40. Master Your Sleep Routine: The Science of Matching Your Sleep to Your Biology

Sleep isn't just about rest, it's a critical pillar of metabolic health, cognitive function, and longevity. In this solo episode of Extend, I dive deep into the science of sleep routines and circadian rhythms. I share how proper sleep habits are foundational to the new healthcare paradigm focused on vitality rather than disease management. I explain that your sleep routine actually begins the moment you wake up and continues throughout your day, not just before bedtime. I also cover relaxation techniques like four-by-four box breathing and supplements that may help sleep quality, though I typically avoid recommending melatonin except for jet lag. Additionally, I address the common issue of nighttime urination disruptions and offer strategies for returning to sleep if you wake up in the middle of the night, including breathwork and non-sleep deep rest protocols. By implementing these evidence-based techniques consistently, you can transform your sleep quality and overall health. If you're struggling with falling asleep, waking up groggy, or insufficient deep sleep, this episode provides a concrete, step-by-step strategy to build a powerful sleep routine that optimizes your health, longevity, and daily performance. I Discuss: 03:40 The genetic factors that determine your natural sleep-wake tendencies 05:54 Morning routine strategies to optimize your circadian rhythm 07:37 Evening wind-down practices 09:09 Lifestyle factors affecting sleep quality 11:34 Supplements for sleep and managing common sleep disruptions 13:14 Breathwork and journaling Studies Cited: https://academic.oup.com/sleep/article/40/2/zsw048/2662182 https://pubmed.ncbi.nlm.nih.gov/33054339/ Links: https://sleepdoctor.com/sleep-quizzes/chronotype-quiz Learn more about Dr. Shah: Website: https://www.drshah.com/ Clinic: https://www.next-health.com/ Instagram: https://www.instagram.com/darshanshahmd/

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

• 0:03Dr. Darshan Shah?

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

• 0:50Dr. Darshan Shah?

  Hello and welcome to another episode of Extend. I'm Dr. Darshan Shah, and today I'm going to be your only guest. I'm doing a solo sode on sleep, and specifically your sleep routine. It's one of my favorite things to talk about because whenever I talk to my patients about optimizing their sleep, it really falls along two levels of optimization. One level is your sleep environment. That's what we talked about in the last solo sode, last week. And the next level is your sleep routine. The latest science on how you can optimize your sleep has a lot to do with your sleep routine. You've probably heard a lot of talk about circadian rhythms. That's all about the routine that you have throughout your day and how that affects your sleep. If you're someone who's struggling to fall asleep,

• 1:34Dr. Darshan Shah?

  or if you're waking up groggy, or you feel like you never get enough deep sleep, you're going to want to listen because you're going to have a concrete, step-by-step strategy by the end of this episode to build a powerful nighttime ritual that's going to train your body and your mind to get good, deep sleep. So let's get started. So first, let's just talk about why your sleep routine matters in the first place. Your sleep routine, one of the most important points about it, is that it's not just what happens at nighttime when you're in your bed. Your sleep routine is actually the rhythm of your day, your circadian rhythm. And it starts the moment that You wake up.

• 2:11Dr. Darshan Shah?

  Your circadian rhythm is really the rhythm that you live in in harmony with the universe is how your body interacts with the movement of the earth and the moon and really the entire universe. Your goal is going to be to set a consistent circadian rhythm, which is your body's natural sleep cycle. This means you can optimize key factors like light exposure, meal timing, stress levels and movement throughout the day, not just before bedtime. I always say that your sleep routine starts the moment that you wake up and you need to start optimizing your entire day along this rhythm. So that when it comes time to go to bed at nighttime, you actually fall asleep and you stay asleep and have good sleep. I said a word there, consistent.

• 2:53Dr. Darshan Shah?

  It's really important that your circadian rhythm, which means the moment you wake up and the moment you go to bed is consistent. It's really about timing and trying to keep that time the same every morning and every night is what's really going to compound into long lasting benefits. So step one is finding out what is the optimal time for you to want to wake up and go to bed. And we all know that there are different types of people out there. There are some early risers like myself that I wake up ready and to go full of energy first thing in the morning, usually around five o'clock in the morning. Other people are like night owls. You want to stay up late and it's harder to get up earlier in the morning.

• 3:33Dr. Darshan Shah?

  This is called your chronotype and understanding your chronotype can help you plan your sleep schedule more effectively. A journal article in the journal Sleep published back in two thousand and seventeen identified multiple genetic foci, actual genes that are genetic variants of sleep. And these genes actually determine your chronotype, whether you're an early riser or a late to bed type of person or somewhere in between. This article actually found multiple genes. Some of them are called period genes, P E R one, two and three, and cryptochrome genes, C R Y one and two. And these genes interact with each other to determine whether you are someone that needs to fall asleep early or late.

• 4:17Dr. Darshan Shah?

  What I find really interesting about these genotypes Is that they actually have their rooting in evolutionary biology. What the theory is, is that when we lived in tribes, there were people assigned to stay up late to watch against predators and same in the morning, people were assigned to wake up early in the morning and watch the tribe so that the people that stayed up late were able to sleep again. This evolutionary biology theory carried through in our genetics. It is the reason why we have different chronotypes. Dr. Michael Bruce, a good friend of mine who I've had on the podcast before, actually wrote a book about these different chronotypes. And you can actually take a quiz online to find out what your chronotype is. I'll put a link in the bio, but basically what Dr. Michael Bruce describes are four different types of

• 4:59Dr. Darshan Shah?

  chronotypes, which he assigns a different animal to, to describe each one. A lion, a bear, a dolphin and a wolf. So, once you determine your chronotype, one of the first things that you want to do is set yourself a non-negotiable bedtime and wake up time. This is absolutely crucial and this is the same time that you will go to bed every single day. Sleeping in on weekends is one of the biggest mistakes that people make. It actually shifts your internal biological clock and it's what makes Monday mornings really miserable for some people. So as I mentioned earlier, let's start with waking up. Remember your sleep routine starts the moment you wake up. And I think it's really important if you can to start training your body to wake up without an alarm clock.

• 5:42Dr. Darshan Shah?

  This may take a couple of weeks to get right and you definitely don't want to be late for work on these days. But if you can afford a couple of weeks of really trialling and error, wake up without an alarm clock, it's going to reap benefits for the long term. Since your sleep routine starts the first thing in the morning, it's important to have some deliberate actions here to set your circadian rhythm. When you set your circadian rhythm, your melatonin begins to be secreted about 14 hours later. So how do we do this? Number one, morning light exposure. The first thing you should do in the morning is get outside and expose your eyes to natural sunlight, preferably within 30 minutes of waking or so. If you wake up before sunrise, consider either getting a lamp or a light box that is 10,000 lux

• 6:24Dr. Darshan Shah?

  to stimulate sunlight or just wait until the sun comes up and go outside when the sun is up. Like I said earlier, try to wake up without an alarm clock, but definitely don't hit the snooze button. Hitting the snooze button confuses your circadian rhythm. You want to try to get up immediately after you wake up and this will reinforce your wake up time to your brain. So it goes without saying, it's not just exposing your eyes to the sunlight, it's also being outside in the outside environment. This is what our caveman ancestors did when they first woke up, they went outside the cave. That exposure to the outside environment is a signal to your brain about it's time to wake up.

• 7:02Dr. Darshan Shah?

  And then this sets into motion this natural biological rhythm that over time, your cortisol levels will come up. And then over time they'll drop and then your melatonin level, which is your sleep hormone, starts going up about 14 hours later. During the day, it's important to limit your caffeine intake, especially after noon for most people. Some people are slow metabolizers, you can actually check this on some genetic testing profiles. If you're a slow metabolizer of caffeine, you probably don't even want to do more than just a morning cup of coffee. Now let's talk about creating drowsiness at night and increasing adenosine buildup. Adenosine is another hormone that builds up throughout your day. Adenosine is a hormone of sleep drive. As your adenosine builds up, you build up pressure to fall asleep.

• 7:47Dr. Darshan Shah?

  Sleep drive and sleep pressure occur late at night after staying awake for the entire day. This is that feeling of sleepiness that you get towards the end of the night. One of the best things that you can do to build up your sleep drive is to set yourself a sleep alarm. This is actually an alarm one hour before bedtime. The sleep alarm tells you that it's time to start winding down. And some of the things that you want to do when you're winding down is number one, manage your evening light exposure. One hour before bed, you want to reduce the amount of blue light or the harsh light that's in your home by dimming your lights. Or what's even better is switching to a warm bulb, some a bulb that is more yellowish in color. This is called the color temperature of the bulbs. If you look at any bulb on the packaging, they'll give you a color temperature.

• 8:33Dr. Darshan Shah?

  And the nighttime bulb should have a warm yellow light reminiscent of a candle, something between 2,400 and 2,700. Cool lighting, on the other hand, emits a brighter, more energizing light with a cooler white tone, and this has a rating of 4,06500 K. You want to change the lighting at nighttime to be on the warmer, yellowish light. At nighttime, you definitely want to avoid blue lights. Blue lights can definitely throw off your circadian rhythms, and that's why some people actually wear blue light blocking glasses at nighttime as well. Now, let's talk about a few other things that definitely affect your circadian rhythm as well. Meals, exercise, and stress management all contribute to whether you have optimal sleep or not.

• 9:14Dr. Darshan Shah?

  Meal timing absolutely matters. You want to avoid sugar, caffeine, and alcohol at least four hours before bed. You also want to try to avoid fluid 90 minutes before bed, so to prevent nighttime wake-ups to go to the bathroom. Try to stop eating four hours before you go to sleep, and you'll avoid acid reflux and blood sugar spikes that could also potentially wake you up. Next, you want to exercise at the right time. Exercise may be great for sleep, but you want to avoid intense workouts four hours before bed. This will prevent elevated cortisol levels and help you to get better sleep. So try to work out a little bit earlier in the day. Obviously, everyone's a different person, and some people love to work out before bedtime. If this works for you and your sleep tracking device shows that you are still getting good sleep, go for it. But if you are having trouble

• 9:59Dr. Darshan Shah?

  with late-night workouts and sleeping, try to move your workout to earlier in the day. Next, you want to reduce your stress for the next day. A lot of people go to bed worried about all the things they have to do their next day, and you have a continual to-do list in your head that you're trying to remember. Try to do some planning for tomorrow before bed. Write down your to-do list so it gets out of your brain and onto a piece of paper. This clears the mental clutter and prevents laying in bed just ruminating. You also don't want to work in your bedroom. Your brain should associate your bed with sleep only, should not be associated with any work, or stress, or social media. This brings up a really good point. You've got to stay off your phone for an hour before bedtime. I know this is going to be hard for a lot of people to do, and in my previous solo

• 10:43Dr. Darshan Shah?

  show, I recommend putting your charger in a different room. You might have a problem with this early on, but You'll see that as time goes on, it'll be easier and easier to have your phone separated from you for at least fifteen to twenty minutes, preferably an hour before bedtime. Next, you want to use some relaxation techniques, using techniques like breathwork, meditation. These activate parasympathetic nervous fibers in your brain, and they help prepare your body for deep sleep. A really good breathwork exercise to use before bedtime is four by four box breathing. Clear your mind and breathe in for a count of four, hold for a count of four, out for a count of four, and then in for a count of four.

• 11:25Dr. Darshan Shah?

  Box breathing about five to six times will increase parasympathetic activity, decrease sympathetic activity, and help you get better sleep. Finally, there are some supplements that can help with sleep. Consider supplements like magnesium glycinate. Also, tea is made of passion flower and chamomile. You can also look into tryptophan, ginkgo biloba, L-theanine. These are all supplements that you can try, and using monitoring devices like an Oura ring or a Whoop band, you can see how much they're helping. If they're not helping, after about a week or so, probably not going to work, and you can stop taking them. But if they do help and you do see a measurable improvement in your sleep, they might be worth continuing. Melatonin, on the other hand, I try not to use melatonin in my patients, and the reason

• 12:09Dr. Darshan Shah?

  is your body is supposed to make its own melatonin. And so, taking a melatonin supplement every single night suppresses that ability and increases your body's need for melatonin for getting sleep at night. I do use melatonin only when traveling to help with jet lag, but otherwise, try to stay away from melatonin for sleep. Next, let's talk about nighttime urination. So, one of the best things that you can do and is often overlooked, is to just use the restroom and empty your bladder before you go to bed. This, for most people, should be able to help you get through the night without having to go to the restroom. If, however, you are waking up in the middle of the night, it's worth talking to a doctor for men for prostatic hypertrophy, and for women for weak pelvic floor muscles.

• 12:51Dr. Darshan Shah?

  Both of these conditions can be addressed with medications or with specific exercises to help strengthen these muscles. Having to wake up in the middle of the night to go to the restroom Often becomes a normal occurrence for many people and it's very disruptive to your sleep. So please make sure you're actively addressing this with your OB GYN or your physician. Lastly, let's talk about what to do if you wake up in the middle of the night from a deep sleep. Even with a perfect sleep routine, many people will find themselves awake in the middle of the night and struggling to go back to sleep. Number one thing you want to do is don't check the time and watch the clock. Seeing the clock increases anxiety about how much sleep you have left, how much time you have left, and it's just counterproductive. Number two, try not to get out of bed unless it's absolutely necessary. Stay in bed and

• 13:35Dr. Darshan Shah?

  try relaxation techniques. Getting up out of bed increases your heart rate and makes it even harder for you to try to get back to sleep. Some of the relaxation techniques that you can use are breathwork techniques. I mentioned the four by four box breathing technique earlier. There's also a four, seven, eight breathing technique where you inhale for four seconds, hold for seven, exhale for eight. These methodologies slow your heart rate and relax your nervous system. You can also try an NSDR or non-sleep deep rest protocol. This was popularized by Andrew Huberman and it helps induce deep relaxation. You can search YouTube for NSDR videos. Finally, if you're one of those people that wake up in the middle of the night with a thousand thoughts in your head, it might help to keep

• 14:18Dr. Darshan Shah?

  a journal at your bedside. Simply writing down your thoughts can help clear them out of your brain and allow you to relax and get some sleep. Your sleep routine is one of the most powerful tools you have for optimizing your health, longevity, and your performance. Once again, I'll mention it again, your key is going to be consistency. Small changes repeated daily will transform your sleep over time. Use your tracking device to see how specific actions help your sleep or hurt your sleep and keep repeating what works. If you found this episode helpful, share it with someone who can use better sleep. And if you have any questions or want me to cover more sleep topics, reach out to me either by email or by social media. Until next time, sleep well and stay healthy.

• 15:02Dr. Darshan Shah?

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