Pod Insights The Diary Of A CEO with Steven Bartlett The Woman Who Helps Athletes Sleep: Stop Having Showers Just Before Bed! New Science! ‘Nappucino’ Phenomenon You Need To Know! About this episode Quicker decision making and faster reaction times, here's how you sleep like an Olympian
Dr Cheri Mah is a sleep scientist and Professor at the Stanford Sleep Medicine Centre, specialising in the relationship between sleep and performance in elite athletes.
In this conversation, Dr Cheri and Steven discuss topics such as, the sleep hacks of elite athletes, the link between alcohol and bad sleep, how to hack naps, and how sleep can improve your sex life.
(00:00) Intro
(00:32) What do you do and why do you do it?
(02:55) Who do you work with?
(05:39) What are the misconceptions about sleep?
(09:19) Study that increases performance by 12%
(12:44) NBA players losing based on schedule
(15:36) Players who slept more sprinted faster
(17:22) Athletes who have changed their careers by focusing on sleep
(20:38) Where to start getting better sleep?
(21:51) Does sound/music hurt sleep quality?
(22:52) Does temperature matter?
(24:47) Food timing for better sleep
(27:42) The food to eat before bed that will destroy your sleep
(32:36) What to do for a racing mind?
(34:07) What is the parasympathetic nervous system?
(38:13) Emotional link to better sleep
(40:17) Perception change on the importance of sleep
(42:34) Cognitive performance and sleep
(46:22) Sleep debt and how it works
(50:55) Muscle memory and its connection to sleep
(52:48) What's a nappucino?
(54:18) Do naps work?
(55:52) Is the snooze button bad?
(58:43) Are there different chronotypes?
(01:01:19) Does school start too early for kids?
(01:02:55) What parents should know
(01:05:20) Sleeping travel tips
(01:09:46) Sleeping drugs
(01:12:34) Does sex before sleep hurt quality of sleep?
(01:14:07) What is the most popular question Cheri Mah gets asked?
(01:16:54) How common is sleep apnea?
(01:18:47) What excuses do we hear for prioritizing sleep?
(01:20:25) Sleep and injury proneness
(01:22:08) Waking up early makes Steven hungry
(01:24:05) Is waking up in the middle of the night normal?
(01:25:38) How much does alcohol affect my sleep?
(01:26:43) Guests last question
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Transcript 17,918 words · 4 speakers
Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.
0:00 Speaker 00 I was 86% correct on accurately predicting when an NBA team will be at highest risk of losing strictly based on the sleep.
0:07 Steven Bartlett? Oh, gosh.
0:08 Speaker 00 Yes, and just 15 or 30 minutes can make a difference. So let's dive into just some very practical strategies to get the best sleep possible.
0:17 Speaker 02 Dr. Shereen Ma is a renowned sleep doctor and performance expert whose sleep optimization research has enhanced the careers of CEOs as well as athletes in the NFL, MLB, and Formula One. And has provided life-changing expertise to companies like Nike, Under Armour, and Google.
0:31 Speaker 00 For my elite athletes that I work with, sufficient sleep, it's a game changer. For example, we saw a 12% faster reaction time, a 9% improvement in free throws, and a 4% increase in faster sprint time. And when you experience what it feels like to be well-rested, you never want to go back to getting insufficient sleep. And it doesn't have to be these big jumps.
0:52 Steven Bartlett? I'd love to dig into that.
0:53 Speaker 00 Okay.
0:53 Steven Bartlett? So I'd have a shower, then I get straight into bed after. Is that good or bad?
0:57 Speaker 00 Tweak the timing of your shower and your hot bath to just an hour or two before bed. It's hard to grasp how much of a difference this can make in your life.
1:05 Steven Bartlett? What about sex? Does it have an impact on your sleep?
1:08 Speaker 00 Oh, okay, so...
1:10 Steven Bartlett? Is there anything that I can eat before bed that won't disrupt my sleep, but will get rid of the hunger?
1:13 Speaker 00 There's a pre-sleep meal. For example, cereal and milk.
1:17 Steven Bartlett? Cereal?
1:18 Speaker 00 And the reason why is because...
1:19 Steven Bartlett? And then I read this fascinating word, macchinio.
1:22 Speaker 00 Yes, this is a useful tool if you're a working professional and you need a little boost in alertness and performance. What you do is...
1:34 Steven Bartlett? Dr. Ma, what is it you do? And why is it so important in your mind that you do it?
1:42 Speaker 00 Great question. So I'm a sleep physician, but I spend a lot of my time and career trying to educate and advocate for people to prioritize sleep, right? This fascinating process that each of us does every single night and arguably is about a third of our lives. But many individuals don't do this very well, or they, you know, sacrifice it and overlook this area. I very much believe if you don't sleep your best, you will not be your best. Or... Counter to that is if your sleep is best, you'll be at your best. And what that means, if I unpack that a little bit more, is we often are sacrificing our sleep. We're underslept. We often don't have good quality sleep.
2:26 Speaker 00 We're very reactive to our sleep at nighttime, and it's the last thing that we think of at the end of the day when we wrap everything up. And that's arguably not going to put ourselves up to be the best we can be in the following day, right? And for my elite athletes that I work with, when you actually get sufficient sleep, you have practices that you plan into your day, and you actually are more proactive with that, it can be a game changer. And for them, when it comes to performance on the field, that can be the difference of a 9% improvement in free throw shots. It can mean reacting 12% faster. And so until you experience that, it sometimes is hard to grasp
3:10 Speaker 00 how much of a difference this can make in your life. But it is one of the foundations that will impact everything about how you function, your mood, how you feel, and ultimately perform the following day. If I could offer you, or yes, you specifically, Steve, if I could offer you something that's free and healthy and safe that's going to help you think more clearly, make better decisions, be in a better mood, be more productive and efficient, would you want it?
3:39 Steven Bartlett? Of course. How much?
3:40 Speaker 00 Exactly. And so it's really a decision of whether you want to invest your time to be able to be more proactive with this particular area of your life to get the benefits that come down the road with it.
3:53 Steven Bartlett? Who do you work with? Give me a sort of broad spectrum of the individuals, organizations that you've worked with on sleep. And why have they come to you?
4:03 Speaker 00 I've had an opportunity to work with a number of professional sports teams and athletes, as well as organizations over the years to try and apply the science into practice to help them improve their sleep, their scheduling, and their travel. So for example, I've been with the San Francisco Giants in Major League Baseball. I've worked with NBA teams like the Golden State Warriors, NFL teams like the Philadelphia Eagles. I won a Super Bowl ring in 2017 with them. To other sports organizations like Nike and Under Armour and ESPN to try and show how you can predict when NBA teams will lose strictly based on the schedule and
4:43 Speaker 00 insufficient sleep opportunities. To individual athletes who recognize, you know, hey, this is an area that I am not optimizing, and I know this can be such a valuable asset to extend my career, to prevent injuries down the road, and to help me be at my best.
5:00 Steven Bartlett? Do you ever work with CEOs?
5:02 Speaker 00 I do. I do work with executives and C-suite executives to try and help them be their best because they too are high performers, right? Their performance outcomes are maybe a little bit different than pro athletes where we're quantifying on-field performance and looking at their swim times and what they're doing when it comes to the, you know, on-court or on-field performance outcomes. But for these executives, they arguably are also making incredibly important decisions. They have to still react when they're under pressure, and they have to make good judgment calls. And so many of the things that I coach and try to recommend to my lead athletes are very much applicable to the C-suite executive or even just the working professional.
5:46 Steven Bartlett? That's really what I found so fascinating about your research and your work is that although there's a focus on athletes, as someone who is also traveling, is also very, very busy, also struggles with sleep sometimes because I have to perform late at night, whether that's on stage or with meetings or whatever it might be, I resonate with so much of it. And I also train in the gym pretty much every day if I can. And I've also noticed a correlation between things like injury in the gym based on how I'm sleeping and my quote-unquote sleep debt. But I want to confront two things. The first thing I want to confront is the misconceptions around sleep that you encounter over and over again. What are the like big overarching
6:28 Steven Bartlett? misconceptions that stand in the way of people believing in and or implementing the advice that you give them?
6:35 Speaker 00 I'll start with just this badge of honor that I really believe still persists in society, where you should get only four or five hours of sleep and should be able to perform at your best. And I think the tides are turning, and I do think that that is changing over the last several years, where there are more vocal advocates of, you know, elite athletes like the Tom Brady's who, you know, say everything is around performance enhancement. I need to go to bed early so that I can wake up early and to be ready to go for the day to, you know, the Simone Biles, who says, I need to get eight hours of sleep. And so I think that that is a badge of honor that is now shifting. And now it's going to become, well, if you're not getting your eight, nine, 10 hours of sleep, right,
7:19 Speaker 00 then you're actually at a decrement to yourself and you're actually not going to set yourself up to be the best that you could possibly be, whether you're on the field as a pro athlete, or whether you're leading an organization, or trying to go after whatever it is that matters to you, right? And I think that's going to continue to shift, but I'm excited about it because that's one thing, until you experience that that difference and that life transformation of what it feels like to be well rested, then it can be a game changer. You never want to go back to it again when you're getting insufficient sleep.
7:52 Steven Bartlett? Are there any misconceptions around how to sleep and sleep hygiene and, I know, the quantities of sleep we need that also seem to stand in people's way of them getting a great night's sleep?
8:04 Speaker 00 Yeah, so I think that there is a misconception that everyone needs a certain amount of sleep. There's individual variability. So the the recommendation from the American Academy of Sleep Medicine and the Sleep Research Society, so two of our national organizations here in the US, recommend minimally seven hours of sleep. But that's the lower threshold. You might actually need eight hours or nine hours or more to feel well rested, right? I personally feel terrible on seven hours and I much more need the eight to nine hours. And there's those in that individual differences. So you need to find what you feel well rested, you're able to function well at a high level during the day. And that will then be your individual requirement. So I think there's this misperception
8:46 Speaker 00 that everyone needs a certain amount, but you need to find what works for you. And it's all about small changes. So if you're not at seven hours, I think you shared sometimes you're you're you're under that.
8:56 Steven Bartlett? Oh, yeah, sometimes, yeah.
8:57 Speaker 00 You know, it's about fifteen or thirty minutes more can make a difference. So if you're getting six hours, then I'm going to recommend getting fifteen minutes or thirty minutes more every day for this one week. And then get fifteen or thirty minutes more next week, so that you're building from, say, six hours of sleep to six and a half hours. And you may not think that that's that much, but we can all do fifteen minutes more, right? We're less scrolling, we're doing what we're wrapping up our day. But those fifteen minutes add up, where that's the difference of like an A student to a B student, or eleven minutes more sleep is the difference
9:30 Steven Bartlett? Is actually.
9:31 Speaker 00 of a B student to a C student in one of these studies.
9:34 Steven Bartlett? Really?
9:34 Speaker 00 Exactly. And then over the course of a week, fifteen minutes will be almost two hours more sleep than if you didn't.
9:41 Steven Bartlett? What was the study?
9:43 Speaker 00 So this was a study done in high school students, but looking at the difference of how much they're sleeping versus their correlation to to grades. And so that fifteen minute difference was shown to be that A to B student, eleven minutes from that B to C student.
9:58 Steven Bartlett? Oh, gosh.
9:59 Speaker 00 Yes. So it doesn't have to be these big jumps, but small changes over time will will add up.
10:05 Steven Bartlett? The the study I have in front of me here, which I've printed out, also highlights the importance of sleep for everybody, but also specifically in this case for athletes. Can you walk me through this study and what you found in this particular study on the adult male basketball players?
10:22 Speaker 00 Yes.
10:22 Steven Bartlett? And how you conducted the study?
10:24 Speaker 00 So in this study, we looked at the men's basketball team, and we really tried to examine if we extended their sleep over five to seven weeks, encouraging them to get nine or ten hours of sleep every single night to pay back what we call an accumulated sleep debt. Would we see any impact on performance outcome? Specifically, would we see an impact on reaction time, their fatigue levels? And would we see an impact on their on-court performance? Specifically, free throw shots, three-point shots, sprint time? And these are measures that we would do after every regular practice. And over the course of those five to seven weeks, we demonstrated that we saw a 9% improvement in free throws,
11:07 Speaker 00 a 9% improvement in three-point shots. We saw a 12% faster reaction time and a 4% increase in faster sprint time. And so these were, the quantification which was novel at the time was what was quite fascinating because it wasn't that 1% that I think many elite athletes are trying to find every small way to adjust their training to get that 1% better. Because in elite sport, that 1% can be the difference, right? Of being at the top versus not. But this was arguably 9% or even double digits for reaction time, depending on the outcome. And so we've expanded that looking at other sports as well. But this was one of the first ones to show that it really potentially could have a significant impact
11:51 Speaker 00 on performance outcome for these athletes.
11:54 Steven Bartlett? How much did they sleep more per night to get those results?
11:57 Speaker 00 Yeah, so they did. So we did quantify objectively through a, what's called actigraphy. It looks like a wearable nowadays. And then compared that also with what they thought they were getting. And so we did extend their sleep substantially over, I believe, an hour and a half compared to what they were getting prior to the study.
12:17 Steven Bartlett? Because getting 9% more free throws or three-point shots or 12% better reaction time is, quite frankly, for some teams, the difference between like winning a championship and not. Because I think about the Premier League often, which is soccer, I guess, football. Often, there's been leagues within my lifetime, there's been years in my lifetime where both teams have tied with the same amount of points and one is won just on the amount of goals they've scored. They've just scored a couple more goals. So after 38 games, they both have the exact same points and the winner is just the person that's scored like a couple more goals. But even you think of reaction times, you think of goalkeepers in soccer. Their whole game is reaction time. So if you can increase your reaction time by 12%, it's really, really staggering.
13:02 Speaker 00 It can be a game changer and I think that's what has been so fascinating with some of the athletes or organizations and teams I've worked with who have made it to the most important games and those championships because the hope is that you've invested not just the night before that championship game, but you've invested an entire season, even starting in the offseason, on cultivating better habits to give yourself that foundation and be able to leverage these strategies that the other team is not because we know that it significantly can impact not just the individual level on performance outcome, but organizations as a whole. And I think one example of that is I partnered with ESPN
13:43 Speaker 00 to do what was called the NBA Schedule Alert Project where they asked, can you predict, Dr. Ma, when NBA teams are going to be at risk of losing games strictly based on the schedule? So not factoring in strength of team, but based simply on their schedule, where they're traveling to, how many times those are crossing, these various factors. Does it affect organizations as a whole and teams and their game outcomes, as you've mentioned? And over three seasons, I was 76 to 86% correct on accurately predicting when an NBA team will be at highest risk of losing strictly based on the schedule. So in the spirit of the project, we didn't factor in strength of team. But to me, that
14:24 Speaker 00 was staggering because there's many other factors that maybe are not always considered to be as clearly important about, you know, this travel schedule up front. But hey, maybe these factors really do play and influence game outcomes in this way. And that's not the only thing that has obviously shown that organizations and teams as a whole will have differences in performance outcome. There's other studies like the Monday Night Football Study that showed if you simply bet on a West Coast team when they play an East Coast-West Coast matchup during night games, over 25 seasons, you'd beat the Las Vegas point spread 68% of the time.
15:05 Speaker 00 And so if you're able to predict with with greater accuracy, then obviously there is potentially some gambling outcomes that could work in your favor here. But really being able to show that you would be able to benefit and predict better than what the spread will be between the the two teams.
15:22 Steven Bartlett? Sorry, isn't that because the west, sorry, the west coast team has gone, which who's who's traveled?
15:27 Speaker 00 It doesn't matter. It simply matters that the west coast team is playing the east coast team during night games. So this can happen on the west coast, it can happen on the east coast. The reason why is because performance is enhanced in the late afternoon to evening, around four to eight o'clock. In both scenarios, the body clock of the west coast team, because they typically go out just the day before the game, it feels like they're on the west coast.
15:53 Steven Bartlett? Okay.
15:53 Speaker 00 Right, so when you're a west coast team and you stay there and the east coast team comes out, the east coast is three hours later. So what is a seven o'clock game on a west coast feels like a 10 o'clock game for an east coast team.
16:07 Steven Bartlett? Got you.
16:08 Speaker 00 Same thing applies when the west coast team goes east coast, even if it's a seven o'clock game there.
16:13 Steven Bartlett? Ah, yeah.
16:14 Speaker 00 The west coast feels like it's a four o'clock body clock.
16:17 Steven Bartlett? Yes.
16:18 Speaker 00 And so that special window around four to eight P M. When world records are broken and performance in a 24 hour day is is optimal. And that is leveraged then over those 25 seasons that the west coast will have more favorable outcome overall.
16:34 Steven Bartlett? Got you. So in this study you did in 2011, it was published in 2011.
16:38 Speaker 00 Yeah.
16:39 Steven Bartlett? One of the things I read as well is that players who had slept more in your study sprinted faster.
16:47 Steven Bartlett? I mean, quite quite dramatically faster as well, I I think, from 16.2 seconds at the start of the study versus 15.5 seconds at the end.
16:55 Speaker 00 Yes.
16:56 Steven Bartlett? Over what distance was that?
16:57 Speaker 00 So that was from the baseline to half court to baseline to full court and back.
17:01 Steven Bartlett? Okay.
17:01 Speaker 00 So we chose a very standardized sprinting, sprinting drill that they are familiar with that we could replicate after every regular practice. As you imagine, not everyone on the team was participating on in this study. And so they did this after every regular practice and that ended up being a 4% difference in sprint time.
17:20 Steven Bartlett? That is pretty crazy. Do professional teams know this? Do athletes know this? Are they aware of this, or is this something that's fairly new?
17:28 Speaker 00 Some are aware, and I think the momentum is shifting towards more athletes, more teams recognizing that this is an untapped competitive advantage, that this is an area that they may or may not have implemented specific strategies or education or planning for when they travel. But I think the more forward-thinking organizations, teams and athletes are starting to pick this up and starting to recognize that they can use this as a weapon, right? As a performance-enhancing drug, if you may, because it is safe, it's healthy, it's effective. And we know that it'll be one of the only things that can give you these performance
18:09 Speaker 00 benefits. And those are the ones that are trying to leverage the science into application for optimizing, yeah, their sleep at nighttime.
18:19 Steven Bartlett? Have you seen athletes, individual athletes, change and save their careers? When I say change, I mean change the trajectory of their career or save their careers because they focused on their sleep. And can you give me some examples of that?
18:32 Speaker 00 Yes. Golden State Warriors Andre Iguodala, he's someone who I worked closely with. He came to the Warriors back in around 2014. He was already an All-Star. He was 28 at the time, knew that his career was going to probably be sunsetting at some future time, but wanted to extend it as long as possible. But he knew he wasn't doing sleep best as possible. He was very open about sharing how he would stay up till the wee hours in the morning, playing video games, would sleep for a few hours, go to practice, play for a few hours, come home and take a two- to three-hour power nap. And that was his routine for 10 years. And he said, you know, how do I improve how I approach my sleep?
19:13 Speaker 00 I know that this is important as an athlete to who wants to play in the league as long as possible. So I had the opportunity to work with him over several months to help him re-craft how he approached his sleep, including a wind-down routine, thought about some of his nutritional choices, tried to shorten his naps, timed them closer to game time to give him the boost in alertness and performance. Be able to manage a racing mind and be able to have just a more proactive approach to his sleep. In a really neat way, the following season, the Warriors went to the championship for the first time in many years. They won. He came back with the finals MVP. He subsequently has won three more championships with them, so four in total, and extended
19:57 Speaker 00 his career for 10 years. When we made these changes, there was a quantification of the performance enhancement. So a third party quantified as he went from under seven to seven and a half to more than eight hours, he had a twofold increase in his three-point percentage. He had an 8.9% increase in his free throw shots, which very interestingly is the exact same 9% that I showed in my man's basketball study that had the same 9% improvement in free throws. He had a 29% improvement in his points per minute, a 45% decrease in his fouls. And so, you know, these numbers are pretty staggering, again, for someone who's already at the highest level as an All-Star.
20:42 Speaker 00 And it's not to take anything away from Andre, but he has been very vocal about the differences made as he changed these habits. He says it changed everything for him. And I think that that's, you know, a very inspiring story of what it can mean to extend your career and be able to almost tap into this additional performance capacity that I think even he was surprised about, that he, for the first time, was able to improve beyond what he already thought was his best. And I think that's what's so inspiring, because this is something that's accessible to all of us, to be able to tap into that little bit more.
21:18 Steven Bartlett? So not only did he win the Most Valuable Player award, but his three-point conversion went up 218%.
21:25 Speaker 00 Yeah, so during the time that I had worked with him, his three-point percentage went up twofold during that time.
21:32 Steven Bartlett? It begs the question, what did you do to him? And you know, you named a couple of things there, but I'd love to dig into some of those key points.
21:41 Speaker 00 Sure.
21:42 Steven Bartlett? Where you started with him, the specific sort of implementate, things that you implemented into his sleep hygiene. And so if I am him, the day that you met him, when he was taking those naps and staying up late, which I often do, to be fair, where would you start with me? And where did you start with him?
21:59 Speaker 00 Okay, so let's dive into just some very practical strategies that I started to challenge him with, which was, we'll start with his sleep environment. We want to make your sleep environment like a cave, really dark, quiet, cool and comfortable. Dark cave. So dark blackout curtains, eye mask are some of the easiest tools that you can grab, but are incredibly helpful and great investment to be able to use that both at home and then when you travel. So that if you're in a non-ideal environment, like a hotel room, you have, for example, an eye mask that can help dampen out the, the light, making it quiet. So ear plugs, also a white noise machine. I'm a huge fan of even a small travel white noise
22:43 Speaker 00 so that you can actually mask over external noises that you may or not be able to control.
22:47 Steven Bartlett? I'm someone that tells myself that I sleep with something playing. I grew up with a radio in my room. So when I'm, as an adult now, I'm always looking to play something as I fall asleep. Is that going to hurt my sleep quality?
22:59 Speaker 00 I would say if you're accustomed to this, I would say that's fine to continue to do so. I am not a fan of having the TV on and having the bright light exposed to you in that hour before bedtime, because it also can just be very psychologically stimulating. But if like you said, it's a radio or it's a podcast that you feel is helping you relax, then I'm a fan of it.
23:19 Steven Bartlett? Do you think Dior Vissio will help people relax?
23:21 Speaker 00 It might. It might help you at least think about your sleep a bit more and challenge you to do maybe one, one change tonight.
23:28 Steven Bartlett? We consider that to be a scientific endorsement of the podcast. Okay, so I've got sound down. You are a fan of the white noise machines.
23:37 Speaker 00 I am, because sometimes there's external noises like a garbage truck or construction that you're not always able to control. So if you can at least mask over it temporarily, that can sometimes be helpful to keep individuals more asleep during the night time. And there's even some now that are adaptive. So if the door slams, then the volume temporarily increases and then will decrease. So there's almost these smart white noise machines that are that are coming out on the market. So that's from a noise standpoint, and earplugs are going to be helpful if you're traveling. When you're at home, you can obviously use those to dampen down any external noise. From a from a temperature standpoint, you want it to be cool. I think this is an area that a lot of people can benefit from because they often sleep in much warmer temperatures than what we know is probably more conducive
24:22 Speaker 00 to sleep, which is cooler. Sixty to sixty seven degrees has been shown to help individuals stay asleep and fall asleep. That may be frigidly cold for some, but you have to find the temperature that's right for you. I would say decrease your temperature by, say, one degree or two degrees every couple of days, and then you can find the temperature that works well for you. And there's even technology now where there's mattress covers that can help you regulate temperature from much cooler to warmer. So if there's differences in bed partners, that's a way that you can actually accommodate both of their preferences.
24:56 Steven Bartlett? So that's about sixteen to twenty degrees Celsius. What about when I shower or I bath? Because often I go and have a shower, then I get straight into bed after.
25:07 Speaker 00 Yes.
25:08 Steven Bartlett? Is that good or bad?
25:09 Speaker 00 I would encourage you to shift that timing a little bit earlier into the night. So an hour and a half before you are planning to go to bed, I would shift your shower because when you are taking a hot bath or hot shower, it increases your core temperature. But when you fall asleep, your core temperature drops. So you don't want that competing signal to be right before bedtime. But if you back that shower up an hour and a half, that should be sufficient time that we think potentially there's an augmentation of helping that drop in temperature. And some smaller studies have shown that that can help decrease the time to fall asleep and also enhance deep sleep, which has implications for muscle recovery regeneration.
25:54 Speaker 00 And you get more of that in the earlier part of your night. So it's an easy fix just to tweak the timing of your shower and your hot bath to be just an hour or two before bedtime, not right before bed. So it's a strategy too, if you have difficulties winding down and relaxing, to implement that hot shower, hot bath earlier in the evening.
26:13 Steven Bartlett? One of the problems I also have when I sleep sometimes is I I hear people say you've got to, you can't eat like three or four hours before bed. However, I sometimes, you know, I sometimes get home at 10:00 P. M. And I get home hungry as hell at 10:00 P. M. And then sometimes if I order food, for example, it might come at like 11.
26:32 Speaker 00 Okay.
26:33 Steven Bartlett? Which means that I end up eating at 11. And then I really see it in my sleep scores. I think as well that I'm someone that tends to fall asleep later. Again, this might just be me telling BS to myself, but that's what tends to happen. And I know I'm not supposed to eat before bed, but I'm so hungry. So is there anything that I can eat before bed that won't disrupt my sleep, but will get rid of the hunger?
26:54 Speaker 00 Yes, the preference is not to have a huge meal right before bed that's fried, fatty, you know, really heavy sitting in your stomach that hour right before bedtime. So if you're able to time that and be strategic, then that's obviously the preference. But I'm okay with you having a pre-sleep snack. A lot of times for my athletes, that means we'll go for something like 50% of a complex carb and like 50% of a lean protein. So for example, cereal and milk is an easy one.
27:22 Steven Bartlett? Cereal?
27:23 Speaker 00 Yes, cereal and milk. Of course, we want something that's whole grain and not, you know, necessarily a sugary, you know, cereal. But cereal and milk is an easy one that's many people have access to, or cottage cheese and fruit, or 100% whole wheat crackers and peanut butter. And the reason why is because I don't want you waking up in the middle of the night being hungry or even trying to fall asleep and you feel like you're hungry. But we want something that's slow digesting through the night because ideally you're going to be sleeping seven, eight, nine hours during the night. Uh, and we want it to be able to get you to the morning time and then you will fuel when you wake up. So a pre-sleep snack can be a great strategy if you're coming home late and you want to obviously be able to fuel before bed.
28:06 Speaker 00 Or if you have a really early dinner and you're hungry before bedtime.
28:09 Steven Bartlett? Yeah, that happens sometimes as well. Sometimes I'll eat dinner at about five P M.
28:12 Speaker 00 Yep.
28:13 Steven Bartlett? And then I get to about ten, eleven P M. I'm still awake and I'm starving.
28:17 Speaker 00 Okay, so what's a pre-sleep snack that you think you can grab for?
28:20 Steven Bartlett? Some nuts.
28:21 Speaker 00 Okay, yeah.
28:22 Steven Bartlett? Does that work?
28:22 Speaker 00 Yeah, yeah, nuts have protein in them. Um, yeah, you can grab a good nut mix. Maybe you can partner that also with like some yogurt too.
28:30 Steven Bartlett? Raspberry?
28:31 Speaker 00 Raspberry? Yeah, fruit. Yeah, and some, yes, a, a protein and carbon there. And those are good, good pre-sleep snack.
28:40 Steven Bartlett? What's the, if I wanted to destroy my sleep, what would you recommend I eat right before bed? What would you recommend I, I, yeah, consume right before bed?
28:49 Speaker 00 If you just wanna destroy your sleep entirely. Okay, so we're gonna have the, the nightcap of having a couple of drinks right before bed.
28:58 Steven Bartlett? Okay, so some alcohol.
28:59 Speaker 00 Yeah, we'll have some alcohol on board. We'll, we'll throw in some caffeine too, to, to really get you to stay awake. In the next couple of hours, we'll add a really heavy meal that's fried, tomato-based, um, fatty, sitting in your stomach right before bed. And.
29:17 Steven Bartlett? You say tomato-based?
29:18 Speaker 00 Yeah, sometimes individuals will have acid reflux with tomato-based products. And so if that's something that is, is, yeah, is that something that you experience? Then you generally want to avoid some of the tomato-based products that can aggravate some of the acid reflux.
29:33 Steven Bartlett? So some fried food with some ketchup?
29:37 Speaker 00 Yes.
29:38 Steven Bartlett? Okay, so alcohol, caffeine, and some fried food with some ketchup?
29:42 Speaker 00 I think that would really work to your disadvantage during the nighttime.
29:46 Steven Bartlett? Any sugar?
29:47 Speaker 00 Yes, sugary carbs are, tends to be some of the preferences when you're particularly also sleep deprived. So people will choose more carb-heavy foods and foods that have, um, less fiber and more, more sugar.
30:02 Steven Bartlett? Why is it that if I eat those foods before bed, it impacts my sleep? What, what, what's going on?
30:09 Speaker 00 I don't think we have a great understanding of that. I think the field of sleep and nutrition is definitely growing. And I think down the road in the next five or 10 years, we hopefully will have more answers to that. But it's a fascinating area that we do start to understand what we eat can affect our sleep. So for example, the stages of our sleep or how we sleep during the nighttime. Some of the smaller studies have shown what you eat can then affect having more awakenings during the nighttime and affecting the quality of your sleep. But I think many of them are still at the infancy.
30:41 Steven Bartlett? Because that's certainly something I can attest to. I talked about one time many months ago, I think it was last year, actually, when I was staying in a hotel here in L.A. And I had a cookie before bed because it was because I'm bloody, you know, I blame the hotel. I don't really blame the hotel. I take full responsibility. It was in the minibar. And I hadn't eaten all day. I came back. I'd been working all day. And when I'm, when I'm, when I've been working a lot, I'm much more likely to reach for something bad. And I had this cookie and honestly, I woke up the next morning, eight hours later, feeling like I hadn't slept at all. I just felt so tired. And I know it was that bloody cookie because I looked at my, um, my whoop, hashtag ad, hashtag investor. And I could see that my heart rate throughout the night was really high, like atypically high.
31:23 Steven Bartlett? My heart rate throughout the night will usually just be this nice, flat, I don't know, 50, 55 beats per minute. And when I'd had that cookie, it started and pretty much stayed for the first three or four hours about 75 beats. So it was like my body was, was still on. It was like I was walking.
31:41 Steven Bartlett? And so I've always just had this idea that when I, if you eat something like that right before bed, that puts your body under a lot of strain, like metabolic strain, then it's kind of like your body doesn't fall asleep.
31:53 Steven Bartlett? And my REM sleep's always attacked as well if I, if I, if I were to eat something like that.
31:57 Speaker 00 Yeah, it's, it's very fascinating. I think we're starting to understand the connection of what we eat, how our gut is responding to that. And then how that potentially can affect your sleep and then ultimately your daytime functioning the next day. But we do recognize from sleep deprivation studies that individuals will make different nutritional choices and grab for the cookies and the ice cream and some of those other snacks later at night than they would if they were well rested.
32:25 Steven Bartlett? That's a real horrible paradox, isn't it?
32:27 Speaker 00 It is.
32:28 Steven Bartlett? Do you know what I mean? Like, if you're tired, then you're gonna eat bad things right before bed, which is gonna make you sleep worse and make you tired, which is gonna mean you eat bad things before bed. This is vicious cycle.
32:38 Speaker 00 It is, and unfortunately, that could potentially lead to potential weight gain and other downstream consequences. So just one other reason why, obviously, making sure you're having sufficient sleep, but also having good practices and your approach to sleep is also a priority. So you're asking, what else did we do with Andre? But in that ways of preparing to sleep, you know, we addressed, does he have a wind down routine? So we implemented one where he would read before bed to actually relax and prepare his brain and body to sleep for the night. Managing a racing mind can be incredibly common for not just the elite athlete, but for for all of us. And so even before he did that reading,
33:22 Speaker 00 we would actually have him stretch and process his thoughts outside of bed. And that set him up with a two-part system so that he could actually be strategic about preparing to sleep for the night.
33:34 Steven Bartlett? A lot of people can relate to this managing a racing mind. Athletes, performers, creatives.
33:42 Steven Bartlett? So if I've got a racing mind, I think as well. I think I tend to feel like I have my best ideas just before I'm about to get in bed. What would you recommend someone do if they have a racing mind?
33:53 Speaker 00 Again, incredibly common to have racing thoughts, thinking through the day, needing to process your thoughts about how to prepare for tomorrow. So what I'd recommend is spending ten minutes processing your thoughts outside of bed in dim light every single night. So that can mean I would recommend you could do stretching. And you could do deep breathing exercises to activate your parasympathetic system and dampen down your sympathetic system. That's what I recommend for a lot of my athletes. If that's not your thing, I recommend journaling, getting your thoughts down onto paper or writing a to-do list. Those are easy ones that all of us can do for, even if you start with five minutes today.
34:36 Steven Bartlett? So I'm gonna stretch. I read something, I think it was Whoop's data they released at the end of the year where they, because there's an activity log in Whoop where you basically say what you're doing. And I'm gonna butcher this, but I think the stat said that reading before bed improved your sleep by about 5% across everyone that was using Whoop, which makes sense. Because you're gonna be away from light, I guess, and you're also gonna be calming, you called it your parasympathetic nervous system.
35:04 Speaker 00 Yes.
35:04 Steven Bartlett? The parasympathetic nervous system, what do I need to know about that in the context of sleep?
35:08 Speaker 00 That's just the system that helps you relax and wind down. It is in balance with the sympathetic system, which you may have heard is the fight or flight system that gets you going. That's where your heartbeat will be much more rapid, your breathing can be much more rapid when you need to go.
35:24 Steven Bartlett? That's when I'm overthinking.
35:25 Speaker 00 Yes, but you want to dampen that down and you want to get your parasympathetic system activated. So you can help actually relax physiologically your body and also your brain. So that you're in a better state to sleep at night, right? It's easier to slowly pump your brakes and then try to sleep. Versus if you were going 60 miles an hour on a freeway and then suddenly slamming on the brakes and just jumping into bed. So you actually have a process to slow yourself down, your brain and body. It will help prepare you to actually get better sleep during the nighttime.
36:00 Steven Bartlett? Just wanna close off on Andre then, is there anything else you did with him?
36:03 Speaker 00 Yes, there's more that we've done with Andre, but this is to give you some highlights. So, you know, approaches to his sleep were having that way to process his thoughts. Being able to wind down before bed and relax, improving his sleep environment. So that it was, as I mentioned, dark and cool. I believe his was around 67 degrees, it was quiet. We tried to, we took out technology from his bedroom, so he didn't have that exposure prior to bed. We looked at cutting down some of his power naps that were several hours long to shorten them to 20 to 30 minutes. And time it much closer to game time, so we would get that boost as you would go into evening games.
36:47 Speaker 00 And we looked at some of his nutritional choices, but this is the highlight of some of the ways that we were strategic about his approach to sleep. And while we're also extending his sleep from that under seven to seven and a half to eight hours, because we knew he had an accumulated sleep debt that had been built from not getting sufficient sleep, probably for many months to years prior to this. And so, as we've shared, some of the performance outcomes were astonishing. And he's been very vocal about sharing his sleep story. And he's not the only one. If I could share another story about another athlete where you've asked what has saved someone's career. So with Andre, I think he saw this performance enhancement that he could tap into
37:29 Speaker 00 that was previously he didn't know almost existed, right? But then there's other athletes where I think having sleep as a foundation almost saved their career. One example is Ryan Jensen. So Ryan Jensen was cut from the Ravens and put on the practice squad. And during this time, as the story goes, his father said, you know, what's happening? You're not yourself. You like made your mom cry the other day. You know, there's something that's going on. And he eventually was tested for sleep apnea, which is a very, very common sleep disorder where your airway has some partial or a full collapse during the night. And so it can have very fragmented sleep through the night.
38:12 Speaker 00 And he was eventually tested, diagnosed, and then put on treatment through what's called a CPAP or continuous positive airway pressure. So it's a mask that provides air to keep the airway open. So then you actually can have consolidated sleep during the nighttime. And in a very neat way, four years later, Ryan Jensen comes back, signs a $42 million contract as one of the highest paid centers in the NFL. And then, three years later, in 2021, Wins the Super Bowl with Tom Brady on the Bucks. I see this as the success story of saving his career. And he's been vocal about how much of a difference it made
38:56 Speaker 00 from literally almost the end of his career happening to now being able to succeed at the highest level. And also, of course, being healthier and being able to have more success on the field than he probably imagined for himself.
39:09 Steven Bartlett? And better relationships. Presumably, he's not made his mother cry. I'm quite curious about that. Why is it that when we haven't slept, we're more likely to make people cry?
39:18 Speaker 00 Because we are, our emotions are not regulated well when we're short on sleep. We are more irritable, we are more grouchy. We respond more with our emotions than being able to. Why we respond with our emotions?
39:34 Steven Bartlett? Yeah, what's going on in the body? Is it like a different part of my brain? Is it my hormones? Is it something else?
39:38 Speaker 00 It's probably a combination of both, right? We know that our emotional regulation is not the same if we're well rested versus if we're sleep deprived. And so we rely more on our innate response, which may not necessarily be that which is strategic for what we should be responding with if we were tempered and had a better rest under our belt. So we ask cognitively, there's an implication of which part of your brain you're going to be using. But then also, you are just not in a state in which you are going to be able to respond in the way that you would otherwise.
40:13 Steven Bartlett? Is it the amygdala that's the emotional center?
40:16 Speaker 00 That is one that's where like fear is very much and emotions and, and yeah, the amygdala is where like fear and emotions are often centered.
40:25 Steven Bartlett? Because I've started, when I started learning more about sleep and the impact it has on my emotions, I could see a huge variance in how,
40:33 Steven Bartlett? how I make my decisions, but also how like short I can be. If I haven't slept. And so on the days now where I haven't slept, I literally have a conversation with myself and tell myself that I'm going to be in my amygdala today. So to try not to make any decisions, try not to talk to many people. Because there's a risk that I might just be, I might be too short in how I consider things and how I respond. And I really wanna stay away from that. But I've seen such a huge, huge variance. And I've also heard of other like famous CEOs and stuff like that, talk about how they, they focus so much on their sleep. I can't, I was reading something the other day and it was, I think it was, it was Jeff Bezos.
41:12 Speaker 00 Mm hmm.
41:13 Steven Bartlett? Do you know what I'm gonna say?
41:14 Speaker 00 I don't, but Jeff Bezos is someone who has been an advocate about sleep and vocal that he needs eight hours every night.
41:20 Steven Bartlett? Yes. The quote that I heard him say, or someone told me that he said was, I think it might have been Arianna Huffington, actually. He said that his job as a CEO is to make decisions. And he says he doesn't have to make that many decisions a year. He only makes a couple of big decisions a year. Every day, he's probably just making two or three big decisions. So if his job is to make decisions, then his job is also to sleep. Because the variance I see in even my own decision making when I'm slept and underslept is just unbelievably staggering. As someone that sits here for seven, eight hours a day, sometimes having conversations, you wouldn't believe the difference when my brain and my mouth are like connected because I've slept. It's like a different human being.
42:03 Steven Bartlett? It's a different podcast host. Have you got data to support this, this impact on cognitive performance?
42:09 Speaker 00 Yes. So you definitely make better decisions when you're well rested. You're less likely to make cognitive errors. You have better judgment when you're well rested and you're gonna react faster. So in the situations where you need to make big decisions, whether it's on the field and you need to react because you're running a pass, whether you are Jeff Bezos and you're running a company and you need to make critical decisions under, under sometimes, you know, acute stressors, or you are someone who just is trying to be your best. We know that the cognitive domain very much is influenced by getting sufficient sleep. And some of the, I would say, you know, large, very
42:53 Speaker 00 Very public disasters have happened as a result of what we know is sleep loss, where people have made poor decisions or decisions that have led to unfortunate disasters. So, for example, the Challenger disaster.
43:07 Steven Bartlett? What was that?
43:08 Speaker 00 With a space shuttle that exploded.
43:10 Steven Bartlett? Right.
43:10 Speaker 00 And as a result, there's investigations of why did this happen? And the final report does suggest that insufficient sleep for some of those key decision makers around being able to launch or not was attributed to fatigue and insufficient sleep. So being able to make good daytime decisions had this disastrous effect ultimately on the Challenger explosion.
43:32 Steven Bartlett? Are you aware of any studies that have measured cognitive performance on and sleep?
43:39 Speaker 00 Yes, so my studies, as well as many of my other colleagues, particularly look at reaction time because we know reaction time is very finely or is very sensitive to sleep loss. And I'm starting to find it also is sensitive to extension of sleep. So the other half of the story, when you pay back sleep debt, we see that benefit on reaction time. But reaction time and looking at aspects of, you know, how quickly are you able to respond? Or if you're having errors when you're responding and you're not supposed to be responding, cognitively, those are tests that are typically used in a lot of sleep studies because we know is quite sensitive.
44:19 Steven Bartlett? Can you give me an example of a study that will convince me that if I sleep more, my cognitive performance will improve?
44:27 Speaker 00 One of the studies I mentioned before, even 15 minutes more sleep was that difference of that A student to the B student. There's another study I often cite where if you look at the difference of someone who gets nine hours of sleep for a full week, the reaction time stays very consistent. Great, you want to react appropriately, you want to not make cognitive errors or lapses in judgment, and that will be consistent over the week. If you're someone who's getting seven hours of sleep, you see a slowing of that reaction time and then a leveling off. If you are getting five hours of sleep, you see an even sharper decline in being able to react fast, and then you see a leveling off. If you're getting three hours of sleep every night, you're just going to tank that reaction time and be slower.
45:09 Speaker 00 At the same time, you have more lapses in judgment and not able to respond appropriately. But the thing about the study that I find so fascinating is When we know that there's this deficit, when you're going to react slower, in the seven and the five hour group, there's this leveling off. So people say, oh, can I get used to getting insufficient sleep? In some sense, there was this stabilizing of it, but the reality is you're not at your best, right? We know what your reaction time could be if you were getting that nine hours. And if we even gave you three nights of what we call recovery sleep, so we said, okay, now we get, let's say, eight hours in bed for the next three days, you're going to feel better and you'll probably feel more refreshed. But those
45:51 Speaker 00 reaction times for the seven hours and the five hours and the three hour group didn't go back to the baseline. So it takes more than one night or one weekend of that recovery sleep to get you back to your baseline. And so that's the bottom line that I tried to show my athletes is that you can pay back sleep debt, but it often can take more than just one day or one weekend of quality sleep.
46:17 Steven Bartlett? How long does it take?
46:18 Speaker 00 So my studies have suggested multiple weeks will really be beneficial to paying back more of your sleep debt than just a night or two nights of sleep. The biggest bankroll tends to be in the first week or two, but obviously this depends on how much more you're actually getting, how you're timing that in your nights. But the bottom line is that if you can invest maybe a week, or maybe if you have a vacation coming up and you do two weeks, that's going to be the biggest impact on paying back your sleep debt. And if you say, hey, that sounds like a long time, Dr. Ma, well, even potentially like five days, as one of my preliminary studies had suggested in professional baseball players, even if it's five days of getting one additional hour of sleep, that was shown
47:02 Speaker 00 to potential, that was shown to improve cognitive reaction time and also processing speed in the athletes that actually got one additional hour. So if you got six hours, you went to seven. If you got seven hours, you went to eight hours versus the athletes that just continued to get their normal sleep.
47:18 Steven Bartlett? Interesting. I guess I've got to understand what this concept or this idea of sleep debt is, because I want to make sure I'm super clear on what it is and isn't. Because when you say the word debt, I assume it's kind of like I owe the sleep bank manager a couple of hours. But I've kind of gone back and forward on this idea of sleep debt. I think some people have told me that it's real, some people have told me that it's not real. And I don't know where I should stand on it.
47:43 Speaker 00 Yes.
47:43 Steven Bartlett? So if I haven't, so for example, I flew into LA, first couple of nights, my sleep wasn't great. Am I still, but I had good sleep last night, am I still paying for it now?
47:53 Speaker 00 The way I explain the concept of sleep debt is that your body requires a certain amount every single night. Again, we talked about individual variability, but let's just say you need eight hours every night. And conceptually, if you don't meet that eight hours, then you build up a debt. So if you're only getting six hours a night, you now have two hours of debt built up. If you go Monday to Friday, that's five days, now you have 10 hours built up. Right? Two hours every night becomes 10 hours. And if you then sleep in on a Saturday and you get, let's just say, 10 hours of sleep, you've paid back two of those hours, but you still have eight hours left to go.
48:28 Steven Bartlett? And my body knows.
48:29 Speaker 00 Yes. So conceptually, that's the idea of accumulating sleep debt. I do stand in the camp that believes that that does accumulate over time. We do think that you can pay back some of that debt on the short term, right? So what you lost, like you said, this past day or this past week, maybe this past month, you should pay that back with getting extra sleep, or we call sleep extension. We don't think that you can surplus and bank more and that you can pull from that in the future. But we recognize that if you've got insufficient sleep, that if you extend it over a couple of days, maybe a couple of weeks, then you will see benefits in your reaction time, in your fatigue levels, in your performance outcomes.
49:12 Speaker 00 And so we do recommend that as a tool, especially if you know that you're going to have a day where you're going to have sleep loss. So it's a strategy, for example, if you know, okay, in a week, I'm going to have a project and I'm not going to be getting enough sleep that night. Then what you can do in the days leading up to it is getting sufficient sleep, but arguably even more, so that we know when it gets to that project. The decrements that you'll experience tend to be less robust than if you went into it with just say that was five hours.
49:45 Steven Bartlett? So what evidence do you have that sleep debt is a real thing? What's the first thing that comes to mind?
49:51 Speaker 00 So my, my, what I've dedicated my career to is trying to understand how to pay back sleep debt with sleep extension interventions. So what that means is typically I'm working with a number of collegiate athletes where many of them are not getting what they need because when we start these studies, many of them have high fatigue levels, they are reacting slowly, we often see lapses in their, their judgment and their ability to ultimately perform and function, which is what they consider their baseline. But then when we actually challenge them by paying back some of that debt by getting additional hours, when we monitor the, the differences that can make over multiple weeks,
50:33 Speaker 00 that's where we see there's improvement in the reaction time, their fatigue levels drop, their performance on the field improves. And so we recognize what has changed in this is trying to pay back some of that accumulated debt when the rest of their training has been held consistent, where we've been trying to maintain the rest of their, their training.
50:56 Steven Bartlett? Which is key, which is the key point because in my mind, I go, well, maybe if you've got the athletes to sleep well on that first night, then when they've showed up to training, they've trained a little bit harder, they've built their muscles a little bit more, they've had better recovery in their muscles. So then the next day, the same thing happens because they've slept. So it's actually just that they're training better, which is causing them to improve their scores.
51:19 Speaker 00 We, we've tried to hold their training to be consistent and choosing periods where their training isn't going to vary significantly, as well as you can almost make the argument too, that sometimes as the season goes on. Athletes get more fatigued, more tired, and that can be actually a decrement to how they'll perform. So when we see the benefits come down the road as the season potentially gets even longer, that at least is some suggestion that the intervention of sleep, while we also have the measures of how much more they were getting, actually were at least associated with these performance outcomes.
51:53 Steven Bartlett? Because REM, one of the key things about REM sleep, which is the sort of final stage of sleep, is that it helps with muscle recovery?
51:59 Speaker 00 Uh, deep sleep is actually, deep sleep is where we, uh, deep sleep is where it's implied that there's more muscle recovery regeneration because there's the biggest pulse of growth hormone during your deep sleep. So to back up a bit, you have light stages of sleep, then you have deep stages of sleep, and then you have that rapid eye movement sleep or when you dream. That is, tends to be more associated with consolidation of learning and memory and skill consolidation. So you go through these cycles during the nighttime, about ninety to one hundred and twenty minutes, but the proportion changes through the night. The beginning of the night, you get more of that deep sleep. And then in the early morning hours is when you get more of that REM sleep. So you might have
52:42 Speaker 00 woken up in the early morning and had the recall of these vivid dreams. It's because you often will be waking up from the, that REM sleep.
52:50 Steven Bartlett? Yes, that happened last night, actually, because I woke up suspiciously early for me. So I woke up at about five or six o'clock and I was just kind of dipping in and out of dreams.
52:58 Speaker 00 Hmm.
52:58 Steven Bartlett? And there were very vivid dreams that I can still remember now.
53:01 Speaker 00 Yeah.
53:01 Steven Bartlett? Um, so the muscle memory element of all of this, what is muscle memory and how is that sort of implicated with sleep?
53:10 Speaker 00 So muscle memory, there's different types of memory and you need sleep, think of sleep as hitting that save button, right? You need to sleep after you have learned new information, learned a new skill so that you can consolidate those. Those memories and be able to retrieve it later. So I always use an analogy of hitting that save button. After you learn new material or learn a new skill set, you need to go home and sleep so that it goes into long term storage and that you can retrieve that the following day and subsequently. Without that sleep, we know that that groundwork for that new skill or that new memory is not going to be as strong. And so in the context of students who are trying to study for a test
53:55 Speaker 00 or an athlete that's trying to remember the playbook, you want to space those intervals that you're learning that material and have sleep that follows so that you strengthen those connections.
54:07 Steven Bartlett? And also, you mentioned when you were talking about one of your athletes, encouraging them to nap before a game.
54:14 Speaker 00 Yes.
54:15 Steven Bartlett? I read this fascinating word in the research that I was doing on your work. I think it's Nappucino.
54:20 Speaker 00 Yes.
54:21 Steven Bartlett? What's a Nappucino?
54:23 Speaker 00 The Nappucino. So this is a useful tool if you're trying to have a temporary boost in alertness and performance. So the Nappucino, you go and take your favorite caffeinated beverage.
54:34 Steven Bartlett? Yeah.
54:35 Speaker 00 The caffeine will start to kick in in about 15 minutes. And you go and then take your 20 to 30 minute power nap. So if you're able to fall asleep within that five to 10 minutes, while the caffeine will start to come on board, then when you wake up after 20 to 30 minutes, then bam, both the caffeine will have kicked in and the power nap will have kicked in. And there's research to show that that's more effective for alertness and performance improvement for a couple of hours than if you only did the caffeine alone or only did the power nap alone. So the Nappucino is a useful tool for some who utilize caffeine and you can partner that together with a short 20 to 30 minute nap.
55:15 Steven Bartlett? So if I wanted to take a nap now, I have an espresso and then go and have my nap?
55:21 Speaker 00 Exactly. Yes. The caveat is you do need to fall asleep within about 10 minutes or else the caffeine will start to come on board. But if you do this in the late morning or early afternoon, it can be a helpful tool so that you have a boost in your alertness for a couple of hours.
55:37 Steven Bartlett? And I grew up thinking that naps didn't work because the minute I learned about sleep and these sleep cycles, and then it takes, I don't know, 45, 60 minutes, whatever it is, to get into late-stage sleep, like the REM sleep, the deep sleep, I thought, what's the point taking a 15, 20-minute nap if I'm not going to get into deep or REM sleep?
55:53 Speaker 00 So there's benefit of just that 15-minute nap you mentioned. You want to stay in lighter stages of sleep because there's benefits of lighter stages of sleep. And that can give you that alertness and performance boost, even when you're in lighter stages of sleep. You actually don't want to go into deeper stages of sleep because when you take the longer naps, as I think you might have shared, you've taken the two-hour nap, the three-hour nap, you wake up and you're much more sluggish, much more groggy. That's not a good state for you to go out and then do, you know, work after that, or it's not the state that you want to be if you're a basketball player and have to go and play a game. But those deeper stages, you come out of what we call sleep inertia with that sluggishness. And
56:35 Speaker 00 so it can also affect your sleep at night and make it harder to sleep subsequently. So you actually want to stay in those lighter stages of sleep and keep those naps very short.
56:45 Steven Bartlett? So what's the maximum length that a nap should be?
56:47 Speaker 00 I like 30 minutes.
56:49 Steven Bartlett? Okay.
56:49 Speaker 00 Yes. So you can time that by setting an alarm. If it takes you five or 10 minutes to fall asleep, you can plan for that as well. And then setting an alarm to wake yourself up 30 minutes later. I think it's a great strategy when, again, you don't get sufficient sleep at night, or you had poor sleep leading into that night, and you need a little bit of a boost later in the day.
57:10 Steven Bartlett? What do you think of the snooze button?
57:11 Speaker 00 The snooze button. I'm not a huge fan of the snooze. I fully understand why people love to hit the snooze and then go back to bed. And if you're someone who does that, one of my suggestions is just to cut down so that you only hit the snooze once, five minutes later, start your day. The reason why is because it helps to maximize your REM or your dreaming sleep in those early morning hours. If you can actually sleep consolidated all the way until the time you have to wake up. So for example, if you're someone who hits the snooze button five times, every five minutes for a half hour. It means that you're having very interrupted sleep for the last half hour of your night. Versus if you just let yourself sleep consolidated all the way through.
57:56 Speaker 00 And then maybe hit the snooze button just one time and then got yourself up to start your day. It means you would have given yourself another 25 minutes of consolidated sleep. Likely that dreaming REM sleep that's so important for learning and memory. And so that is one just easy adjustment that you can make in terms of your morning approach to maximizing what you get during the night.
58:18 Steven Bartlett? So what's the, what's the value in consolidating it versus just?
58:22 Speaker 00 Having fragmented sleep?
58:23 Steven Bartlett? Yeah.
58:24 Speaker 00 So then if you're getting a lot of that REM sleep in those early morning hours and you're snoozing. You're going to be waking up and coming out of that REM sleep. So you likely are changing the stages of sleep you would be getting in those early hours. So you would then be awake and then probably going into lighter stages of sleep, awake, lighter stages of sleep. Then necessarily having a solid REM period all the way until you wake up.
58:47 Steven Bartlett? What's the cost of that?
58:49 Speaker 00 So learning and memory and consolidation is definitely one area that we recognize as associated with that REM sleep. And so you want, as we talked about, it changes through the night. You want to have as much as possible, but you part have to have just the duration. So when you get the most of it in the morning hours, if you cut that short and either wake up earlier. Or you're snoozing and you're interrupting it, you're not going to maximize the value you get of the hours in REM.
59:16 Steven Bartlett? Okay, so I just want to make sure that I, those 25 minutes, I give them to REM sleep. Versus just giving them to a little fragmented, light sleep.
59:25 Speaker 00 Exactly.
59:26 Steven Bartlett? So I, I'm better off just.
59:29 Steven Bartlett? Putting my alarm to the time that I actually have to get out of bed.
59:31 Speaker 00 Exactly.
59:31 Steven Bartlett? Just to maximize the amount of REM sleep that I get.
59:33 Speaker 00 Yeah.
59:33 Steven Bartlett? To consolidate my memories.
59:35 Speaker 00 Are you a snoozer?
59:36 Steven Bartlett? No, not really.
59:37 Speaker 00 Okay.
59:37 Steven Bartlett? Well, I mean, we will have our moments, but not really. I can't remember the last time I pressed the snooze button. But the thing that I do, and I'm not sure if this is a good idea or not, is because I have told myself, and I say told myself because I'm quite conscious of the BS that I believe about myself. But I've told myself that I'm like an owl chronotype or something, which by the way, I don't even know if it's true. And I don't know if chronotypes are true. And I typically work quite late and I love working late. I get better ideas late. I do my writing pretty late at night as well. And so what I've done in my life is I've basically made sure that I don't have any meetings or any engagements before 11 o'clock. So even like this podcast today started at 11 o'clock.
1:00:18 Speaker 00 Yes.
1:00:20 Steven Bartlett? Basically, nothing in my life starts till 11 o'clock for that very reason, just to, because if I do end up staying up a little bit late, I want to be able to kind of sleep through without having to set an alarm and just wake up naturally. What do you think of that? Is that suboptimal?
1:00:33 Speaker 00 No, I think it's a great strategy. So there are chronotypes where you've mentioned you're more of an evening owl. You go to bed later. You like to wake up later as a natural predilection.
1:00:43 Steven Bartlett? Is that real?
1:00:44 Speaker 00 This is real. This is real.
1:00:46 Steven Bartlett? Justifying myself.
1:00:47 Speaker 00 No, there is a natural tendency for some to feel like they're evening owls. And there's others who feel like they do much better in the morning. So they go to bed earlier, they wake up earlier, they're more productive in the morning. Those are our morning larks. And then there is a group that's somewhere in the middle that don't strongly lean one way or another. But really what you're doing is you're making your sleep work to your chronotype and to your advantage, where you do feel like you're more productive in the evenings. And then you want to be able to maximize your sleep, waking up without an alarm and starting your day later. I think that's like a great strategy because a lot of people aren't able to have that flexibility. And so society often will force particularly the night owls onto an earlier schedule
1:01:29 Speaker 00 where you have to wake up whether to go to work or other obligations or kids.
1:01:33 Steven Bartlett? And then we fail in school.
1:01:35 Speaker 00 Point. Yeah. And then you're cutting your sleep short, like you mentioned, like with school. And then we're getting these, and then you're on a schedule that doesn't work. Synergistically with what your chronotype is.
1:01:48 Steven Bartlett? They should do some studies on kids in school and like disobedience and ability to pay attention and do your homework and grades. Because honestly, I was so useless in school and I really, I really think a lot of it. Now, I'm not entirely sure here because I got diagnosed with ADHD when I was like thirty years old. So part of me thinks I've just got like a very active brain. And part, part of having an active brain meant that late at night, I was finding ways to stimulate it by playing video games, et cetera. So that might just be the reason, but the other reason might be that I'm an Alcorno type and I found it really hard to get up at like seven thirty. To get, to go to school by sort of eight thirty ish. And so I would miss school, I would show up knackered, I would sleep in lessons. I feel like school just starts way too early for kids.
1:02:31 Speaker 00 It's a ongoing, uh, it's an ongoing problem. And actually, in a very interesting way, there has been a change to school start times, particularly in California. This, this year was the first year that school start, start times for high schools and for middle schools was shifted much later. Because there are studies to show that our, when our students are better rested, they have higher attendance rates. Their GPA and grades are much higher, there's less mental health issues, um, there's less car accidents. And so this, these studies have been over the last decade and longer in which they have built evidence to help make decisions to start school time later.
1:03:13 Speaker 00 Um, and that is in California been enacted this year and some other states are starting to follow suit. But to your point, what makes it challenging is that at the age of high school, many of those body clocks are shifted. And so students want to, in adolescence, go to bed later and wake up later naturally. That's just how our sleep changes through the life cycle. But when they stay up late and then we cut their sleep short by forcing them to get up really early for school. Now they have insufficient sleep and that builds like a sleep debt. And so they're not setting themselves up for success in school for learning and memory. So that's where, again, there's more evidence of if we can shift the school start time, get these students to have a little bit more sleep.
1:03:55 Speaker 00 They ultimately are better prepared for school, come to school, have less car accidents and are just healthier students.
1:04:03 Steven Bartlett? Do you think there's anything parents need to know about sleep when it, as it relates to their children and? Sleep hygiene with their children.
1:04:11 Speaker 00 I think it's important for parents to start at the early, early years of instilling good sleep habits.
1:04:17 Steven Bartlett? Yeah.
1:04:17 Speaker 00 A good sleep routine and giving their, their children the tools and skills to be able to make sure that it's a priority as they go through early childhood into adolescence. And hopefully then sets themselves up for making sure it's a priority for their adult life. Um, I'm a young parent myself. I just had uh my first son and so um I recognize and can empathize with the tru- the struggles of getting sufficient sleep when they're very young. But then trying to instill how they can approach your sleep from early age, I think would be incredibly helpful to also just change culturally how we think about sleep because so many of us now have never heard learned about sleep before or what we should do until you're an adult.
1:05:00 Speaker 00 But if we can make that change earlier on, I think we're gonna have healthier kids, better families, um, who are better rested and, and also just this generation where we recognize this is so important that we shouldn't sacrifice it because we're doing ourselves a disservice to letting us be the best that we can possibly be.
1:05:19 Steven Bartlett? How old is your son?
1:05:20 Speaker 00 Eleven months.
1:05:21 Steven Bartlett? Eleven months. So how are you sleeping?
1:05:22 Speaker 00 Oh, I transparently am quite tired.
1:05:25 Steven Bartlett? Okay.
1:05:26 Speaker 00 I, I as a, yeah, new young mom also, um, I don't have the ideal sleep that I know I would love. Um, and it's just for a short time, but I'm trying to be strategic of the things that I can do with some of the tools that we've talked about trying to leverage power naps. Um, when, for example, I do have to still wake up during the nighttime to tend to him. Um, and you know, the early morning starts are not always consistent. So my sleep schedule is not always consistent. So, you know, going back to those three buckets we talked about earlier, like if I don't get the full duration that I want, then how do I maximize the quality, right? I've optimized my sleep environment. I try to have a process to wind down
1:06:06 Speaker 00 at nighttime, um, or the timing, you know, is, and the sleep schedule is another area that you can still work on when, for example, you may not be getting the duration. Um, so these are strategies that I try to employ when I know that I um also am a work in progress in trying to get the best sleep possible.
1:06:24 Steven Bartlett? What are the other examples of sort of case studies that you're, you're most proud of or that were most pivotal in shaping your thinking about sleep?
1:06:32 Speaker 00 I, I mentioned the Philadelphia Eagles back in twenty seventeen and tried to help them. Educate their players about sleep, how to have a more strategic approach to their wind down routine, to thinking about how they're integrating sleep into their training practices and thinking about ultimately how they travel and and having, for example, strategies to minimize jet lag when you're crossing time zones and having to play in different locations and.
1:06:59 Steven Bartlett? Give me some of those then. So some the tips you'd give me as someone that travels a lot.
1:07:03 Speaker 00 Yeah.
1:07:03 Steven Bartlett? Um, pre, during and post travel.
1:07:06 Speaker 00 Yeah.
1:07:06 Steven Bartlett? What should I be thinking about before I travel, while I'm traveling and after I I land?
1:07:09 Speaker 00 Yes. So have a game plan for every trip. I think most people have no strategies in place when they travel. They just get onto an airplane, get to a new location and try to adjust when they get there. That is not really a great strategy. You want to have at least a pre-flight strategy, in-flight strategy and post-flight strategies because that will set yourself up better to minimize jet lag, also travel fatigue and ultimately then be able to acclimate faster if you're crossing multiple time zones. Before or pre-flight, try not to panic pack. I know all of us do do panic packing right before bed, right before we're getting on a flight.
1:07:44 Steven Bartlett? Why?
1:07:45 Speaker 00 Uh, so you want to try and be strategic and pack early. You want to get at least.
1:07:49 Steven Bartlett? Why do I want to not panic pack?
1:07:51 Speaker 00 Because most people will panic pack the night before they they have a flight and then they'll cut their sleep short. So they'll get only, say, five hours of sleep because they're staying up late, trying to pack everything and get ready for that early morning flight or for the next day.
1:08:03 Steven Bartlett? Well, I I pack the morning of travel, so.
1:08:06 Speaker 00 Okay.
1:08:06 Steven Bartlett? But I'm I'm out here in L A for I'm out here for two weeks and I packed a carry-on back, carry-on suitcase.
1:08:12 Speaker 00 Okay.
1:08:13 Steven Bartlett? Cause I opt, so look at what I'm wearing. I wear just the same outfit every day. So I have like the same outfit. Um, but I pack literally an hour before I go to the airport.
1:08:20 Speaker 00 Okay, okay. So.
1:08:22 Steven Bartlett? But you're right, it does cut my sleep because I could have been in bed.
1:08:24 Speaker 00 Whether it's beginning of the day or the end of the day, if it's affecting then the duration of your sleep, I would recommend trying to be a little more strategic and do it a day before, two days before. Don't panic pack.
1:08:36 Steven Bartlett? Yeah.
1:08:36 Speaker 00 Number two, try to get at least those seven hours, if not your your amount of sleep that makes you feel like you're functioning and performing well, uh, at least a day, if not two days. If you get insufficient sleep before you get onto an airplane, jet lag will be worse and that travel fatigue can feel much more robust.
1:08:56 Steven Bartlett? And you're more likely to have a croissant in the airport.
1:08:58 Speaker 00 Exactly.
1:08:59 Steven Bartlett? Which is going to destroy the whole thing for for you.
1:09:02 Speaker 00 So those are things that you can do before flight. Depending on where you're going, you can actually start to adjust your body clock before you even get onto the airplane. So let's just take a three hour time difference. Here in the US, if you're in the west coast and you're going to the east coast, three time zones, you can actually start to go to bed a half hour early, wake up a half hour early, do that for two or three days, and and get sunlight in the morning because that sunlight reinforces to your brain to start to shift that body clock. So if you can do that a day before, two days before, maybe three days before, when you actually get to the new location, you don't have to shift your body clock three time zones. You've already shifted it one time zone or two time zones.
1:09:45 Speaker 00 Because the rule of thumb is for every time zone you cross, it takes about a day to reacclimate. Even if you feel better after the first day, usually jet lag feels the worst in that first day when you arrive, but physiologically, you haven't really adjusted fully, even if it's over, you know, a couple of days. So that's the rule of thumb. So those are some things pre-flight you can do. When you're in-flight, you want to hydrate throughout the flight because dehydration can worsen jet lag. You want to think about getting onto the new time zone schedule. So again, depending on which direction you're flying and how many time zones you're crossing, you want to start to synchronize perhaps like when you're actually sleeping or some of your mealtimes, so that you're getting onto that schedule. And then you partner that with, for example, building a travel sleep kit.
1:10:30 Speaker 00 I'm a huge fan of investing in sleep tools that will help you sleep when you need to in non-ideal situations, whether you're on the plane and now trying to take a nap or shift your sleep schedule, then you actually have an eye mask and earplugs, you have noise cancelling headphones, you have your own travel pillow, you have the tools with you.
1:10:49 Steven Bartlett? Sleeping drugs?
1:10:51 Speaker 00 Sorry?
1:10:51 Steven Bartlett? Sleeping medication.
1:10:52 Speaker 00 Okay, so some medications can be helpful, like melatonin, particularly if you're trying to advance your clock, has evidence that it can help shift that a little bit more quickly when you're trying to advance your clock earlier.
1:11:06 Steven Bartlett? Would you recommend it to athletes?
1:11:08 Speaker 00 Um, I would say if it's something that you've used before and you know that you don't experience some of the side effects, it could be a useful tool. So melatonin, while it's one of the most commonly used supplements and sleep aids, there are still side effects that'd be wary of. So specifically for athletes too, you can feel more groggy and sluggish when you wake up from it. It's not regulated by the FDA here in the US. And so you don't always know what's actually in those supplements. So for my lead athletes, they use what's called NSF Sports Certified versions. They're just, there's more regulation around them. But in for the, for the, you know, everyday person, you know, there's a study where they looked at the amount of melatonin that was actually in a variety of these supplements.
1:11:53 Speaker 00 And it was a wide range from over 400% of what was on the label to obviously sub, you know, you know, under 100% of what they actually indicated. So there's a wide range of what's actually going to be in the supplement. But it can help particularly when you're on travel with re-acclimating.
1:12:11 Steven Bartlett? My team here, we, most of them use a certain app when we travel. And it just tells you, basically, you say where you're going and then it will tell you what time to eat, what time not to eat, et cetera. So you can get aligned with that, with your destinations, like circadian rhythm, I guess. So we'll link below one of the apps that our team use. We're not affiliated with them in any way. But when we're flying out here, I know Will and my team sent me a screenshot and said, Steve, this is what time you need to be eating and everything because we're going to LA. So it's been super helpful for all of us. I'll, I'll link that below because I know some people are going to be wondering what apps they should be using. So we're in the flight. We've got our post-travel flight kit with the eye masks and all those kinds of things in. We've got our app. Is, we're hydrated, noise cancelling headphones.
1:12:54 Steven Bartlett? Is there anything else we need to be thinking about while we're traveling?
1:12:57 Speaker 00 When you're traveling, so.
1:12:58 Steven Bartlett? On a plane.
1:12:59 Speaker 00 On a plane. So we talked about hydration.
1:13:01 Steven Bartlett? Yeah.
1:13:02 Speaker 00 Minimizing alcohol and caffeine or eliminating entirely is going to be a great strategy instead of having some on board because that can also potentially worsen jet lag and/or make it more difficult to sleep when you're actually trying to, when you arrive. And again, seeking light, that is the most powerful signal to your brain to help shift your body clock. Also bringing sunglasses so that you actually avoid sunlight at certain times because your body can respond differently depending on again on your home location and how many time zones you cross. So there's certain times that these apps can be helpful that will likely tell you you don't want to get sunlight during these hours. And so you want to be strategic about that and just make sure you have sunglasses so that you can
1:13:46 Speaker 00 still go about your day but try to minimize that sun exposure. Um, getting well rested and getting sufficient sleep, even if it might be a little bit more fragmented than usual, just giving yourself at least a day to acclimate so that I would recommend not scheduling your most important meetings right when you get in or in that first day. For athletes, they don't want to do maximal exercise because there's a risk that that jet lag could increase injury in that acute period. So you want your body clock to be able to readjust. And then using caffeine and power nap strategically. So for example, our afternoon, one to four o'clock is typically when we have this dip in our alertness. Now, when you get to a new time zone, that can occur at a different time
1:14:28 Speaker 00 point in the day. But strategically, then you can use caffeine and and uh power naps to be able to help you through those lulls when you're in that new time zone.
1:14:38 Steven Bartlett? What about sex?
1:14:40 Speaker 00 Sleep and sex in bed and that is it. Because I think so many people actually make the mistake of being in bed and being on their computer, on their phone, doing other work while they're awake. And that actually helps strengthen that connection that when you're in bed, you're awake and your brain will start to associate that. So sleep and sex are all that you want in bed. Everything else should be outside. So when I talked about that wind down routine or that racing mind, all that should happen outside of bed because you want to actually tease apart that association that your brain is making of being awake in bed. And that will be one small adjustment that's helpful to to get better rest at night.
1:15:17 Steven Bartlett? But will will sex improve or hurt my sleep? I'm thinking, you know, because I'm really trying to get at like, should you be in bed with someone? Does it does it improve your sleep to sleep with someone? And does sex have an impact on your sleep? Because I, you know, speaking from personal experience, I think that if I have sex before bed, I sleep better.
1:15:36 Speaker 00 I don't think that there's great literature on sleep and sex out there, but I will say that there has been, there's definitely an impact potentially of a bed partner sleeping with you in bed because their movements can affect your sleep. If they snore, that can very much affect your waking up during the nighttime. And then, you know, with sex, I think that that is something anecdotally, some people will definitely say it helps them to be able to consolidate their sleep and they feel like the quality is better. But I don't think there's a lot of great studies that are being funded for research right now.
1:16:11 Steven Bartlett? What is the most popular question you typically get asked about sleep from people?
1:16:15 Speaker 00 Most popular question's napping, which we've discussed. Keep them short 20 to 30 minutes. I get asked a fair amount about can you oversleep? So, no, we don't think really you should, you can oversleep. When some people say they get, say, nine hours or 10 hours and feel much more groggy, it's because often they've shifted their sleep schedule, or they have an accumulated debt that's has built up, and then they're fine allowing their body to relax. And so now that they're, they're, they don't have the mask of stimulating activities from their day or their work.
1:16:47 Steven Bartlett? I read, I didn't read a study. One of my podcast guests told me that there is a harm to oversleeping, but I think from what I managed to ascertain, the studies they were citing just prove that people who sleep for like 10 or 11 hours typically have a higher risk of disease and mental health. But then it's hard to establish cause and effect, because if you're in bed for 11 hours, maybe you're A, depressed, and B, one would assume you're exercising and moving a little bit less. So you probably got a lot of like cardiovascular issues.
1:17:17 Speaker 00 Yeah, so there are studies of looking at the more extremes of less hours of sleep and then even more hours of sleep, like the 10 hours. And obviously, there can be other comorbid conditions that go along with individuals like who sleep much longer, as you mentioned. You can sleep much longer because of depression or other chronic health issues. And so that's a different context of thinking about oversleeping. I think in the question I typically get is, oh, I slept one night of 10 hours and I feel worse. So I'm never going to do that again. And that's actually not true, right? I think we want to have just more consistent hours that are timed. So you're not having a shift in the bedtime and wake time by like three hours later. Because that could be why you're having that grogginess when you wake up, not because you got the 10 hours,
1:18:00 Speaker 00 but because you're waking up now at 11 a.m. instead of your typical, you know, 8 a.m. wake up time. You could be more dehydrated because of that longer time. Snoring is one that I get asked a fair amount about is, you know, is it completely benign? And I would say if you're snoring, you should go talk with your primary care doctor. And you should potentially ask about getting a sleep study. There is sleep disorders like obstructive sleep apnea. We mentioned before that's incredibly common. And that's when that airway has some partial or full collapse and can lead to very fragmented sleep. So you can wake up not refreshed because you really didn't get quality sleep during the nighttime. And snoring, I think in our society, has become just an accepted norm that can happen as you get older.
1:18:44 Speaker 00 But that is not always the case, that it is a benign, a benign symptom. And so making sure that you talk to your primary care doctor and potentially get a sleep study, I think is incredibly important.
1:18:57 Steven Bartlett? Is sleep apnea the, the most common disease, disorder that you see?
1:19:01 Speaker 00 Yes, yes, it is. Sleep apnea can be incredibly common. I believe it's about 26%
1:19:08 Steven Bartlett? Of people.
1:19:09 Speaker 00 Of people in the ages of 30 to 70. And so that, as you imagine, that's like one in four individuals. But many individuals don't actually get tested or diagnosed and then treated until they're way into their adulthood or even past into their 60s, 70s. So with a sleep apnea, oftentimes people will not wake up refreshed. They will often feel tired in the daytime. They may have a lot of caffeine or have to rely on power naps to keep their alertness up. A lot of individuals will have early morning awakenings. So in those three, four, five o'clock in the morning, they'll wake up and not realize why they're waking up frequently. Snoring can be very common. If you've ever had a bed partner or a roommate and they've ever noted that you stop breathing
1:19:54 Speaker 00 or pause breathing or gasp and choke. Those are very suggestive that you might have sleep apnea. Um, and again, it is incredibly common, but very manageable. So something that I would highly recommend if you, your bed partner, your, your roommate snore, just uh suggest to have, um, I would suggest they go see their primary care doctor.
1:20:18 Steven Bartlett? And typically, is it people that are slightly overweight that are more likely or and susceptible to having sleep apnea?
1:20:24 Speaker 00 Yes, yes. A lot of individuals who are overweight or obese um will be more at risk for sleep apnea. As you imagine, the collapse of the airway typically is here around the neck. And so more weight um typically is, is not helpful for, for apnea. But you can also be a very fit, healthy, young individual. So I work with elite athletes and I have a number of my professional athletes who, again, are young, healthy males, but their anatomy is just more susceptible for this condition.
1:20:55 Steven Bartlett? What are the um, the big rebuttals you get? The big excuses that you hear from people?
1:21:00 Speaker 00 I don't have enough time.
1:21:01 Steven Bartlett? Yeah, I don't have enough time to sleep, okay?
1:21:03 Speaker 00 I don't have enough time to sleep.
1:21:04 Steven Bartlett? And what do you think of that one?
1:21:05 Speaker 00 Uh, I don't think that that's true. I think we, we all are going to make sacrifices and priorities in our day. And I think if you are saying you don't have enough time, I think there's ways to be strategic about how you manage your time in the day. I think we all have five minutes to implement a wind down routine. We can all do that at the very least. I think all of us can um optimize our environment. I think we all can invest in some sleep tools. I think we can make better choices about how you go about your day. So you set yourself up better for sleep. So I think that those are just small adjustments, but will be huge in terms of what that will mean at night.
1:21:46 Speaker 00 Um, I hear that, you know, I will sleep, you know, I'll sleep in the off season. Right now, in season is when I want to focus on being my best. But really, I think that's the, a backwards way of thinking about it. If you're thinking about optimizing your sleep when it gets to the season or the postseason, when some of the most important games come down the line, you're just playing catch up. Because if you have a sleep debt built up and you're just trying to maintain that through the season, you actually are at a deficit versus the other guy or girl on the team who has paid that back in the offseason. Now you have given yourself, you know, zero sleep debt. You're at your best and now you're just trying to maintain that through the season.
1:22:29 Steven Bartlett? What about injury? Well, if I if I'm an athlete and I'm underslept, are there any studies that suggest I'm more prone to injury?
1:22:37 Speaker 00 There are a few studies that do suggest getting insufficient sleep. So under six hours, there's been more fatigue-related injuries in adolescent athletes. There's also a study that has looked at under eight hours of sleep. It still has an increased risk around 1.7-fold higher of injury.
1:22:54 Steven Bartlett? 1.7-fold? Is that 170%?
1:22:57 Speaker 00 Yes. Yeah. Of higher risk of injury when you're getting under eight hours of sleep versus those that got more than eight hours of sleep. And so I think it's unclear exactly why you're specifically more at risk for injury. But I tried to take a look at the biomechanical changes of what happens when athletes are not getting sufficient sleep. In one of my early studies, that has explored the biomechanical changes. And what we showed is that when you're not getting sufficient sleep for multiple days, you have more variability in your biomechanics.
1:23:33 Steven Bartlett? So I'm moving differently?
1:23:34 Speaker 00 Yeah. So you're moving differently. So you're not actually selecting probably your preferred coordination strategy. So for example, I had them doing a vertical jump. And if you're well-rested, you likely should be able to do that very consistently as an elite athlete. But when you're not well-rested, it's much more variable. So they're moving differently and that may put people at risk for injury.
1:23:56 Steven Bartlett? So they're like landing differently a little bit?
1:23:57 Speaker 00 Exactly. Yeah. How their knees, their hips are coordinated together differs. And so that may put you at risk for injury down the road. But more to come, hopefully, on that front. There's just not that many studies that currently exist.
1:24:12 Steven Bartlett? I've noticed something recently because recently I've had to get up quite early on a few occasions. So when I say early, I mean, I've had to go get, wake up at four AM because I've got a flight at six AM. And really interestingly, if I, so say if I got in bed at like 11 PM at night and I, and I have to wake up at say three or four AM. When I wake up at three or four AM, I'm really hungry, but if I wake up at eight AM, I'm not hungry.
1:24:38 Speaker 00 Hmm. Well, you are starting your day much earlier. So your body clock is starting at a much earlier time than you typically would versus eight o'clock. So you almost have what we call socially jet lagged yourself, right? Where you didn't get on an airplane yet, but you literally shifted your whole sleep schedule to be an earlier wake up time. And so you can feel some of the symptoms of jet lag where you can have, and you can have stomach GI upset. You can feel more fatigued. You can have those symptoms as if you got onto a new time zone and flew there, but you hadn't yet.
1:25:10 Steven Bartlett? If it, it almost feels, dare I say, like hormonal, like it, cause I was trying to understand what hunger is. And hunger is essentially a bunch of hormones, isn't it?
1:25:19 Speaker 00 So yes, you have certain hormones that regulate your appetite. So leptin and ghrelin are two hormones that impact your appetite. Ghrelin makes you more hungry, leptin feels more satiated. If you don't get sufficient sleep, these levels can be imbalanced. And so that's where people tend to, as we've talked about, gravitate towards, you know, carb and unhealthy foods in the later evening time. But also when these are not well balanced, that can also lead to weight gain or situations where you're not able to potentially regulate your weight appropriately. And so when I have individuals who are wondering about not making weight goals, I ask them about their sleep
1:26:01 Speaker 00 and they don't recognize that sometimes being able to address how they sleep will actually help them to get to the weight management goals that they're really striving for.
1:26:09 Steven Bartlett? Jack, what about you? We've talked about sleep before. How, how are you sleeping at the moment?
1:26:13 Speaker 03 I've got pretty good at my sleep, but waking up in the middle of the night, you spoke about it in terms of like sleep apnea.
1:26:19 Speaker 00 Yeah.
1:26:19 Speaker 03 But it feels like it should be normal to wake up.
1:26:23 Speaker 00 So awakenings actually can be very normal. This is a very common question I get asked is, you know, should I never wake up at night? And that's actually not true. So you shouldn't necessarily hit your head on the pillow and then you're out for the full night and then never have an awakening. If you wake up, you go to the bathroom one time, you come back, fall asleep in the five to 10 minutes, great, that's actually very normal. So you can have awakenings that happen even in the early morning hours and that can be just a typical part of your sleep cycle because it can be as you're transitioning between these sleep stages that you'll have these awakenings. Sometimes you'll consciously know that you're awake and other times you will unconsciously awaken. And so something like a werewolf might actually show you that you have these awakenings during the nighttime that you don't recall.
1:27:09 Speaker 00 But when it becomes very frequent, then you have these awakenings and over multiple weeks or it makes it more difficult and challenging than to function in the daytime. That's when we get more concerned about awakenings because there's a number of ways, reasons why you can awaken at nighttime, to name a few. It could be environmental factors that affect your sleep. It could be that you had alcohol, you know, that right before bedtime. Maybe there's caffeine that's causing you to be awake. There's also just stress or if you just have a racing mind that potentially could cause those awakenings. A bed partner is something that is a common culprit or underlying sleep apnea that can happen. And so there's early awakenings that need to be investigated with your doctor.
1:27:52 Steven Bartlett? How much does alcohol impact my sleep in percentage terms?
1:27:56 Speaker 00 I don't know the specific statistics of how that's going to impact the duration, but I will say that when we look at the studies of moderate to high consumption of alcohol, that very much has an association with more fragmented sleep, more awakenings during the nighttime. And so the quality of your sleep is significantly impaired. So if you're trying to have an important meeting the following day, an important game or you're just trying to be able to be your best that following day, at least try to minimize or eliminate the alcohol or in the sleep docs world, we say drink when you wake up. We'd rather you have that alcohol in the morning.
1:28:34 Steven Bartlett? Jesus Christ.
1:28:36 Speaker 00 Or the early afternoon, not necessarily right before bed. And so, um, yeah, that's, that's one of the strategies is to eliminate the alcohol right before sleeping.
1:28:46 Steven Bartlett? Dr. Mah, we have a closing tradition on this podcast where the last guest leaves a question for the next guest, not knowing who they're going to leave it for. And the question that has been left for you is if you could go back and fix your worst mistake, but it would change everything afterwards with no guarantees, would you do it?
1:29:09 Speaker 00 No, I would not do it. I think we make mistakes in life and we learn from them and we adapt. And we, it can set us off in a different direction, but that ultimately is going to influence who we become, who we interact with, how we build a life forward. And I wouldn't change my life if I could go back and it would set me on a completely different trajectory.
1:29:35 Steven Bartlett? Could you think of a worse mistake when I said that? Did one come to mind or was there a category?
1:29:40 Speaker 00 There wasn't. I, maybe I haven't spent a lot of time to try and dive into some of my worst mistakes. I definitely have made mistakes along the way and, uh, obviously would have done some things differently in my personal or professional life. But I do think that that is what has made me who I am today. Right? I think I have tried to learn from those mistakes, try not to make them again, um, and try to figure out how to adapt from there. But that has, I think, set me on a path that, uh, is where I am today. So I wouldn't, I wouldn't change that.
1:30:11 Steven Bartlett? It's so interesting, the subject of sleep for me, because I, I was part of the like burnout brigade. The like badge of honor burnout brigade for a long period of time. And I, I definitely thought in my early career, when I started my first business at around eighteen, nineteen, twenty, twenty-one, up until probably about, I'm going to say up until about twenty-six. I thought that me not sleeping was something to show off. And I thought that I was more impressive if I communicated to people how little I slept and how much I was able to accomplish in spite of that. I think actually the greatest enabler to my productivity is like being really obsessive about my sleep and having that rule that I said where nothing in my life, unless there's a, something that's immovable is booked before eleven o'clock.
1:30:55 Steven Bartlett? And I really hope other people, um, After listening to you, after going through your work, which is all available online, really prioritize their sleep because as you've shown through your research and the studies, the impact, the very real impact on our lives is so profound.
1:31:13 Speaker 00 Maybe one shift in your mindset too, that I encourage you, but everyone that's listening as well is, the way I frame it to athletes is, it's a small tweak, but if you think about sleep as not the end of today, it's the beginning of tomorrow. What you do to prepare, what you do to try and get the duration that you're striving for, and how you set yourself up, will affect everything about how you function, how you interact with individuals, and ultimately perform tomorrow. If you're willing to do everything it takes for you to be your best, sleep has to be foundational in every day. And if you're willing to put in that time and that effort, you'll reap the benefits that come down the
1:31:56 Speaker 00 line, and it can be completely life-changing. But you have to give yourself that grace and that patience to be able to make these small adjustments. But as some of my athletes have shown, it can be a game changer for them. It can completely change the trajectory of their career and even life, once they actually get quality sleep under their belt. And so I challenge everyone to make small adjustments, starting tonight, and reach out if you have questions, but
1:32:26 Steven Bartlett? Where do we find you?
1:32:27 Speaker 00 You can reach me at Instagram, Twitter, or X, Facebook, LinkedIn at Dr. Sherry Mah, D R C H E R I M A H. Or you can find me, my website is drsherimah.com.
1:32:44 Steven Bartlett? Thank you so much. I know that there's a lot of different individuals from various sports teams that listen, because I speak to them. I was speaking to some of the guys at Manchester United, two weeks ago, in a hotel about, from the wellbeing team, about These subjects and the sort of interconnected subjects of sleep and wellbeing generally, but also I've spoken to people at Chelsea Football Club that listen to the podcast about these themes. So I'm convinced there's going to be a lot of athletes and aspiring athletes and just people like me who are going to benefit profoundly from the work that you do and the research that you've done that really shines a light on the importance of sleep, which is often misunderstood and is seen as a negotiable part of our lives. So, thank you so much for the work that you do and I'm very excited to see where your research and where your studies take you because it will be pioneering research, no
1:33:29 Steven Bartlett? doubt. Thank you so much.
1:33:31 Speaker 00 Thanks for having me. It's been a pleasure.
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