them.

• 27:41Speaker 01

  It's easier for them to get in and out of it. And again, this is not fat shaming. Like, we're not talking about that. We're talking about, these are the logistics of how to get a good night's sleep in your environment because I believe that equipment matters, right? So I'm a runner, right? And when I go for a run, I can run a race in my flip flops with my boombox on my arm, but my time box, time's not going to be too good, right? But if I've got my Asics on and my dry fit wear and I'm listening to some good tunes, I can drill off a few miles and be happy with it. Matters for performance.

• 28:08Dr. Darshan Shah?

  Right.

• 28:08Speaker 01

  And sleeps a performance activity. I don't care what anybody says.

• 28:11Dr. Darshan Shah?

  So when you say equipment, you mean your pillow, your bed.

• 28:13Speaker 01

  Pillow, mattress, sheets, pajamas, keeping the temperature cool. Again, what works for you, right? So for my wife, what works is having the television on and two dogs in the bed. So guess what? After 26 years of marriage, I've adapted.

• 28:28Dr. Darshan Shah?

  Exactly.

• 28:29Speaker 01

  That's what happens sometimes, right? But, but you can see me like I get pretty good sleep. I also want to be clear. There are nights where we don't sleep together because I have something big the next day. And I want to make doggone sure I'm going to get a great night's sleep. A lot of people don't understand that the strength of your relationship has nothing to do with the location in which you sleep. A lot of people would say to me like, I can't go to bed at a different time than my partner. Or I can't sleep in another room than my partner because I'm concerned that it will affect our relationship. When you dig into that a little bit longer and you say, well, what aspects of your relationship would it dig into? Intimacy usually comes up first, right? They're, they're, they're like, we're not going to be intimate anymore. It's going to crater our marriage. We're going to, we're going to get divorced. Here's what I'll tell you.

• 29:11Speaker 01

  When people don't sleep in the same bed on the regular, they have more sex, not less.

• 29:15Dr. Darshan Shah?

  Really? Interesting.

• 29:16Speaker 01

  Because it's more planned.

• 29:18Dr. Darshan Shah?

  Yeah.

• 29:18Speaker 01

  Right? And they're like, hey, I'm going to be, I'm, I'm going to be in the, in the bedroom this weekend, right? Yeah, let's go. I've, I've been ready for it. So like you actually have more fun with it when you start to again, adapt and understand. So sometimes your environment might need to be a different room.

• 29:33Dr. Darshan Shah?

  So interesting. I remember old sitcoms where the husband and wife would be in two separate beds.

• 29:38Speaker 01

  Lucille Ball and Desi Arnaz. Remember that?

• 29:40Dr. Darshan Shah?

  Next to each other, two different beds. You're right. I love Lucy.

• 29:43Speaker 01

  Yeah, exactly.

• 29:44Dr. Darshan Shah?

  They knew what they were doing back then.

• 29:45Speaker 01

  I think they kind of did, right? It's kind of interesting, but as we get closer and closer, sometimes that can be disruptive, right? Now, again, to be clear, for some people it works great.

• 29:55Dr. Darshan Shah?

  Yeah.

• 29:56Speaker 01

  Right? I mean, there are cultures out there where a family bed is, everybody's in the bed. It's not my favorite, but that's what it does.

• 30:02Dr. Darshan Shah?

  Right, right.

• 30:06Dr. Darshan Shah?

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• 30:44Dr. Darshan Shah?

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• 31:23Dr. Darshan Shah?

  So back to temperature. You know, I think one of the problems with relationships and sleeping with significant others is the temperature differences that people need to have, right?

• 31:31Speaker 01

  Yes, indeed.

• 31:32Dr. Darshan Shah?

  There are devices, I have the Eight Sleep in my home, which I love, that you can modify your own temperature on your side of your bed.

• 31:39Speaker 01

  Absolutely.

• 31:40Dr. Darshan Shah?

  How do you feel about those kind of things?

• 31:42Speaker 01

  So I'll tell you. So number one, I've had the opportunity to play around with the Eight Sleep. There's also one called a Chili Pad. There's a few of them out there. So I want to be product agnostic, right? Just let's talk about temperature and sleep. So here's what I'll tell you is, it definitely works. Like, there's definitely something to it. But you have to be somewhat thoughtful in understanding what's going on. So like, as an example, I have a client who said to me, he said, "I want to start taking my temperature regulation device with me when I travel." Because he said, because when- When I travel, I sleep better when it's a cooler environment.

• 32:18Dr. Darshan Shah?

  Sure.

• 32:18Speaker 01

  Right? And I was like, that kind of makes sense to me. But are you gonna lug around a $4,000 piece of equipment that's, you know, big and it's an overlay on your bed and things like that, right? It it's almost impossible to do. So I have created something new and it costs almost nothing. So what people should do is you take a bo- plastic bottle of water, right? Take two of them and at whatever hotel or resort that you're staying at, ask them to freeze them. And then bring a tube sock, you know, like those old athletic socks? Drop it in there because there'll be some condensation, but one on one hip and one on the other hip.

• 32:47Dr. Darshan Shah?

  Really?

• 32:48Speaker 01

  It's like your own personal air conditioner, brother.

• 32:49Dr. Darshan Shah?

  Great. I love that idea.

• 32:51Speaker 01

  So what I tell people to do is do this first, before you go out and spend the money on one of these devices. And I want to be clear, these devices are pretty interesting. I like some of the things that they do. I do think that they're a little bit too expensive. But on the general, I think these can be very helpful and I think they can do some really cool stuff. But try this method first of the two frozen water bottles on either hip to see if that is helpful before you go out and do all of this other stuff.

• 33:14Dr. Darshan Shah?

  Yeah, I love that. You know, the other thing that we talk about with sleep environment, the thing, the talk tactic I always use with my patients is, is your bedroom like a cold, dark cave? Cause that's what our ancestors slept in, right? And so I think the darkness is incredibly important.

• 33:28Speaker 01

  So here's what I can tell you is darkness depends on people, right? So as an example, my wife sleeps with the television on all night long, doesn't seem to bother her at all, right? I wear an eye mask.

• 33:39Dr. Darshan Shah?

  Yeah.

• 33:39Speaker 01

  So that it doesn't bother me, right? So light can have interesting, you know, associations with people. Also, the amount of light that you get during the day determines how light changes for you circadian wise at night. So for example, if you have a lot of light exposure during the daytime, people say like, oh, should I wear my blue light blocking glasses at night?

• 33:58Dr. Darshan Shah?

  That's my next question.

• 33:58Speaker 01

  I know, I know. So here's what I'll tell you. I don't think, I like, I used to sell blue light blocking glasses. I looked into this, like I had the right lenses, the right frames. I looked at all the data. Here's what I'll tell you. You might have a 1% difference by using them. This is not gonna move the needle for you in a big, big way. Unless putting on your blue light blocking glasses then starts your habit of going to sleep and following a ritual or routine. Now, if that's what you If that's your method of turning on your sleep superpower is the second you put on these glasses, now you're doing your thing. I freaking love that. I think that's fantastic. But I want to be super duper clear. Walking around with blue light blocking glasses on from six o'clock in the evening until you fall asleep,

• 34:39Speaker 01

  it's going to help some, but it's really not going to be, it's not going to be the big difference maker. Much bigger difference maker, wake up at the same time every single day.

• 34:47Dr. Darshan Shah?

  Yeah.

• 34:48Speaker 01

  Right?

• 34:48Dr. Darshan Shah?

  Yeah.

• 34:49Speaker 01

  Not even a comparison.

• 34:50Dr. Darshan Shah?

  That's great advice. You know, you see people wearing like, there's some biologists, it seems like they wear them all day.

• 34:56Speaker 01

  Look, let's talk. Like Dave Asprey's got the yellow glasses during the day. He's got the True Dark at night. Now, let me tell you about his glasses because he and I have talked so many times about him. I love his glasses. His True Dark evening glasses, oh my God, those things will, you can't see anything. I actually have a pair of those that I like to wear internationally. Like when we go to Barcelona, you might see me have those on on the plane because it blocks it all out. And it's fantastic. So I like them when you're in a situation where there's a lot of light around and you need to block it all out. True Dark, they will do it for you. I don't know how much lift you really get from wearing them during the day. We'd have to ask Dave what he, like what energetically he seems to feel. But I have never really experienced anything of the, using them during the day to have any real effectiveness.

• 35:40Dr. Darshan Shah?

  I'm sure it's super individual as well, right? I mean, I think this is one of those N of one experiments that you can do. If it works, great. If it doesn't work, you tried it, it didn't work. You could, you know, give them to your buddy of yours or something, right?

• 35:51Speaker 01

  Now, what I will tell you is if you try them and they don't work for you, it's probably not the worst idea to give them to your kid.

• 35:57Dr. Darshan Shah?

  Hmm, that's a good idea too.

• 35:58Speaker 01

  Because kids have a lot more blue light exposure because they're on video games and, you know, their phones and YouTube and things like that. So what I would say is if you want to give it a shot, give it a shot. If it doesn't really work for you, toss them to your kids and say, hey, if you want to play video games, you got to wear these.

• 36:12Dr. Darshan Shah?

  Got it. You know, another kind of on the lighting topic is a red light at night, right? What, tell me about that a little bit.

• 36:19Speaker 01

  So here's what I can tell you. There's not great data.

• 36:21Dr. Darshan Shah?

  Yeah.

• 36:22Speaker 01

  Okay. I can tell you that when it's red light at night. It means there's no blue light.

• 36:27Dr. Darshan Shah?

  That's true.

• 36:28Speaker 01

  And that is a bonus.

• 36:29Dr. Darshan Shah?

  That's helpful, right.

• 36:30Speaker 01

  Right, but does red light itself?

• 36:32Dr. Darshan Shah?

  Yes.

• 36:33Speaker 01

  Do anything to propagate or promote sleep? I've not seen any convincing data on that.

• 36:38Dr. Darshan Shah?

  Got it.

• 36:38Speaker 01

  Um, but again, the lack of blue light can be helpful.

• 36:41Dr. Darshan Shah?

  Yeah.

• 36:42Speaker 01

  So like as an example, I had a patient, so this is kind of a funny story. So I had a patient, um, who came to me and, um, his sleep was all messed up. He was, I called him the exhausted executive, right? Forty-five years old.

• 36:53Dr. Darshan Shah?

  I know a lot of those. I'm one of those sometimes.

• 36:54Speaker 01

  Sometimes, me too. You know, forty-five years old, uh, we did a sleep study on him. He's negative for sleep disorders. We ran blood work on him. He was low on iron. You know, a couple of things that we could kind of fix and, and start to make him feel a little bit better. And when I was going through his nightly routine, he said, oh, I got the best night routine ever. I'm like, what is that? He says, I watch Star Wars every night. Right? So I'm thinking, okay, like, how bad could that be? He had a private theater room. Okay, a theater room, right? So it's like a movie screen and he would, and he had all of the Star Wars and he would fall asleep. I mean, he would be bathing in blue light. Like he would go into this theater room, like his kids are asleep. His wife thought he was a nutbar, right? And he's watching Luke Skywalker and falling asleep to it every night, right?

• 37:37Speaker 01

  And so I was like, you need blue light blocking glasses, but most people probably.

• 37:42Dr. Darshan Shah?

  Yeah, yeah, no, that makes total sense. And the, the, I think the other thing that's been helpful for me personally with the light is my bulbs in the bedroom. We had him change from white to yellow.

• 37:54Speaker 01

  Yeah, what great idea.

• 37:55Dr. Darshan Shah?

  Massive improvement. And we, then we did this for the whole house. So at nighttime, the house just turns the yellowish color of light instead.

• 38:02Speaker 01

  Absolutely. They're, believe it or not, they're now circadian lighting systems.

• 38:06Dr. Darshan Shah?

  Right, like Catra is one, I think.

• 38:07Speaker 01

  I think so, yeah. So you can actually come in, they can change your lights, change your bulbs, things like that. If you don't want to go cuckoo crazy, because those are kind of expensive.

• 38:15Dr. Darshan Shah?

  Right.

• 38:15Speaker 01

  There's two things you can do. Switch to yellow or lower the wattage.

• 38:18Dr. Darshan Shah?

  Right.

• 38:19Speaker 01

  Right? So what I do tell people is put forty watt bulbs in your bedside table lamps. If you can find lower wattage, the lowest wattage you can get. Now, if you read before bed, you don't want low watt light, but what you do want is a book light.

• 38:32Dr. Darshan Shah?

  Right.

• 38:32Speaker 01

  Right, because, because you don't want a hundred watts blowing. You out here while you're trying to read. But if you've got enough watts on your book on the page, your eyes will be able to adjust and see that without getting all that blue light exposure.

• 38:43Dr. Darshan Shah?

  Yeah, I use a book light at night.

• 38:45Speaker 01

  Yeah, I love the itty bitty book light or whatever it's called. Yeah, like that's what I do.

• 38:50Dr. Darshan Shah?

  Yeah, yeah. And then last point on light is using an iPad or a phone at night.

• 38:57Speaker 01

  Yep, let's talk.

• 38:59Dr. Darshan Shah?

  What's that?

• 38:59Speaker 01

  Let's talk about it.

• 39:00Dr. Darshan Shah?

  Yeah, let's talk about that. And then also, you know, the phones also have like a night shift mode.

• 39:04Speaker 01

  Yep, I know all about it. So let's talk about it. So the University of Rochester did the study looking at the night shift on the iPhone.

• 39:11Dr. Darshan Shah?

  Yes.

• 39:11Speaker 01

  It does not work. Period. Full stop. It doesn't change melatonin production whatsoever. Okay, it just doesn't do you any good. But I'm gonna be honest with you. I don't think that light is the biggest issue that's coming from an iPad or from your phone. I think it's engagement.

• 39:26Dr. Darshan Shah?

  Stimulation and engagement, absolutely.

• 39:28Speaker 01

  If you're trying to get your high score on Candy Crush, you ain't trying to go to bed, right?

• 39:33Dr. Darshan Shah?

  Or even the switching in social media from one video about one topic to another video about another topic. It is all that mental switching.

• 39:39Speaker 01

  Well, also, like, I know a lot of people for TikTok, right? So people have seen my videos on TikTok. I'm on there all the time. But I also enjoy, like, I watch it and things like that. But what I've discovered is it's super addictive. You lose track of time like this. And when you start to think about it, it feels very dopaminergic.

• 39:55Dr. Darshan Shah?

  Yes.

• 39:55Speaker 01

  Right? It's like, oh, that looks cool. Oh, I'm bored. Oh, that looks cool. Oh, I'm bored. You're gonna exhaust your brain. Like, here's what ends up happening. If you do, like, if you start scrolling before bed, here's what I think honestly happens is you get these dopamine hit, dopamine hit, dopamine hit, dopamine hit. And then you start to burn out. And now your body stays elevated.

• 40:12Dr. Darshan Shah?

  Right.

• 40:12Speaker 01

  Right? And so this isn't what we're, we need runway to land the plane.

• 40:17Dr. Darshan Shah?

  Yes, yes.

• 40:18Speaker 01

  Right? And so for me, runway is meditation, relaxation, breath work, prayer, reading, like, something to slow your roll. Because here's the object of the game. Most people don't know this. In order to enter a state of unconsciousness, you need a heart rate of 60 or below. Right? If you're doing all these other things, your heart rate ain't at 60. Right? So you've got to do things to slow yourself down. And you've got to give yourself the opportunity to relax and sleep. You have to recover.

• 40:45Dr. Darshan Shah?

  Yes.

• 40:46Speaker 01

  In order to get to your recovery.

• 40:49Dr. Darshan Shah?

  Makes total sense. Yeah. So the overarching theme there is, like you said, the runway. You have to 20, 30 minutes, 40 minutes before to start landing the plane.

• 41:00Speaker 01

  Yeah, yeah, yeah. And so, and so I broke that up. I created this thing called a power down hour.

• 41:05Dr. Darshan Shah?

  Okay, let's talk about that.

• 41:06Speaker 01

  Right. So, so if you went to bed at 10, I would say, starting at nine, chop that last hour up into three 20 minute segments. 20 minutes for just stuff you gotta do, 20 minutes for hygiene, and then 20 minutes for some form of meditation, relaxation, prayer, something like that. You can shorten the whole thing into 30 minutes, but you don't do 10, 10, 10. You want to make, you want to have a minimum of 15 to 20 minutes of meditation, relaxation, something that is lowering your heart rate. You might only spend five minutes doing hygiene and five minutes doing the few things you gotta do. Like in our house, we were getting backpacks together, finding shoes, sports equipment, you know, for kids. Because nobody likes the morning time when where's my lacrosse ball and, you know, all this other stuff. And so that's what we would do in the beginning.

• 41:49Speaker 01

  Then we would all, you know, brush your teeth, wash your face, you know, all that stuff. And then if it's your chronotypical bedtime, you go to bed.

• 41:55Dr. Darshan Shah?

  Yeah. Well, I love that. Let's talk about the last aspect of this was this noise.

• 42:00Speaker 01

  Yes.

• 42:01Dr. Darshan Shah?

  Obviously, it's hard to sleep when it's not quiet. There's some ways to mitigate that. One of them being like, put some earplugs in your ear.

• 42:08Speaker 01

  Yeah, yeah. Well, here's the weird thing. The most annoying noise, snoring.

• 42:11Dr. Darshan Shah?

  Yes. And so I want, that's what I was getting to. How do you mitigate the effects of you, yourself snoring and your partner snoring?

• 42:19Speaker 01

  So this is, okay, so this is a bigger topic, but there's a lot of different things to think about. So if we wanted to actually reduce snoring, that's one topic. Or do we want to deal with a snoring bed partner? That's another topic. Yeah. So we'll do with, deal with the snoring bed partner first, and then we'll get to how do you actually reduce the snoring? So dealing with the snoring bed partner. So here's what I'll tell you. It's annoying, right? And people get pissed. I've saved more marriages, as I've said, as a sleep doctor than I ever would have as a marital therapist. And snoring is a big part of that. One of the reframes that I do, remember, I'm a clinical psychologist, so I like to reframe things, is I remind people that if you can hear them, they're alive. That sometimes really sinks into. People, they're like, wait a second. Oh, I can, I can hear him breathing like he's not snoring all the time. I can, oh,

• 43:04Speaker 01

  now I feel safe. Yeah. Now it's okay. Is it annoying? Yes, of course it's annoying. I get that, but let's get past the annoying part. Because let's be fair, everybody's fallen asleep in loud environments before. Sure. Right? Have you ever fallen asleep in a car, on a bus, in an airport, on an airplane? Right. We're talking about very loud environments, much louder than your bed partner snoring. So there's an emotional component to what you're listening to. That's what has to be changed. So instead of this emotional component of being annoyed, you want to feel love. You want to say, oh, that's the person that I care about and I know that they're alive. They're, they're annoying the shit out of me right now, but I care about them and I know they're alive. And when you start to reframe that, you start to forgive them. Because by the way, it's not a hundred percent their fault. Yeah.

• 43:49Speaker 01

  Now let's fix the snoring, okay? Yeah. So you want to fix the snoring? Number one, weight loss. Like, I don't care what anybody says. If you lose between five and 10% of your body weight, your snoring goes down between 30 and 40 decibels. That's a lot. That's huge. Okay? And like 10% of a 200 pound person is 20 pounds. Right? Even 5%, we're talking 10 pounds. We're not talking about acres and acres of weight to lose here. But if you don't lose weight, you're gonna continue to snore. Let me explain. So you ever been in the garden, right? And, and you're, you're watering the plants, right? When you stick your thumb over the hose, the water squirts out faster. Mm hmm. Right? So in this analogy, your nose is the hose, right? So your nose goes up and down in the back. So anytime that your nose gets narrow, air moves faster, right? Total sense.

• 44:34Speaker 01

  When air moves faster, it causes a vibration, which causes a cadence, which causes a snore. Right? So we gotta do something to open the pipe. Right? So the air doesn't have to move so fast, right? So the number two thing, congestion. Right? So lose some weight, check out your nose, okay? If you've got any level of nasal congestion, any level of sinus infection, any particulates that are flying around up there that are causing any kind of inflammation, guess what? You've just narrowed your pipe, right? So you gotta deal with the congestion. Now, one of the things I tell people, and this is interesting, and, and you can only do it for one night, is if you want to find out if nasal congestion is the primary focus of your snoring. snoring, use Afrin.

• 45:10Dr. Darshan Shah?

  Yeah.

• 45:10Speaker 01

  For one night, you can't use it for long periods of time because your tissue, you know, gets, you know, addicted to it. But if you use it for one night and it's a silent night, now, now we know where to go.

• 45:19Dr. Darshan Shah?

  Yeah.

• 45:19Speaker 01

  Right? And so then we could focus on that. Another thing that is important to understand is snoring actually occurs in three different places. In curling the nasopharynx, the oropharynx, or the hypopharynx. Right? So there's all these different things that can come where the narrowing comes in.

• 45:32Dr. Darshan Shah?

  Sure.

• 45:33Speaker 01

  So that's the other thing that we have to start to think about. So as an example, if you've got a really thick neck, right? Crazy statistic. Any male who has over a seventeen and a half inch neck has an eighty-two percent chance of having obstructive sleep apnea.

• 45:44Dr. Darshan Shah?

  Wow.

• 45:45Speaker 01

  It's like the largest physical marker.

• 45:46Dr. Darshan Shah?

  That's one of the questions of the stop and questionnaire, right?

• 45:49Speaker 01

  Yeah, exactly. It's how big is your neck?

• 45:51Dr. Darshan Shah?

  How big is your neck?

• 45:52Speaker 01

  Right, so weight loss is going to be helpful. Decongesting is going to be helpful, right? Then also position has something to do with it. When you're lying on your back, right? Gravity throws stuff to the back of your throat, which narrows your throat. Roll to the side, you will not snore nearly as much. And to be fair, your bed partner's probably already given you the elbow and asked you to roll to your side anyway in order to do something like this. There are also snore guards, right? So mouth guards which slowly pull your jaw, uh, lower part of your jaw forward to open up your posterior airway space. Again, opening up the pipe.

• 46:23Dr. Darshan Shah?

  Yep.

• 46:23Speaker 01

  That can be helpful and there are surgeries out there that people can do. I mean, if I'm being honest, I, I don't love the snoring surgeries. I get it and why people do it. I think that if, if you're at the point where you have a snore, you're requiring a snoring surgery, you probably have several other physical things that are going on and we really need to check you for sleep apnea.

• 46:42Dr. Darshan Shah?

  Yeah.

• 46:42Speaker 01

  And I think that's the big underlying thing is if you've got somebody next to you snores, and by the way, one out of two people do, just listen for a half a second and see if they breathe, stop breathing one time.

• 46:51Dr. Darshan Shah?

  Yeah.

• 46:51Speaker 01

  If they stop breathing once, it's happening.

• 46:53Dr. Darshan Shah?

  It's sleep apnea.

• 46:54Speaker 01

  For sure.

• 46:55Dr. Darshan Shah?

  For sure.

• 46:55Speaker 01

  For sure.

• 46:56Dr. Darshan Shah?

  On the snoring piece, a couple of things I want to add to that is I, once in a while will notice a patient's nose is off and they have an obstruction from a previous broken nose.

• 47:06Speaker 01

  Yeah, well, deviated septums all over the place.

• 47:08Dr. Darshan Shah?

  Right, exactly. And um, seeing E and T doctor at that point in time and getting your nose fixed can be very helpful. I've seen people get help with that.

• 47:16Speaker 01

  Absolutely.

• 47:17Dr. Darshan Shah?

  Right?

• 47:17Speaker 01

  Absolutely.

• 47:18Dr. Darshan Shah?

  And then. Some people have uh um some people have their nasal valves collapsing.

• 47:24Speaker 01

  Absolutely. And you'll see that when you and you'll see that when people's nostril kind of caves in. And and so if you if you raise your head up like this and you breathe into the in in in front of the mirror. You'll see when it collapses. That's what we're talking about there. So I just saw this new thing. I don't know how good it is, but it's it looks like a breathe right strip. But it's got two pieces of metal in it. And then it's got a arc. Piece of metal that you put on top and it they.

• 47:49Dr. Darshan Shah?

  Pulls it open.

• 47:49Speaker 01

  Pulls it open, right? So I think that could that would certainly be better than a breathe right strip. There are also these things called mute, M U T E. And you there's internal nasal dilator. So it's like a small stent that you put up in here about thirty seconds. You don't feel it. I actually use it when I exercise and I get more air in when I exercise.

• 48:06Dr. Darshan Shah?

  Interesting. Okay, I haven't seen these.

• 48:08Speaker 01

  It's pretty cool. Now, if also if you're sleeping next to a snoring, I'll bring you some. If you're sleeping next to a snoring bed partner, another big thing that you can do, create a pillow wall.

• 48:16Dr. Darshan Shah?

  Yeah, exactly.

• 48:17Speaker 01

  Right? So people don't realize it. Sound is a matter wave. Right? And so if somebody's snoring at you, if you put a pillow in front of them, that sound wave will bounce back at them. And then they'll turn and face the other way. Uh, sometimes that's all you need is somebody to just turn the other way. So that's one thing. Earplugs, not a bad choice. For some people, especially if you've got a snoring bed partner, but again, you're having to adapt to what's going on with them and what's going on with them. Could actually be a medical situation. So please, please, please, if you've got a snoring bed partner, let's let's figure out if they got sleep apnea or not. It's so easy to get tested now. It's literally two hundred bucks online.

• 48:49Dr. Darshan Shah?

  Absolutely. You know, on this uh snoring, one last thing I'll add is there's a pillow called a sleep Nora pillow. Have you seen this? And it detects snoring and it turns your head for you.

• 48:59Speaker 01

  Yeah, so I think there are pros and cons to these types of things. One of the issues that I have it with uh with the devices like that. When you put electronics inside a pillow.

• 49:08Dr. Darshan Shah?

  Yeah, it's right by your head.

• 49:09Speaker 01

  Yeah, so like you got the leaky radiation because it's gonna because it's got to have a battery. It's got to have some kind of hookup in it. So I don't know what kind of radiation is going on. And you're literally putting your head on it every night. I mean, if if you're asking me, should you do something like a pillow related technology? Or lose some weight? I'm saying lose some weight.

• 49:29Dr. Darshan Shah?

  Have you seen the app SnorLab?

• 49:32Speaker 01

  I have.

• 49:32Dr. Darshan Shah?

  Yeah, what do you think about that?

• 49:33Speaker 01

  So I think there are pros and cons. I think the technology is getting better and better. I think what we're going to start to see over time is there will be a scenario where I would say in the next five years where you will be able to take a recording of your snoring, send it to your doctor and get a full diagnostic workup. That would not surprise me if that technology would be able to get to that point. I don't think we're there yet. I do think that SnorLab is doing a good job because one of the things that they do is they listen and they just basically listen for pauses. And then they let you know, hey, this could be going on. No different than your bed partner could.

• 50:07Dr. Darshan Shah?

  Exactly, exactly.

• 50:08Speaker 01

  But to be fair, I think it's a good, I think it's a good tool. And if it's something that you utilize and it helps you find diagnostic relief, absolutely, go for it.

• 50:16Dr. Darshan Shah?

  I think what's really important about sleep apnea too is the relationship to chronic disease. Obesity, diabetes, metabolic syndrome, Alzheimer's, stroke. So you gotta get it treated.

• 50:27Speaker 01

  Afib, like it just goes on and on and on.

• 50:29Dr. Darshan Shah?

  If you have sleep apnea, you have to treat it. And you know, you and I talked about this a little bit earlier, but now GLP-1s are becoming a mainstay of treatment of sleep apnea. So let's talk about that, yeah.

• 50:39Speaker 01

  So we just saw the very first FDA approved for Monjaro. It's now called ZepBound.

• 50:45Dr. Darshan Shah?

  ZepBound, right.

• 50:46Speaker 01

  And it is FDA approved for sleep apnea. It's the first time we've ever seen a GLP-1, you know, being now allowed to be used to treat sleep apnea. So let's break this down a little bit and think this through.

• 50:58Dr. Darshan Shah?

  And when it gets FDA approved, does that mean insurance will cover it for sleep apnea?

• 51:01Speaker 01

  Yes, it does. And here's what else it means. Medicare will cover a GLP-1 for sleep apnea.

• 51:08Dr. Darshan Shah?

  That's huge.

• 51:09Speaker 01

  That becomes massive within that universe right now. Is that really what's going to happen? And how is, like, look, I don't know what's going to be happening with Medicare and Medicaid services moving forward. The good news is, is that whether you're a fan of the administration or not, there's somebody who may be codified and be in charge of it, who really knows his stuff. His name is Mehmet Oz. He's a good friend of mine. And if he gets in charge of Medicare and Medicaid services, I think some really good stuff is going to happen.

• 51:34Dr. Darshan Shah?

  I just talked to him yesterday.

• 51:35Speaker 01

  Did you? Yeah. So I was talking to him earlier. So like, at the end of the day, there's a lot. A lot of interesting things that are going on in that universe. But let's again, double tap on GLP-1s. When we start to look at GLP-1s, is that the substitute for CPAP? Like, that's the question that I'm getting, like.

• 51:49Dr. Darshan Shah?

  That's a great question, right?

• 51:51Speaker 01

  Right?

• 51:51Dr. Darshan Shah?

  Because people hate sleep apnea.

• 51:52Speaker 01

  Of course they do, right? Who wants to sleep with a mask?

• 51:55Dr. Darshan Shah?

  But I will tell you, a lot of people, once they get it and they, they start using it, they say they can't live without it and they love it. So I think they hate the idea of it. And then a lot of people, once they get it, they actually love it.

• 52:06Speaker 01

  So I think that's exactly right. Here's what I would tell you is the compliance rate, initial compliance is low. It's like 30, 40%. But once you move past the first like three months and people really start to see the benefit, then people are locked and loaded on their CPAPs. I'll also tell you that the more severe your disease is, the better CPAP works and the more tolerable it will be because, well, I shouldn't say the better it works, because it works actually whatever severity of disease that you have. But it's more tolerable because when you've got really severe sleep apnea, you feel like shit. And when you stick on a CPAP mask, you feel significantly better. But when you have mild sleep apnea, you don't feel that, you don't feel that bad, right? And so you're not feeling that big rise in benefit as people do for severe ones.

• 52:49Speaker 01

  So could GLP-1s be something that helps somebody with mild sleep apnea? I think so. I think, I, I mean, look, as far as weight loss is part of sleep apnea, and to be clear, weight loss isn't the only thing that moderates and modulates sleep apnea, right? I mean, there's all kinds of aspects of your body. Weight is one factor. So if weight is the factor that is intensifying the severity of your sleep apnea, then I think a GLP-1 might make a lot of sense. But what I don't want people to do is I don't want people to say, CPAP into the closet, I'm gonna go online and I'm gonna get a GLP-1 and that's how I'm gonna fix my apnea. Because I don't know if that would really happen.

• 53:26Dr. Darshan Shah?

  Right, no, I think it's part of the, it's an exciting new part of a protocol to treat sleep apnea.

• 53:31Speaker 01

  Yeah, well, and also I think you and I were talking before about microdosing GLP-1s. Like, this feels like a situation where microdosing GLP-1s could be effective as well.

• 53:42Dr. Darshan Shah?

  So let me ask you on that topic. If someone is not overweight and they use a GLP-1, will that still positively affect their sleep apnea?

• 53:50Speaker 01

  That's a great question. I don't think anybody knows.

• 53:52Dr. Darshan Shah?

  Right, I think that'd be an amazing study for someone to do, right?

• 53:54Speaker 01

  Yeah, it'd be super interesting.

• 53:55Dr. Darshan Shah?

  There's quite a lot of people that are not overweight that have sleep apnea.

• 53:58Speaker 01

  Absolutely, absolutely. Probably between 15 and 20% of the people who have sleep apnea are fairly lean, BMI below 24, 23, something like that.

• 54:08Dr. Darshan Shah?

  Maybe you and I are next sleep apnea patient that's not overweight, we give it a try and see if it helps.

• 54:13Speaker 01

  I don't see any reason why we don't. I mean, I think it could be super duper interesting for folks. But I also, I, I, here's what I would say is another thing that I think a GLP-1 could do is they could make CPAP more tolerable. Right? So if you lose 15 pounds, we can lower that CPAP pressure.

• 54:28Dr. Darshan Shah?

  Right, I see what you're saying.

• 54:29Speaker 01

  Right? Then it becomes more tolerable, then you, you're, you're okay. Because remember, for GLP-1s, you gotta be on them for extended periods of time.

• 54:36Dr. Darshan Shah?

  Yeah.

• 54:36Speaker 01

  Right? And so that can be costly and that can be difficult and like, there's a whole host of, and by the way, not all GLP-1s work on everybody and GLP-1s have side effects and there are people who don't lose weight. And so like, there's a lot to this, but I think we're at a very exciting time right now because we've got at least one group that is now noticed. Hey, we've got a relationship between obesity and obstructive sleep apnea and we now have an indication to be able to use a GLP-1 to do that. I think that's pretty cool.

• 55:03Dr. Darshan Shah?

  That's really cool. And we're gonna find out a lot more. I mean, sleep apnea is such a huge, underappreciated problem.

• 55:08Speaker 01

  Right.

• 55:08Dr. Darshan Shah?

  And people are suffering with it just day to day because they're feeling tired.

• 55:13Speaker 01

  And they don't know.

• 55:13Dr. Darshan Shah?

  Right. And they get narcolepsy from sleep apnea, they don't know what it is. And then I also think just the level of chronic disease that comes from sleep apnea is massive.

• 55:23Speaker 01

  So when you, so like, think about it like this, like chronic disease feeds on the feeble body, right? So when your body is not humming and gunning and right, when your body is not at, you know, 80%, 90%, 100%, that's when chronic disease loves to come through the door, settle in and then really make your life terrible, right? And so what we have to do is we have to start thinking, how can, how is sleep apnea putting people into that compromised scenario? Because I think that's what's going on. Like, when you don't have enough air going through your system, your system doesn't work as well.

• 55:55Dr. Darshan Shah?

  Yeah.

• 55:56Speaker 01

  Right?

• 55:56Dr. Darshan Shah?

  Makes total sense.

• 55:57Speaker 01

  That's problematic.

• 55:57Dr. Darshan Shah?

  Makes total sense. So on that topic, we can move on to breathe because I feel like we've talked a lot about breathing already.

• 56:04Speaker 01

  Yeah, yeah.

• 56:04Dr. Darshan Shah?

  But there's a few more aspects here we can talk about. I'd love to be really complete here because I feel like, you know, you've done an incredible job in your book writing about this, but the way we breathe has changed a lot.

• 56:16Speaker 01

  Yes.

• 56:17Dr. Darshan Shah?

  In the last 100 years or so, right?

• 56:19Speaker 01

  Thankfully.

• 56:19Dr. Darshan Shah?

  What are the reasons for that?

• 56:21Speaker 01

  I think it's partially education. I think people are starting to learn. And let's be clear, there are people who've been doing breathwork for thousands of years. Right? Like, you know, like the yogis and the people of the world who've figured this out long before, you know, any of us, you know, people are like, oh, let's do breathwork, right? So this has been around for a long period of time, but one of the things that we have to understand is like, breathing sets the pace for your body. Right? So when you have, when you breathe heavy, right, or when you breathe deep, your heart rate gets to slow down. When you breathe shallow, your heart rate speeds up, right? And so breathing really is the, the pace setter for your body. And it's different based on emotion. It's different based on your age. It's different based on your physicality, all of these different things.

• 57:06Speaker 01

  If I had just learned breathwork when I was getting my PhD in clinical psychology, do you know how many more people I could have helped on the anxiety side of things? For sure, right. Because I was taught cognitive behavioral therapy. Don't get me wrong. I love cognitive behavioral therapy and I use it with my sleep patients daily. But I've now incorporated breathwork and breathing. And so let me break down what do I mean by breathwork and breathing, right? So as an example, my favorite technique for patients who wake up in the middle of the night and cannot return to sleep, which by the way, is the number one question that I get asked. I have them do four, seven, eight breathing. Okay? So let me describe for the audience what it is, since I know you already know. Four, seven, eight breathing was developed by Dr. Andrew Weil, and he developed it for the Navy SEALs. And so the goal was to slow people's heart rate down so they could fire in between the bullets.

• 57:50Speaker 01

  I mean, between the heartbeats, rather, right? So, great story, very interesting, blah, blah, blah. I decided to look at that and what I discovered was four, seven, eight breathing dumps your heart rate to about 60. Remember that statistic I gave you earlier? Absolutely. You need 60 to get into a state of unconsciousness. I'm on. So here's what I do is when you wake up in the middle of the night, one of the things I ask you to do is to consider using four, seven, eight breathing. Now here's why it's so good, is you breathe in for a count of four, you hold for a count of seven, you push out for a count of eight. And to be clear, these aren't strong pushes. It's a very gentle, very relaxed type of situation. But after 12 cycles, it dumps your heart rate to 60. So that's progress, number one. Number two, you have to count while you do it.

• 58:35Speaker 01

  Okay, and you know what that stops? Monkey mind.

• 58:38Dr. Darshan Shah?

  Right.

• 58:38Speaker 01

  Right? The biggest problem I hear from people in the middle of the night is, holy shit, I can't turn off my brain, Michael. I start thinking about my kid, or I start thinking about my work, or I start thinking about something else. And zzzzz, and now, there's no universe where I'm falling back asleep. But with four, seven, eight breathing, you're distracted by the counting, and when doing the breath work, you're lowering your heart rate. So this is a double hack that works really, really well in the middle of the night.

• 59:00Dr. Darshan Shah?

  Right. It could also help probably getting to sleep as well, right?

• 59:04Speaker 01

  Absolutely, it helps getting to sleep. And by the way, depending upon the number of cycles that you do, you can use it during the day. So, for example, like, right before I go on stage, like, remember, a couple of years ago, I was on Unleash, did Unleash the Power with Tony Robbins?

• 59:17Dr. Darshan Shah?

  Yes.

• 59:17Speaker 01

  Right? Right before, 12,000 people in the audience. Big show, right? Big stage. I did four, seven, eight breathing for about five or six cycles before I got on stage to just pull me down a notch.

• 59:27Dr. Darshan Shah?

  Yeah.

• 59:28Speaker 01

  Right? And allow me to focus and allow me to go. So this breathing can be useful in so many different areas. I mean, for sure, for life, but generally speaking, for sleep, I think there's a lot of different ways we can breathe. Now, one thing that we haven't talked about yet is nose breathing versus mouth breathing.

• 59:42Dr. Darshan Shah?

  Yes, absolutely. But before we go on to that, I wanted to say one real quick thing.

• 59:46Speaker 01

  Please.

• 59:46Dr. Darshan Shah?

  So, one of the mechanisms I don't think people fully appreciate is the way breath work affects our physiology. And it's through the parasympathetic and sympathetic nervous system, right? And so, what you're talking about, the four, seven, eight breathing, makes your parasympathetic tone increase over your sympathetic tone.

• 1:00:04Speaker 01

  Correct.

• 1:00:04Dr. Darshan Shah?

  And then, if you want to do the opposite, which is, say you want to be more on point and energized, then you use something like the fire breath, or is the Wim Hof type of breathing, right?

• 1:00:15Speaker 01

  Absolutely.

• 1:00:15Dr. Darshan Shah?

  Which is shallower.

• 1:00:16Speaker 01

  Kundalini, anything like that, yeah.

• 1:00:17Dr. Darshan Shah?

  Shallow and fast breathing brings you up in a more sympathetic tone.

• 1:00:21Speaker 01

  Right. So, so, what Dr. Shaw is talking about is, we have this thing called our autonomic nervous system in our body. And it branches out into sympathetic and parasympathetic. Now, I always get confused, so I think of sympathetic as like, you know that Rolling Stones song, Sympathy for the Devil?

• 1:00:34Dr. Darshan Shah?

  Yeah.

• 1:00:35Speaker 01

  Right? Like, I'm running from the devil. So I think that sympathetic is, is that, you know, fight or flight. And then, parasympathetic is that rest and digest.

• 1:00:42Dr. Darshan Shah?

  And you can turn either one of these on.

• 1:00:45Speaker 01

  Just by breathing in a particular way. That's what's so cool.

• 1:00:49Dr. Darshan Shah?

  And it's super powerful.

• 1:00:50Speaker 01

  Yeah.

• 1:00:51Dr. Darshan Shah?

  One of the mechanisms is you have the vagus nerve that runs from your head down through your chest and the breath work is stimulating that in a certain rate, but there's many other reasons that it works. A diaphragm, the movement of the diaphragm. And so it's a very powerful technique because our sympathetic, parasympathetic nervous system has been part of the evolution of not just humans, but almost every single animal since the beginning of the development of the brain.

• 1:01:15Speaker 01

  Right.

• 1:01:16Dr. Darshan Shah?

  And so it's very fundamentally ingrained in our brain pathways and our neural pathways for this to work. And we've, we've lost kind of the appreciation, I think, in modern times of breath work. It's such a powerful technique. I mean, I grew up in a household, the Indian household where Ayurveda and like you were saying, like yogic breathing.

• 1:01:35Speaker 01

  This has been around for thousands of years.

• 1:01:36Dr. Darshan Shah?

  Thousands of years. This was, you know, this was a true treatment modality because we did not have drugs and all these other things in the past.

• 1:01:43Speaker 01

  Exactly. And by the way, it works.

• 1:01:44Dr. Darshan Shah?

  It works, absolutely. So I'm glad you allowed me to double click on that a little bit.

• 1:01:48Speaker 01

  No. Sleep, drink, breathe. Like this is important shit.

• 1:01:51Dr. Darshan Shah?

  It is, it is.

• 1:01:57Dr. Darshan Shah?

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• 1:02:41Dr. Darshan Shah?

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• 1:02:55Dr. Darshan Shah?

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• 1:03:37Dr. Darshan Shah?

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• 1:03:47Dr. Darshan Shah?

  Let's talk about nose with his mouth breathing.

• 1:03:49Speaker 01

  Yeah, for sure.

• 1:03:50Dr. Darshan Shah?

  Maybe we can talk a little bit about mouth taping, too.

• 1:03:52Speaker 01

  Sure, I'd be happy to. So when we're looking at nose versus mouth breathing, right? The way I think about it is like when you're breathing through your mouth, it's like putting leaded gas in your car. Right? There's no filter. There's no, you know, obfuscation of any particulates. Like, everything that's in the air is going in your lungs. Breathing through your nose, actually, believe it or not, you get more air. That's something that most people don't realize.

• 1:04:14Dr. Darshan Shah?

  They would not think that, right?

• 1:04:15Speaker 01

  But you actually get more air, number one. And you've got cilia, you've got mucus, you've got turbinates. All of these things moisten the air, warm the air, and filter the air so that you're getting clean gas or clean fuel. Because to be clear, oxygen is fuel for your body. Like, that is what is going on here. Like, people are like, "Oh, I ate a good meal." Brother, if you ain't breathing, nothing's going to happen to that meal. We need that meal, we need oxygen to make that meal, you know, do something for us. So, understanding the importance of that level of breath work and things like that, I think, becomes really critical and essential.

• 1:04:46Dr. Darshan Shah?

  Yeah, exactly. And so, you know, I think there's a movement now to talk about why we should be nasal breathing over mouth breathing.

• 1:04:54Speaker 01

  And mouth tape.

• 1:04:55Dr. Darshan Shah?

  And mouth tape, right. So let's talk about mouth tape. How do you use mouth tape? How do you recommend people use it?

• 1:05:00Speaker 01

  Okay, so... I'm kind of in the middle on mouth tape if I'm if I'm being honest, which I always am with you. So at the end of the day, mouth tape can be dangerous and I want to talk about that part first.

• 1:05:10Dr. Darshan Shah?

  Please.

• 1:05:11Speaker 01

  So there are tremendous number of people who have not been diagnosed with sleep apnea and have undiagnosed sleep apnea. And if they tape their mouths, they will never figure out if they have it.

• 1:05:21Dr. Darshan Shah?

  Right, right.

• 1:05:23Speaker 01

  And it's much easier to tape your mouth shut than it is to go get a sleep study done. So my big warning is to every every patient I have who uses mouth tape. I think do a sleep study first and let's make sure that it's okay to do it.

• 1:05:37Dr. Darshan Shah?

  Yeah, makes total sense.

• 1:05:38Speaker 01

  Right, if you got apnea, I want to treat your apnea first. Now, let's say you do the study and you don't have apnea. Okay, Michael, should I tape my mouth shut? There's a couple of different things I think about this and I think it might be okay, but there's a couple of methods that you need to think about first. So number one, it's never horizontal. It's only vertical, okay? Number two, don't use any other tape than micro pore tape or surgical tape, which is specifically designed to not rip your lips off, right? I can't count the number of people, like people actually use Scotch tape, masking tape, duct tape, electrical tape, like it's unbelievable what people are doing out there. Also, by the way, if you have undiagnosed sleep apnea and you tape your mouth shut and you have an apnic event, guess what happens?

• 1:06:19Speaker 01

  You you open your mouth, you literally rip almost all the skin off of your lips. And by the way, that's painful.

• 1:06:27Dr. Darshan Shah?

  Really painful.

• 1:06:27Speaker 01

  That's really painful. So I would say mouth tape is something that you can use vertically. You need to use the right kind of tape. Also, I'm going to say one thing that I I just have a hard time with it. There are companies out there that have weird names for these mouth tapes. There's one out there that's called hostage and I think that's disgusting.

• 1:06:43Dr. Darshan Shah?

  Yeah.

• 1:06:44Speaker 01

  We have hostages still being held and somebody out there thinks that mouth tape should be called hostage. I think that is the worst taste I've ever seen.

• 1:06:52Dr. Darshan Shah?

  Oh, my gosh. So micro pore tape, this is standard medical tape you can find on Amazon or CVS.

• 1:07:00Speaker 01

  CVS, Duane Reade, wherever.

• 1:07:01Dr. Darshan Shah?

  It doesn't need to be these expensive brands of mouth tape, right? Exactly.

• 1:07:04Speaker 01

  Of course not.

• 1:07:05Dr. Darshan Shah?

  And. If you don't have sleep apnea, but you're snoring, is it okay to wear mouth tape?

• 1:07:10Speaker 01

  Yeah, I think it is. I think it is. But also, don't forget, there's other ways to fix snoring, right? So look at your congestion. Because remember something, when you tape your mouth shut, if you still got congestion, you ain't getting a whole lot of air.

• 1:07:19Dr. Darshan Shah?

  Right, right. And that's the issue. Like, I think a lot of people have tried mouth tape, but they feel like they can't breathe.

• 1:07:24Speaker 01

  Well, they feel suffocated.

• 1:07:25Dr. Darshan Shah?

  They feel suffocated, right. And that's because their nasal passage wage is not open.

• 1:07:29Speaker 01

  Yeah, exactly. And by the way, there are a lot of easy ways you can fix your nasal passages without having to use chemicals and things like that. A simple saline wash, a neti pot. There's this cool thing called the Navaj, or I don't know what it, I think that's what it's called, which pushes water through your sinuses and comes out. Like, this is all stuff that you can do that can be very healthy for you. Clean this whole sinus area out. And by the way, it might take care of your snoring, too.

• 1:07:51Dr. Darshan Shah?

  Yeah. And also, on the point of sinus congestion, one major reason for sinus congestion that's often ignored is poor gut health issues.

• 1:07:59Speaker 01

  Oh, yeah, absolutely.

• 1:08:01Dr. Darshan Shah?

  Food allergies, food sensitivities, gluten sensitivities. So those are some things to look at if you are having a lot of nasal congestion.

• 1:08:07Speaker 01

  Well, and I think that's important for people to realize. Like, when you think about your nose, you don't think about your gut.

• 1:08:11Dr. Darshan Shah?

  No, right.

• 1:08:12Speaker 01

  Right? And you need to think about your gut.

• 1:08:14Dr. Darshan Shah?

  Yeah, yeah, absolutely. Okay, great. So on the breath work point, other than at nighttime before going to bed, are there any breath work practices that you recommend?

• 1:08:25Speaker 01

  Yeah, I like to do like fire breath in the morning, when I wake up. It's a great way to wake yourself up in the morning. So I have a routine that I call the three fifteens every single morning. And so what I do in the morning is I have a chair that actually sits outside, because I like to be outside in the morning if I can. It's nice when you're in Southern California, you have the opportunity to do that. Not everybody does. If you're listening here from New York and you can't have a chair outside, I get you. But don't worry, spring is coming, right? And so chair outside, 15 ounces of water, 15 deep breaths, or whatever I want to do, and 15 minutes of sunshine, all at the same time.

• 1:08:55Dr. Darshan Shah?

  Love it.

• 1:08:56Speaker 01

  Okay, so there's a lot of science behind what I'm asking you to do. So number one, the 15 deep breaths, or the fire breath, or whatever you want to do, this wakes you up from a respiratory standpoint. It also brings you present and makes you focus. For folks out there who may not realize it, most of breath work is not used to make you calm down. Most of breath work is to either bring you present, or to bring you up, right? In in most ways, when you start to look across the depth of it. So I like people to do that. The second thing, hydrate, right? So we haven't talked much about drink yet.

• 1:09:23Dr. Darshan Shah?

  That's next. So we're gonna talk about that.

• 1:09:25Speaker 01

  So here's the thing, people don't realize it, but sleep in and of itself is a dehydrative event. You lose almost a full liter of water just from the humidity in your breath.

• 1:09:34Dr. Darshan Shah?

  Right.

• 1:09:34Speaker 01

  Every night. So I want you to hydrate before you caffeinate. Because so many people are like, oh, where's the coffee? Terrible idea. I'm not saying you can't have coffee. I'm not saying you can't have coffee. Because people would kill me for that.

• 1:09:47Dr. Darshan Shah?

  You skip your hydration because it eliminates your thirst there.

• 1:09:51Speaker 01

  Exactly, because the caffeine slows your appetite, which also slows your your thirst. And therefore you don't drink nearly as much. So I try to get people to get that load in. And then the sunshine turns off the melatonin faucet in your head. Right? So and being outside is good.

• 1:10:06Dr. Darshan Shah?

  Yeah.

• 1:10:06Speaker 01

  Like, I like being in nature. Like, it feels good. And I'll tell you one other kind of woo woo thing that I do that's kind of stupid, but I like it. I keep my shoes off and I put my feet on the earth. It's called grounding, right? There's not a lot of data on it, but you know what? It feels good, so I do it.

• 1:10:20Dr. Darshan Shah?

  My morning routine is very similar to yours. I like the breath work in the morning too, because it obviates the need for too much coffee in the morning. And what I mean by that, I used to do like three or four cups in the morning.

• 1:10:30Speaker 01

  Yeah.

• 1:10:31Dr. Darshan Shah?

  Now I just do one cup, do the breath work, the

• 1:10:34Speaker 01

  And it it literally is a substitute for caffeine, like wakes you up.

• 1:10:37Dr. Darshan Shah?

  And it works so well. Yeah. And being outside first thing in the morning and this it's not just the sunlight. I think there's a lot of um talk around exposing yourself to sunlight, but it's also just being in the outside environment.

• 1:10:49Speaker 01

  Absolutely.

• 1:10:49Dr. Darshan Shah?

  There might be cooler.

• 1:10:51Speaker 01

  Well, and like, you know, there's data coming out about forest bathing and, you know, being in nature and all the things that it does for you. Like, here's the other thing is, don't bring your phone.

• 1:10:59Dr. Darshan Shah?

  Yeah.

• 1:11:00Speaker 01

  Okay, like, just be quiet and breathe and drink water for 15 minutes in the morning. It will change your life.

• 1:11:09Dr. Darshan Shah?

  Absolutely. Biggest like life hack I have is I move my phone charger to my closet.

• 1:11:15Speaker 01

  Perfect. I love it.

• 1:11:16Dr. Darshan Shah?

  I put it in there at nighttime. It creates 30, 40 minutes of separation of my phone before I go to bed.

• 1:11:21Speaker 01

  Yep.

• 1:11:21Dr. Darshan Shah?

  In the morning, I don't go to my closet until after I'm done with my morning routine. Then then I go in there to dress. So it's another 30, 40 minutes in the morning without a phone.

• 1:11:29Speaker 01

  So good for you, dude. So good for you.

• 1:11:32Dr. Darshan Shah?

  We don't realize how much that cellphone in the last 20 years, being on our person, has really affected our health and our physiology, mental. You know, physical, all of it.

• 1:11:42Speaker 01

  I'll tell you how people can tell. Do what you do. Like, it drives my wife crazy. Like, sometimes she'll be like, I've been calling you. I'm like, oh, I left my phone. I actually don't know where I left my phone. Like, she's like, how do you not know where your phone is? Like, she can't be without her phone. Like, you need to be able to leave your phone in a room.

• 1:11:58Dr. Darshan Shah?

  Right.

• 1:11:59Speaker 01

  And be okay with it. You know?

• 1:12:01Dr. Darshan Shah?

  Especially during meals, too.

• 1:12:02Speaker 01

  Especially during meals. I think, I, I, I think there's data to suggest that you don't digest as well. And there's, I think there's some other things to show that, like, like, why do you need to look at YouTube while you're eating, you know, with your family? Like, I just don't think you do.

• 1:12:16Dr. Darshan Shah?

  Right. And I, I had Sean Stevenson on here yesterday.

• 1:12:19Speaker 01

  Oh, yeah.

• 1:12:19Dr. Darshan Shah?

  He and I talked about just family connection and having your phone with you, even on your person or just definitely on the table as you're eating.

• 1:12:27Speaker 01

  Right.

• 1:12:27Dr. Darshan Shah?

  It just, not, not only is it distracting for you, but it shows the people that you're eating with that you're distracted.

• 1:12:33Speaker 01

  Yeah.

• 1:12:33Dr. Darshan Shah?

  So it really needs to be in a different room. Sean does something awesome, which I'm gonna do. He leaves his phone in the car when he goes into.

• 1:12:41Speaker 01

  I know, but he goes, you know, he's a different human. Like, he does, he does really, really cool, fun, extreme stuff. I'll tell you what I, what I've done before that is interesting is if you're out with, you know, people is everybody stacks their phone and the first person who reaches for it pays the bill.

• 1:12:54Dr. Darshan Shah?

  I love that. I love that. That's fantastic.

• 1:12:58Speaker 01

  It works well.

• 1:12:59Dr. Darshan Shah?

  Yeah, it does. Okay, so we talked about breathing.

• 1:13:01Speaker 01

  Yep.

• 1:13:02Dr. Darshan Shah?

  Let's talk about hydration.

• 1:13:03Speaker 01

  Yes.

• 1:13:04Dr. Darshan Shah?

  So, why are we all so chronically dehydrated right now?

• 1:13:08Speaker 01

  It's such a great question. I, I, if I had to guess, I think there's a few different factors. One of the factors I think is stress. I think, because we're all sweating all the time, right? And the reason we're sweating all the time is because everything is moving too quick. Information is coming in too fast. We're getting anxious about so many things. So, number one, I think as the universe, we are sweating more, which means we are losing more water. That's number one. Number two, people aren't in the habit of drinking. Um, they really aren't. And to be fair, I don't think they're drinking the right way. So let me explain. So I don't know if you've ever seen this, like, I'm at the gym every day. And when I'm at the gym, I'm going over to the water station to fill my water bottle up. And there's always somebody in front of me and they've got their thing under there.

• 1:13:53Speaker 01

  They fill it about halfway, they pull it and they gah, gah, gah, gah, gah, and they drink it. And then they put it back in and they fill it up the rest. I'm the asshole who taps them on the shoulder and I say, hey, sip, don't gulp.

• 1:14:04Dr. Darshan Shah?

  Hmm.

• 1:14:05Speaker 01

  And they all tell me the exact same thing. They say, Michael, it's the only way I can get enough in me. And so my response is it's not going in, it's going through.

• 1:14:14Dr. Darshan Shah?

  Right.

• 1:14:14Speaker 01

  Right? So remember, when you wake up in the morning, your body is like a sponge, right? So you know, when you walk out to the kitchen and there's that little sponge, it's kind of shriveled up. It's hard as a rock and it's sitting on the sink, that's you, right? And if you open up the faucet full force, what happens? The water hits it, splashes and doesn't absorb. But if you open up the faucet a little, so that's gulping. If you open up the faucet a little, like sipping, droplets hit, they slowly absorb. And now it expands and now you have a useful tool.

• 1:14:41Dr. Darshan Shah?

  Hmm, it's great analogy.

• 1:14:42Speaker 01

  Sip, don't gulp.

• 1:14:44Dr. Darshan Shah?

  Yes.

• 1:14:44Speaker 01

  If that's one thing I could do.

• 1:14:46Dr. Darshan Shah?

  The rate of consumption makes a big difference.

• 1:14:48Speaker 01

  It does, it does. And that's why in that 15 minutes in the morning, I want you to complete the ounces. I don't want them completed in the first three minutes.

• 1:14:55Dr. Darshan Shah?

  Right, right.

• 1:14:55Speaker 01

  Right? Give yourself some time. Like, why is everybody in such a rush?

• 1:15:01Dr. Darshan Shah?

  They want to check it off their list, right?

• 1:15:03Speaker 01

  Right, right, right, right. And so that's one of the big areas, things that I learned about hydration was just how we're not hydrating. Then I started to look at, well, is our water safe? Right? Like, like what kind of water are we drinking? Like, do we need filtered water all the time? Do we need unfiltered water? Like, what's going on? So in the book, one of the things we do is we provide a website where you can punch your zip code in. You can get a water report of exactly what's going on in your county and your area with your water. You know, you'll understand the minerals that are in it. You'll understand how much fluoride is in it. You'll understand what chemicals are in it, right? And so people don't understand this, but the way we clean water is with chemicals.

• 1:15:39Dr. Darshan Shah?

  Yes.

• 1:15:40Speaker 01

  Right? And those chemicals leave residues in them. Doesn't matter how many times you filter them. That's, it becomes part of it. And so that is something that you are ingesting. And by the way, that could be harmful. I'm not saying it is for everyone. I'm not saying everything out there is harmful, but there are people who definitely have reactions towards that. So what's the easy way to fix this? Go buy a Brita filter for 20 bucks. I'm not, you don't, you don't have to have some triple osmosis, you know, $10,000 system. You can if you want, and those are really cool. And I've been to some people's houses and they got some really cool water. But like, if you don't want to spend a boatload of dough, just go to Target and buy a Brita filter. Or get on Amazon and buy a Brita filter and just drink water from that as your first step. Step number two is, you know, if you can, buy better water, right?

• 1:16:24Speaker 01

  So what are the different waters, Michael? Well, first of all, distilled water. There's no nutritional value in distilled water whatsoever. Do not drink distilled water. Like, there are people who are like, well, that's, that's the cleanest. No, that's the worst kind. That's what you put in your CPAP machine, that's what you put in your humidifier. That's what distilled water is really useful for.

• 1:16:43Dr. Darshan Shah?

  And you use that for machines because it definitely has nothing in it. So it's not going to clog up the machine.

• 1:16:48Speaker 01

  Exactly.

• 1:16:48Dr. Darshan Shah?

  You don't use it to drink, you don't drink distilled water.

• 1:16:50Speaker 01

  Right, so please, don't drink distilled water. Okay, step number two, is there a difference between spring water and mineral water? You bet there is. So these are legal definitions. You are not allowed to put on your packaging that you are a spring water unless you actually have water derived from a natural spring. Mineral water, the water actually has to move through minerals and rocks and it's tested to see if it has a mineral content to it.

• 1:17:16Dr. Darshan Shah?

  Interesting.

• 1:17:17Speaker 01

  Right, so when you start looking, like when you go to the store and there's 50 waters, look for the mineral water. And by the way, look for the one in the glass bottle. Cause it's probably the best one and it's probably the healthiest one. It might be a little bit more on the pricey side. I like those mountain spring or the mountain mineral with the green bottles. That's my favorite one, just because I know exactly what's in it every single time I drink it, right? And I think that becomes important as well.

• 1:17:41Dr. Darshan Shah?

  And that mineral water, it's the minerals that you need and there's no other contaminants in there?

• 1:17:47Speaker 01

  Generally speaking, no, and that's part of what they're trying to accomplish is they get it from the earth with the minerals that are on it. By the way, you can make your own mineral water. We give you a recipe in the book. Take a little bit of lemon, a little bit of Himalayan salt, a couple other things. You can actually create your own mineral water very easily on the cheap. Uh, you know, if that's something you want to do.

• 1:18:06Dr. Darshan Shah?

  What about those expensive powders you can buy?

• 1:18:08Speaker 01

  I was waiting for you to ask me about that one. We call them hydration multipliers.

• 1:18:13Dr. Darshan Shah?

  Yeah.

• 1:18:13Speaker 01

  Right, so this is the LMNT, the Liquid IV, the whatever. And to be clear, I'm agnostic, I don't care, we're just talking powder.

• 1:18:19Dr. Darshan Shah?

  Yes.

• 1:18:20Speaker 01

  Here's the biggest problem, they're almost all salt.

• 1:18:23Dr. Darshan Shah?

  Yeah.

• 1:18:23Speaker 01

  Right, so when you look at them, yeah, there's like a thousand milligrams of salt. Like, people don't need a thousand milligrams of salt. And here's the other issue, is people have a tendency to use them too frequently.

• 1:18:32Dr. Darshan Shah?

  Yeah.

• 1:18:33Speaker 01

  So what I tell people is, if you want to use a hydration multiplier, do it on a long day run. Right, like if you have a, you know, you run five miles during the week and you do a long run on the weekends, that's when you use your hydration multiplier.

• 1:18:44Dr. Darshan Shah?

  Right.

• 1:18:44Speaker 01

  Right, going on a three-hour hike, that's when you want to use a hydration multiplier. Right, or you're taking a spin class and you haven't, you know, and it's a hard one and they're gonna kill you and you're gonna sweat a lot, that's when you do it. But if you do that spin class every day, you do not do a hydration multiplier every day, because you're just gonna put way too much salt in the system. And then you throw your, remember, your system, hydration is really based on salt balance.

• 1:19:05Dr. Darshan Shah?

  Uh huh, right, right, right.

• 1:19:07Speaker 01

  So you don't want to do that.

• 1:19:07Dr. Darshan Shah?

  Yeah, if you use a fair warning, I think too much salt becomes an issue as well.

• 1:19:11Speaker 01

  And if you're hypertensive, it's probably not a good idea.

• 1:19:13Dr. Darshan Shah?

  Yeah, yeah, it could definitely drive up hypertension, but also, obviously, you know, we all need salt and I think there's been a...

• 1:19:19Speaker 01

  Oh, I'm not saying anything against salt.

• 1:19:20Dr. Darshan Shah?

  Yeah, yeah, but I do, but I do think there's over-usage of these, because people put like one or two of them in every single, you know...

• 1:19:26Speaker 01

  That's a terrible idea.

• 1:19:27Dr. Darshan Shah?

  Yeah, in every single bottle of water they're drinking, they're drinking like...

• 1:19:29Speaker 01

  That's a terrible idea.

• 1:19:30Dr. Darshan Shah?

  Five, six of these a day, it's crazy.

• 1:19:32Speaker 01

  There'll be consequences, for sure. I mean, they'll probably get kidney stones, right?

• 1:19:35Dr. Darshan Shah?

  Right, right, so, okay, so, um, and also like what you drink your water out of is important, so glass bottles for the most part?

• 1:19:43Speaker 01

  I kind of like that idea, but here's the, here's the truth of the matter is, we're all completely exposed to microplastics.

• 1:19:49Dr. Darshan Shah?

  Yeah, of course.

• 1:19:49Speaker 01

  And we've all got them in us, and they're in every part of us. It would be great to lower the exposure rate. Right, and so, if you can have a glass, right? If you can have a metal container that you bring with you, that you refill on the regular, I think that's probably the best way to go.

• 1:20:06Dr. Darshan Shah?

  Yep.

• 1:20:07Speaker 01

  If you possibly can. Now, I want to be clear, if the only thing you can drink water of is a plastic bottle, please, drink the water out of a plastic bottle!

• 1:20:13Dr. Darshan Shah?

  Right, right. The other thing about plastic bottles and water, from my research is that, is when you heat up the plastic, then actually...

• 1:20:20Speaker 01

  It leaches.

• 1:20:20Dr. Darshan Shah?

  It leaches into the bottle, so...

• 1:20:21Speaker 01

  Yeah, and so here's the problem, you leave your bottle of water in your car...

• 1:20:25Dr. Darshan Shah?

  Yeah.

• 1:20:25Speaker 01

  While you're at the store, now you have contaminated water.

• 1:20:28Dr. Darshan Shah?

  Yeah, massively contaminated water, so you definitely don't want to do that, and drink that bottle of water that was sitting around in your car for a long time.

• 1:20:34Speaker 01

  Right.

• 1:20:35Dr. Darshan Shah?

  Now, let's talk about hydration and sleep. Because I think it's a big topic too, because some people, I actually told this before I, when I was a kid, was drink a big glass of water before you go to bed.

• 1:20:47Speaker 01

  Pros and cons in either direction, okay?

• 1:20:49Dr. Darshan Shah?

  Let's talk about this, yeah.

• 1:20:51Speaker 01

  So, here's one of the things. So I give people, one of my hacks or rules is I call it the three, two, one rule. Stop alcohol three hours before bed, stop food two hours before bed, stop fluids one hour before bed, okay? And let me explain why. In my patient population, I don't deal with kids mostly. I mean, I have before, but I don't, I'm not on the regular. We got guys waking up to pee in the middle of the night. And so that becomes problematic. Now, sometimes that's enlarged prostate, sometimes it's over fluid, uh, things of like, like having too much fluid on board, things like that. And so what I'm trying to do is trying to figure out a balance. But what I've discovered in my research is the more water you can get earlier in the day, the better, right? And the easiest way to tell if you're hydrated is look at the color of your pee.

• 1:21:31Dr. Darshan Shah?

  Right.

• 1:21:32Speaker 01

  Right? If your pee is clear to light yell, light, light yellow, you're fine.

• 1:21:36Dr. Darshan Shah?

  You're fine.

• 1:21:37Speaker 01

  You're fine. In fact, in India, I, you probably know this, they have color charts.

• 1:21:40Dr. Darshan Shah?

  They do.

• 1:21:41Speaker 01

  Right? Uh, next to the urinals, so you can look and see if you're hydrated, because the heat there is so different than the heat other places. You get dehydrated, you don't even know it.

• 1:21:48Dr. Darshan Shah?

  When they put those stickers in the bathrooms in India, it really helped reduce the rate of people going to the hospital for dehydration, you know?

• 1:21:55Speaker 01

  Exactly.

• 1:21:56Dr. Darshan Shah?

  So, because that's when you, that's when you think about it, is when you're there.

• 1:21:59Speaker 01

  Hundred percent, hundred percent. So what I'm telling people is have a water goal, right? And then see if you can accomplish it with healthy, good water. So how do you figure out how much water you need? I'm gonna make it super simple. Take your weight, multiply it by point six, that's how many ounces. Period. Done.

• 1:22:14Dr. Darshan Shah?

  Weight in pounds times point six, that's how many ounces, right?

• 1:22:16Speaker 01

  Yep. Just make your life easy.

• 1:22:18Dr. Darshan Shah?

  And you know, I think sometimes people have said to me, well, if I'm not thirsty, that means my body is fine.

• 1:22:24Speaker 01

  Wrong.

• 1:22:24Dr. Darshan Shah?

  It's wrong, right? Because we know our thirst systems get worse and worse as we age.

• 1:22:29Speaker 01

  Not only that, our thirst systems get overridden by caffeine.

• 1:22:32Dr. Darshan Shah?

  That is true as well.

• 1:22:33Speaker 01

  Right. How many caffeinated beverages does a person have to have in a day to quench to, you know, lower their thirst? Not many, right? And it happens. And so when you have two cups of coffee in the morning, you don't even think about hydrating until lunch.

• 1:22:44Dr. Darshan Shah?

  Yeah, that makes sense.

• 1:22:46Speaker 01

  So like, again, just thinking, like, we're talking about the basics, right? Sleep, drink, breathe, right? Like, if everybody just gets back to the basics, like, we don't have to worry about blue light blocking glasses, and we don't have to worry about, you know, crazy temperature. What, if you just do some basic, basic stuff, you will be surprised at how well this unit will respond.

• 1:23:04Dr. Darshan Shah?

  Yeah, it's such a key message, and I love it that you've put it so concisely into this. This book is great because it's really an easy read for most people, right?

• 1:23:14Speaker 01

  That's the goal. Yeah, this is not a heavy lift, right? I'm not, I'm not getting you to do, you know, Kundalini breathing here, right? Like, what I'm here to, like, we talk about it in the book, but I give you a very simple plan. Within three weeks, I can have you sleeping better, well hydrated, and breathing to the point where you're actually seeing a benefit. Three weeks, and you do something three or four times a day. It's not hard, really isn't. You set alarms on your phone, you do exactly what it says. It's simple.

• 1:23:39Dr. Darshan Shah?

  I love that. Your last book was about energy as well and having good energy. And I want to touch on that a little bit because you talk about chronotype. I think that's really important, but part of your chronotype is also when you exercise in the day, right? So can you talk about that for our audience?

• 1:23:54Speaker 01

  Absolutely. So, energy and feeling energized comes from movement. So, actually, I'm gonna, I'm gonna keep referring back to Andy Galpin because he had a great part when you guys were podcasting. You really did. By the way, if anybody hasn't listened to that, go listen to it because you will learn a ton. So, there's a difference between exercise and activity, right? And that was one of the things he talks about. Exercise is formal, activity is more, you know, around and about. Here's what we're discovering is so few people do activity. Is they just go to the gym for 30 minutes.

• 1:24:23Dr. Darshan Shah?

  Yeah.

• 1:24:24Speaker 01

  They get some exercise and they don't have activity. And what that does over the course of time is very detrimental. So number one, joint health just flies out the window when you're sedentary, right? And, and by the way, when it hurts to walk and it hurts to lie down, you don't sleep well.

• 1:24:39Dr. Darshan Shah?

  Exactly.

• 1:24:40Speaker 01

  Right? So, we see Activity becoming very, very important. Also, by the way, single best way to improve sleep quality? Exercise and activity.

• 1:24:48Dr. Darshan Shah?

  Yeah.

• 1:24:48Speaker 01

  Single best way. And I want to be more clear. It's not just exercise and we need to break out cardio versus resistance versus stretching, right? So a lot of people don't even think about that. So look, I'm fifty six years old. And you know what I used to do? I used to get on the bike and do a spin class and then I would do a second spin class because I thought I would blow through more calories.

• 1:25:06Dr. Darshan Shah?

  Right.

• 1:25:06Speaker 01

  What a stupid idea that turned out to be.

• 1:25:10Dr. Darshan Shah?

  Yeah.

• 1:25:10Speaker 01

  Right?

• 1:25:11Dr. Darshan Shah?

  Yeah.

• 1:25:11Speaker 01

  At age fifty six, here's what my routine is. I go to the gym every single day. I spend almost twenty minutes stretching. Because I don't feel like getting injured.

• 1:25:20Dr. Darshan Shah?

  Right.

• 1:25:20Speaker 01

  Because that's the thing that takes you out of the game, by the way, is if you get injured and you're out, you're not exercising for three, four weeks, you lose every bit of gains that you had. And now you're back to square one. So the goal at my age is don't get injured.

• 1:25:31Dr. Darshan Shah?

  Sure.

• 1:25:32Speaker 01

  Right? So I stretch for twenty minutes. Then I have a very specific resistance exercise. So I do a hundred pushups, four sets of twenty five, and I do, I have curls that turn into extensions. So I'm doing full body exercise with resistance. I have three sets of those in several different ways. And then I do, I get on the treadmill and I either walk or jog for one mile. Right?

• 1:25:54Dr. Darshan Shah?

  Yeah.

• 1:25:54Speaker 01

  And then every Friday, I do a twelve minute Cooper's test.

• 1:25:57Dr. Darshan Shah?

  Yeah.

• 1:25:57Speaker 01

  So I test my own VO two max. So for folks out there who want to know what that is, so there's a great way to tell how well you are doing from a cardiovascular standpoint. It's called the VO two max test. But there's an easy way to do it, which is the Cooper's test, which is a twelve minute run.

• 1:26:11Dr. Darshan Shah?

  Right.

• 1:26:12Speaker 01

  So you just run for twelve minutes and then you look at the distance and you can actually punch it into a table on the internet and it'll tell you roughly, you know, what your cardiovascular health is. That's my whole routine. I'm out of there in forty five minutes.

• 1:26:23Dr. Darshan Shah?

  Yeah, that's fantastic. I love the weekly Cooper's test. That's, that's really good because you can get a good estimate of your VO two max. And it tells you, and for people who don't know, VO two max is about your body's utilizing oxygen at its maximal capacity. And you want that in your fifties, around fifties, somewhere in the fifties is where you want that to be.

• 1:26:41Speaker 01

  Yeah. So for folks out there who want to know what that translates to, as an example, in twelve minutes, you want to probably, if you can, you want to get to a mile and a half.

• 1:26:49Dr. Darshan Shah?

  Yeah.

• 1:26:50Speaker 01

  Right? If you can run a mile and a half in twelve minutes, you are in great shape for a fifty year old.

• 1:26:54Dr. Darshan Shah?

  Yeah, pretty good. Yeah. And then I like how you separate activity versus exercise because you need both.

• 1:27:00Speaker 01

  Absolutely.

• 1:27:00Dr. Darshan Shah?

  You need that time at the gym, plus you gotta stay active during the day.

• 1:27:03Speaker 01

  So for me, it's walking my dogs.

• 1:27:05Dr. Darshan Shah?

  Yeah.

• 1:27:05Speaker 01

  Right? And so, and I spend a lot of time with my dogs, which by the way, I think is also good for my mental health. And that's part of my morning routine. So I forgot to mention, after I do the things that I was talking about with you, I have a meditation that I do every morning for 25 minutes.

• 1:27:19Dr. Darshan Shah?

  Wow, 25 minute meditation?

• 1:27:20Speaker 01

  Every single morning. And I do it with my dogs. So they come into the room. One of the dogs likes to sit in my lap while I'm meditating. The other sits next to me. I honestly think they're getting something out of it.

• 1:27:29Dr. Darshan Shah?

  They probably are.

• 1:27:30Speaker 01

  I think they're digging on it. And by the way, it's nice getting a little unconditional love in the morning from my pups. Like, they're fantastic. So I layer that in. And look, it might sound like, oh, my God, when does this guy have time to treat patients and do work and all these different things? These aren't heavy lifts. These are not large time swaths that are being taken out of my schedule. I'm a busy guy. You're a busy guy. But in order for me to be able to be this productive and be able to give out this much information in a way, shape and form that people can understand it and do something with it, I have to be at my best. I have to be at my peak. And that means sleeping, drinking, breathing, exercise, movement, all of those things become incredibly important.

• 1:28:08Dr. Darshan Shah?

  No, such great advice. On the exercise piece, one other thing that you mentioned in your last book is what time of day you should be exercising by your chronotype?

• 1:28:16Speaker 01

  Absolutely. So let's break that down for a second. So remember, your chronotype, early bird, night owl, people in the middle, and then what we call a dolphin, which is somebody who's got very irregular sleep patterns, right? So early birds actually should be exercising earlier in the morning because that's when you have your exercise drive. That's when you have a lot more energy in that direction. But if you're a night owl, like I used to be, like getting up for the gym at 6:30, there's no motivation that gets me up to them. I mean, not only do I hate mornings, like, I hate morning people, right? Like, they're all chipper and ready to go at 6:00 AM. I'm a night owl guy. Like, I'm strolling into the gym at 1 o'clock in the afternoon, if we're lucky. As I've gotten older, that seems to have changed. So you notice how when you talk to your parents or your grandparents and you say, hey, I want to go to dinner, and they say, hey, I'll meet you at 4:30

• 1:29:00Speaker 01

  at the diner, right? Because their circadian rhythm is advancing earlier. Same is starting to happen to me as I'm getting into my older years. At age 56, I'm noticing that being a night owl is actually starting to change a little bit, and now I'm starting to rise Earlier, I'm starting to want to eat earlier, things like that happen as well.

• 1:29:16Dr. Darshan Shah?

  Wow, that's that's good. I mean, I think that timing your exercise.

• 1:29:21Speaker 01

  Based on your chronotype.

• 1:29:23Dr. Darshan Shah?

  Yeah, based on your chronotype was a game changer for me because I was running exercise in the afternoon, but really it's the morning when I should be exercising.

• 1:29:30Speaker 01

  And your workouts were better, right?

• 1:29:32Dr. Darshan Shah?

  Yeah, much better. The best part was I got it done with when I had the most energy.

• 1:29:36Speaker 01

  Yeah.

• 1:29:37Dr. Darshan Shah?

  I had the most energy in the morning. And so my workouts in the afternoon were never that good. And now the morning workouts are so much better.

• 1:29:43Speaker 01

  Yeah.

• 1:29:44Dr. Darshan Shah?

  Exactly. So much good information, man. Thank you so much for.

• 1:29:48Speaker 01

  Always a pleasure to hang out with you, buddy.

• 1:29:49Dr. Darshan Shah?

  I love it. Your book came out, how long ago?

• 1:29:53Speaker 01

  December 5.

• 1:29:54Dr. Darshan Shah?

  December 5. Okay, great. So we got to get this podcast out there.

• 1:29:56Speaker 01

  Absolutely. So for folks out there, if you get a chance, please pick up a copy, write a review. Let me know what you think. This is my fifth book on sleep, so I've been talking about it for a lot. But this one's different. So you're going to learn different things in this than you would have learned in any of my other books. And to be fair, I don't think anybody's covered these topics quite this way.

• 1:30:13Dr. Darshan Shah?

  Yeah, no, I love how concise it is, how easy of a read. And where else can people find you?

• 1:30:18Speaker 01

  So I'm pretty much everywhere. I am the Sleep Doctor on every social media that you can find. That is my website, thesleepdoctor.com. And so if you're looking for me, I'm there. I'm also on TikTok, believe it or not. We have some very fun TikToks out there for people to get some good sleep information and things like that.

• 1:30:35Dr. Darshan Shah?

  Fantastic. And I know you've done a million podcasts, and so just search your name.

• 1:30:39Speaker 01

  Well, listen to this one for sure. But you know, at the end of the day, I think if you're looking for good, solid sleep information and things that are practical that can be helpful, I think I'm your guy.

• 1:30:50Dr. Darshan Shah?

  Yeah, definitely, definitely. Thank you so much.

• 1:30:53Speaker 01

  Thank you.

• 1:30:53Dr. Darshan Shah?

  For joining me.

• 1:30:54Speaker 01

  This has been awesome.

• 1:30:54Dr. Darshan Shah?

  Can't wait to have you on again.

• 1:30:55Speaker 01

  Absolutely. I'll be here.

• 1:31:00Dr. Darshan Shah?

  Thank you so much for listening to the podcast today. Please remember to subscribe if you liked this episode and give us a good review and share a link with your friends. It really helps us support all of our efforts. I also want to remind you that the information shared on this podcast is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. Please consult with your healthcare provider. Or physician before making any decisions or taking any action based on what you hear today, especially if you have any underlying health conditions or on any medications. Your doctor knows your personal health situation the best and it's always important to seek their guidance.