Stay Off My Operating Table

"How Do I Sleep Better?" Mollie Eastman Has the Answers - #119

November 28, 2023 Dr. Philip Ovadia Episode 119
Stay Off My Operating Table
"How Do I Sleep Better?" Mollie Eastman Has the Answers - #119
Show Notes Transcript Chapter Markers

Like many of us, Mollie Eastman struggled with sleepless nights and groggy mornings. In this episode, she describes her very personal crusade against insomnia and how that led her to become a legitimate Sleep Guru. 

Mollie explains the hazards of disrupting your circadian rhythms through irregular activities like shift work and the potential fallout on your health. We dive into topics such as social jet lag, sleep fragmentation, and the concept of sleep age.

Surprises: Mollie talks about the potential benefits and problems of using blue blockers, the influence of our dietary choices on sleep patterns, and the crucial role of cortisol in our circadian rhythms. She even hints at a relationship between Multiple Sclerosis (MS), exposure to sunlight and Vitamin D deficiency.

Practical Tips: Learn how to remain asleep and how to distinguish between normal and excessive wake-ups.

Finally, we introduce you to Mollie's online sleep health assessment, newsletter, and one-on-one coaching opportunities for those wrestling with sleep. Get ready to transform your sleep, and in turn, your life! Tune in now!
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Connect with Mollie Eastman: https://www.sleepisaskill.com/
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Theme Song : Rage Against
Written & Performed by Logan Gritton & Colin Gailey
(c) 2016 Mercury Retro Recordings

Jack Heald:

Well, if you're looking for the stay off my operating table podcast, you're in the right place. If you're looking for somebody to help you become a much better sleeper and you accidentally ended up here, then you're also in the right place, Because today, on the stay off my operating table podcast, we have, as far as I know, some of if not the only world's sleep is a skill experts. I got to admit, Phil, when I saw we've got a sleeping expert scheduled. Everybody's good at sleeping. What's, what's the deal? And then I went to a website and started digging around. I went oh my gosh. So there's the setup, your turn to hit it.

Dr. Phillip Ovadia:

Yeah, definitely. As anyone who's read stay off my operating table knows, sleep is one of the pillars of health that I discuss and I kind of realized that we haven't talked about it a lot on this podcast. We've talked about most of the other aspects in great detail, and so I was very excited when we I got introduced to Molly and said we need you and our audience needs you Because, honestly, what I see in practice is sleep is a big challenge for people and a big impact on their metabolic health. So very excited for this conversation. And why don't we start, molly, by having you give a little bit of your background and tell us how you became a sleep expert?

Mollie Eastman:

Yeah well, first off, thank you so much for having me, and I completely hear the original kind of question marks that might go off in people's head when they hear about this concept of optimizing your sleep. What can that look like? And I can just say right off the bat that my intention is to provide as many practical takeaways for anyone listening, no matter if you relate to yourself as a great sleeper or a poor sleeper or wherever you are in the spectrum of sleep. We can still take it to the next level, 110%. I'm very confident around that. That's one of the reasons why I named this company.

Mollie Eastman:

Sleep is a skill. Like any great skill, there's always areas for mastery or opportunities for mastery. But the background for me came at it from, I think, one of those places where people often come into. This passion or obsession with certain areas can often times come from kind of trauma or things that did not go so well, and that was certainly my experience. And what that looked like was.

Mollie Eastman:

I now think of my life in a three part series and it's all kind of related to sleep and I'll explain. So the first part of my life. I had a lot of labels and narratives around my sleep and I would say things like I'm a short sleeper, I'm a night owl, it's in my jeans, I'll sleep when I'm dead. Just a lot of isms or ways of kind of thinking about sleep, where it was almost fixed and something to survive and, in my case, not doing so great with it. And I thought that's just how it was for me and this was as a kid teenage years, going to college, and it just kind of progressively some of my habits and behaviors got more and more extreme, but I would continue to say, well, I'll go to bed late, I'll wake up later, I'm an entrepreneur, so I can sleep in. So what's the big deal? Who cares? Not connecting the dots with kind of some of these maladaptive behaviors and my poor health and what that looked like was the beginnings of an ulcer, shingles in my 20s, anxiety, yeah, all these things that were.

Mollie Eastman:

Now I can look back hindsight, you know 2020 and see that how I was certainly managing things was not working, but also not connecting the dots for my sleep. And it wasn't until as this serial entrepreneur in Manhattan burning the candle both ends stressed to the max that it was when I finally went through this period of insomnia where I had this for the first time in my life, this kind of sense of fear around my sleep. I started to kind of develop this sleep anxiety where the sun would be setting and my heart would start racing and I would start dreading the nights and fearing the nights of I can't go another night like this, I feel like I'm losing my mind, was the real fear. So I went to the doctors, left with sleeping pills and that's not really supposed to be how it goes first go around. It is supposed to now, in the United States anyway, be CBTI is supposed to be the kind of first line you know that we're supposed to be introduced to. But that didn't quite go that way for me and I left.

Jack Heald:

What is that?

Mollie Eastman:

I think it's behavior therapy.

Mollie Eastman:

Exactly Yep Cognitive behavioral therapy specifically for insomnia, and insomnia being kind of more defined as difficulty falling asleep, staying asleep, early morning awakenings. And so for me, I had this moment of standing here with my sleeping pill prescription and, coming from a family with a lot of pharmaceutical use and seeing kind of what that path looked like for them. It was very fearful for me that, okay, now what am I embarking on? So this kind of lit this fire to you know, understand, like, how do I restore this area of my life? But also I met a lot of problems along the way. I remember vividly trying to find, like support groups or places that I could go to discuss this. I felt very shameful, alone, fearful that I was going to be stuck like this, that this was this ongoing problem, like I flipped a switch and now I just can't sleep so flat. You know, going forward, I ended up trying a lot of things, spending a lot of money and time, energy and effort, things that worked, things that didn't work, but in the whole period of all this discovered a number of things, including what completely continues to pass. I mean this world of chronobiology, the science of time and how time affects our biology, as well as circadian rhythm entrainment, this idea that we all have this circadian rhythm that we can strengthen. That I certainly was not aware of and was doing everything unbeknownst to me, to weaken the strength of my circadian rhythm. And so, once I started discovering this, it created this blueprint for me of how to live and conduct my life in alignment with these rhythms of nature, not from a woo perspective, but from a biological, hardwired perspective, and what came out of it was amazing. Like so started restoring my sleep not only to how it was, which I, as I shared, wasn't that great but now getting to an optimal, quantifiably optimal kind of sleep opportunities, as it comes from wearable trackers in lab sleep kind of studies and other things.

Mollie Eastman:

So what I discovered was something that I could not stop talking about. So, organically, these small groups kind of started emerging, started an online newsletter, then it grew into this podcast, so now we have the number two sleep podcast. We have online courses to help people go through this process. We have one of the larger databases of ORA ring users, if you're familiar with that sleep tracker. So we have hundreds and hundreds of people utilizing the ORA ring and we could see really on a granular level what are some of the things that can move the needle for people and improving their sleep over time. And we have a particular niche in high stakes poker. So we work with a lot of high stakes poker players on improving their sleep, gamifying their sleep, and they're in a casino designed on purpose to confuse your circadian rhythm, so they're a great test case.

Mollie Eastman:

So I say all that not to say that, but to say that what I experienced was a place of thinking that sleep was just kind of a. I was this lot that I was born into and I had these particular sets of results, and it turned out that I was very wrong about how I was thinking about my sleep, and I'm clear, after working with so many people, that many of us have this opportunity to tap into this thing, that we do a third of our lives on average, 26 years of our lives or spend a sleep, and we don't think that much about it. So that's my story, great.

Dr. Phillip Ovadia:

I love it. Let's start with maybe some basics and some basic concepts around sleep. So one of the big questions that oftentimes get bought up that I get asked a lot is quantity versus quality. We've all heard you need to sleep eight hours or pick your number, but I'd love to hear your thoughts on whether it really is a set amount of sleep that we need or whether kind of the quality of your sleep is what matters most.

Mollie Eastman:

Yeah, great, great call out. So a couple of ways to think about that. And so duration is important. How many hours you are logging, that's important. So to your point. Then it goes deeper than that. Then what is the quality of those hours that you're logging? What's the regularity of those hours that you're logging? I have a lot of people that say, oh yeah, I always get eight hours, no problem. Then we take a look at their stats and then they might be all over the place in the times that they're going to bed, the times that they're waking up. That can be a real sign that we're dealing with certain things like social jet lag. You don't get on a plane but you're experiencing jet lag just because it's all over the place.

Jack Heald:

Social jet lag. That's a good word, good phrase.

Mollie Eastman:

The term right Exactly, and many of us are dealing with that one. But beyond that, then we can also look to some of, as you were speaking to, that quality piece, but that can go into the realm of sleep fragmentation. So how often are you waking up throughout the course of the night, of those wake-ups? Are you aware of those wake-ups, or are they only coming up on trackers and you're kind of you're not cognizant of them but they're still disrupting your sleep? Sleep fragmentation can be kind of a hallmark of something that we're coining sleep age. So you know how you can test for your chronological versus biological age. Nowadays you can. Now we're putting together this conversation of your sleep age, and an older sleep age is characteristic of some of those things that you're pointing to. So some of this poor quality of sleep, but also sleep duration often being lower. So there are many factors that go into that overarching piece of. Are you quote unquote a good sleeper or a bad sleeper?

Jack Heald:

What are the unmistakable signs that you're a bad sleeper?

Mollie Eastman:

Yeah, well, one, I think, might surprise some people, because a lot of people I talk to and I say what I do and then they say, okay, well, that must be nice for some people, but I fall asleep the minute my head hits the pillow. I'm a fantastic sleeper. That right. There is a counterintuitive red flag that something is actually probably wrong or not not working with your sleep. The reason being is that we should have so sleep latency the time that it takes for you to fall asleep. We like to have that be somewhere in the realm around 10 to 15 minutes or so. That can indicate that you're not overly sleep deprived, because falling asleep the minute your head hits the pillow or while you're watching a movie or certain times, they're kind of just not indicative of really being well rested at the right times.

Mollie Eastman:

If you're falling asleep immediately, that can be a sign that we might be dealing with an undiagnosed sleep disorder, sleep deprivation or otherwise. But that would be kind of one that most people aren't aware of. But then other ones that people might be more aware of are some of the difficulty falling asleep, staying asleep early morning awakenings that goes under the category of insomnia. But then there's also the group that maybe they can fall asleep. They maybe can stay awake, stay asleep throughout the course of the night. Maybe they're not waking up early, but they might not be prioritizing their sleep. So for some of my poker players I might see that where they're dealing with just kind of difficult schedules or shift workers or other things. So you want to look at what bucket you're dealing with.

Jack Heald:

Can you unpack that, not prioritizing your sleep? A little bit more, Because it sounds like there's a lot more detail there than at least is making sense to me. Shift workers I understand.

Mollie Eastman:

Totally.

Jack Heald:

That's a good. I've lived with a shift worker for a while and that's a bloody nightmare.

Mollie Eastman:

Oh, absolutely Right. And shift workers, you know, and so grateful for the work that they do and doing such important work for our society, and yet that can be difficult for them to balance. Or if they're having just a lot of demands on them and their time, then they might be able not be able to log the sufficient number of hours they might not be able to get into bed with that total sleep opportunity time, so that's kind of something in their circumstances are hitting at their ability to get great sleep. And then if we unpack that a little more to your point, then there might be the group that maybe is dealing with something that's another trendy term called revenge, bedtime procrastination. This is something that kind of gained some popularity during COVID.

Mollie Eastman:

Very funny term, and what that is pointing to is that so many of us maybe are dealing with a lot of pings on our attention or time or what have you, and so then it can feel like the only time that we have a bit of time to ourselves or just to do nothing or relax, Then we might have that in the evening and then we're stealing time away from our own sleep. So it's kind of hurting no one but us really. But we're still, you know, doing this, whether it's, you know, you can point to a lot of things. Is it the addiction of our phones? Or, you know, all the stimuli? What is it?

Mollie Eastman:

But one of the things that I would point to for all of these problems is that for many people now there are asterisks that might not apply to certain groups, but for many people I find that beginning with tracking your sleep to get a sense of what is going on can be a great place to begin, so you can start to see are you someone that isn't giving yourself just a long enough sleep opportunity? You know you just don't have enough time that you're getting into bed and that you have to get up when the alarm goes off and there's just not sufficient time for you to log that type of quality sleep, and we might see that very clearly with if we utilize wearable trackers or if you're not into the tracking game. Even just keeping an old school sleep diary or log. All of that can be really insightful.

Jack Heald:

Chrono biology. You know this is a podcast about health. We're not afraid to get down and dirty with some of the biochemistry and so forth and so on. I would love to hear more about this field of chronobiology.

Mollie Eastman:

Absolutely.

Jack Heald:

Assuming you can give us that.

Mollie Eastman:

Well, if we think about even the title, so anything chrono kind of relating to time and biology, of course, then, as you're pointing to, I'm assuming you've delved into that quite a bit on this podcast.

Mollie Eastman:

So time, how time affects our biology. Now I am of the estimation and I've been speaking on this now internationally, on what I proclaim like Nostradamus or something, that in the future we will be talking about this conversation around time and these rhythms, so as it relates to circadian rhythms, infradian rhythms, these various rhythms and biorethms that impact our health, results more readily. So this if we're thinking about the science of time and how time affects our biology, we're starting to see more of this coming out. You spoke about shift workers or kind of being connected and seeing firsthand what being a shift worker can, how that can disrupt certain things in our lives. We know this to be true from many reputable sites and studies that even just doing things at the time of day that are upside down to the rhythms of our nature as human beings as human beings were diurnal creatures, meaning that we're meant to be active by day and at rest at night, so anytime we start deviating, from that Hold on.

Jack Heald:

Hold on just a minute. When you say we are meant to be that way, there's got to be more to it than just that we are meant to. Why do we know that?

Mollie Eastman:

Well, if we think about rats, they're nocturnal creatures, right. So we know that, okay, as nocturnal creatures active at night. So that's something, a category that we've been, that they're in, right, and we're not in that category. So one of the things that we see is that why would there be these deleterious health effects for a person engaging in activities? Really, nothing much different besides the fact that now they're active at night and that would be shift workers. So we have plenty of studies that point to what happens when people are working at night. Well, we see one cancer rates go up. So we see things like breast cancer and prostate cancer in particular, really having clear signs and correlations with circadian disruption, and circadian disruption was that circadian rhythm is around 24 hours by which we're operating on this rhythm, and if you're disrupted from that, if you're not kind of entrained in that strong circadian rhythm, then things can start to go awry. So there's that cancer.

Jack Heald:

Doing the same, engaging in the same kind of biological activities that you have choices over at the same time, every day. At the same time, every day Going to bed at the same time, waking up at the same time, eating at the same times Aligned with certain zeitgevers.

Mollie Eastman:

Zeitgevers is a term that means time givers, so time givers are things that tell our body what time it is and what to be doing when the most important time giver or zeitgeber is light.

Mollie Eastman:

So that is the big one that we're finding, to the point that actually this year, a preprint just came out with 250 circadian biologists that are all calling for warning labels on light bulbs at night. Why? Because when we're using warning labels on light bulbs at night, we're finding the risk of things like that cancer going up, diabetes, risk for diabetes going up in metabolic dysfunction, mental health concerns, and then certainly, what we came probably to talk about is the sleep wake disruption that we're seeing for so many people. But what's really exciting about this area, I think, is that it can start to point to oh my gosh, I had no idea. For many people had no idea that something is innocuous, as a light bulb using at night can throw off some of our rhythms to a point that is measurable and study worthy. They're actually pointing to 2,700 peer-reviewed studies to support this urge to bring on these warning labels on light bulbs at night. That's an example.

Dr. Phillip Ovadia:

So, circling back to the shift workers, what you're saying is that even if you're consistent in the shift work, so you work that same overnight shift. Just the fact that you're up at night, working at night, is problematic in itself, because I was always under the impression that difficulty came when you were kind of going back and forth you sometimes work day and then you work night. But you're saying even consistently working night is problematic.

Mollie Eastman:

Yeah, no, that's a very important point. So you touched on something very key, because we do see that rotating shift work is particularly problematic for people. So when we've got a couple night shifts and then we go to midday shift and let's do it again, or whatever, that can be super, super problematic. The other thing we can find to be problematic is, even if people do have consistent shifts, then they're practicing, unbeknownst to them, kind of that social jet lag like we were talking about before, where then on the weekends they want to be with their family, they want to do some, engage in maybe normal schedule of things.

Jack Heald:

Daytime activities yeah.

Mollie Eastman:

Right, totally, and so when they start doing that, then that can really throw things off. But even beyond that because I don't want to scare shift workers and if anyone is a shift worker listening I just want you to be aware that this is clear this is listed as a possible cancer causing agent, this process of working at night. You can look at World Health Organization and other established groups that have called this out. So be aware of this. There are things you can do to help soften that or support yourself, like you're pointing to, as much consistency as you can possibly have. That can make a big difference. But yes to your point if there is a lot of variability, but there is just that clear element that if we are being active at night with these faux lights in our environment, this is doing something to our biology that we're not fully understanding and seems to result in some of these deleterious health effects.

Jack Heald:

Can you dive into the? I've got two different questions. I'll ask them both and then take it where you want. Blue light blockers have kind of been a thing. I'd love to hear your thoughts about the use of blue light blockers.

Jack Heald:

And then, secondarily, my understanding is that our circadian rhythm, specifically our sleep wake cycle, is driven by the levels of cortisol in our system at any given time. I became aware of this a long, long time ago because I was having problems and my doctor explained to me that your cortisol is supposed to rise in the morning. Your body warms up when that happens and part of the reason that you tend to get colder is because the levels of cortisol drop. And so I started to become very aware of in the morning I'd feel my body getting warmer and I'd go oh, my cortisol is going up and at night it's cooled off. So I'm guessing I don't know this, but I'm guessing that part of what happens when your sleep is disrupted is that hormone cycle is being disrupted. Could you talk about that as well? And those may be related.

Mollie Eastman:

No, that's a great question. So first off, yes, a very popular test that people might engage in if they're dealing with difficulty with their sleep could be things like the Dutch test. So testing cortisol levels throughout the course of the day and then how your melatonin levels are functioning in the evening and seeing do we have that strong pulse? But it's kind of a Goldilocks effect of that cortisol in the morning around the same time each day, and that's where that regularity becomes so important. So if anyone, if people are like, well, what are some practical takeaways out of all this? If you just do nothing else but get up at around the same time every day to support, to your point, that clear cortisol pulse, that can be a great place to begin, including the weekends, so that clear cortisol pulse can happen, has a delayed kind of signature of disrupted sleep, is often delayed cortisol pulse and it's pushed out, and then that can further disrupt things like your melatonin pulse, and so we want a really strong melatonin pulse in the evening. And what happens when your melatonin is pulsing? Well then we hope then your cortisol is going down and then that's facilitating this preparation for sleep and then our body temperature, to your point, is then going to go down. We're going to down regulates, almost going to help automate, automatize this process of sleep so that we don't have to try so hard to sleep, we don't have to do a million meditations and all these different things. If you want to, you can, but if we have these things working, then this should really help kind of usher us off to sleep. Now, what are some things that could disrupt our, for instance, melatonin pulse? Well, you mentioned the blue blockers. What I would say there is that one of the reasons that we're that, that, you know, call to arms of the warning labels on light bulbs at night, not just to be cutesy, but instead to point to this kind of prevalence of evening lighting post sunset disrupting our melatonin production. And certainly melatonin got a lot of breasts over COVID and at other points and for many different reasons. And so what are some of the things that can disrupt? That will certainly one, a regularity and pushing that out too late, but two, having those artificial lights at night.

Mollie Eastman:

Because you pointed to circadian rhythm and its connection with cortisol. So circadian rhythm entrainment is one of the things we do with sleep as a skill and how to entrain and strengthen your circadian rhythm Cause you can really have a weak circadian rhythm or a strong circadian rhythm, so it's kind of on a spectrum and you might fall somewhere in between there. Many of us are running around with kind of a weak circadian rhythm, one in which you're not having that clear cortisol pulse in the morning, clear melatonin pulse in the evening. But what are the ways to impact your circadian rhythm?

Mollie Eastman:

The top, most important one that zeitgeiber is light, dark. The second one being related to temperature and you pointed to temperature beautifully, and so that's something that we see very clearly can impact the workability and automation of this rhythm and then also your sleep quality. So if you're testing and tracking your sleep, one of the easiest ways that I see for people to improve things like some of their sleep quality limit, sleep fragmentation, the wake ups throughout the course of the night, as well as the quality of their sleep, lowering their heart rate while they're sleeping, improving HRV is things like cooling mattress pads. So you know, chilly sleep, eight sleep, but also just lowering the temperature in your environment as much as you can, even though our current modern day bedding makes it more challenging because we're kind of rotisserie chicken insulated in our bedding which is the problem.

Jack Heald:

It's so true, yeah, right.

Mollie Eastman:

Oh gosh. So those are some things that I could point to.

Dr. Phillip Ovadia:

So, yeah, I mean so many different interesting aspects of this to get into, but I wanted to ask you about the relationship between sleep and insulin resistance specifically. It's a big thing that we talk about here, you know, around metabolic health, and I'd love to hear your perspective on that.

Mollie Eastman:

Sure, yeah, well one. I just realized I didn't fully answer the blue blocking question, so that could lead us into.

Mollie Eastman:

Okay. So just to complete some of that, because that can play into that conversation that you shared on the insulin piece or glucose, how the functionality of that is the interplay there. So blue blockers are. There's different types of blue blockers. Some people have clear blue blockers and I would say those are not sufficient, not going to do anything really to support you in the evening. If you're using blue blockers in the evening and they're also not like a free pass to then have as much light in your environment, they can kind of mitigate some of the effects. If you have amber or red lenses Now there's lots of different conversations around that I would not rest on my laurels or hopes on the blue blockers.

Mollie Eastman:

I would aim to change our environment as much as possible, but they can be helpful, say, if you want to watch Game of Thrones or something and you throw them on and there's some blue light coming out.

Mollie Eastman:

To not be quite bold over as much, there's different studies to support that, but I would say that that's something that can help ensure that you're not disrupting your melatonin as much to make it easier to fall asleep and stay asleep. Now, if, for the person that is not getting a great night of sleep. What we find is that even with one night of insufficient sleep that we can see an uptick and it sounds like you guys have touched on this as far as this uptick in our even just resting glucose rate. For those that are using continuous glucose monitors they might see, oh, wow, geez, my numbers are suddenly just have gone up and now I'm more likely to be craving some of these things that I might not normally, because of this biological impact of not getting enough of that sleep the night before, that is, after. We certainly are studies that pointed that after one night, but then if you augment that into multiple nights you can very quickly impact that stability and workability of the glucose insulin dynamics.

Jack Heald:

Zowie.

Dr. Phillip Ovadia:

Yeah, very, very important and something I oftentimes recognize in my patients these days looking at their continuous glucose monitors. I'm like you didn't sleep very well that night and they're like I know. But yeah, you can definitely see the signature patterns there.

Mollie Eastman:

I would say if anyone is curious about that, we have had levels, nutrients, signals, very who else? I think we're going to taste ceremonial. Many of the representatives from different continuous glucose monitor companies, at least in the United States and various outside of the United States, touching on this and what they're seeing as well is being part of. Many of them actually put it into their IP on how they're thinking about training people to improve their glucose regulation and stability is around sleep being a key pillar of the management of our glucose.

Dr. Phillip Ovadia:

So related question what are your recommendations around eating and sleep? How long before you want to go to sleep should you stop eating? Are there certain types of foods that are more problematic?

Mollie Eastman:

closer to bedtime this is one of my favorite questions, so this is another fascinating topic. So I mentioned this fancy term, zeitgeiber, which points to time giver. So if you open any chronobiology textbook, they'll point to these different zeitgebers, right? Well, another zeitgeiber or time giver is food and what time we're eating our food, and it's telling the body what to be doing and when, and it's communicating with all these cells, trillions of clocks within every cell and organ in our body and aiming to stay on time, and so one of the signs is what time are we eating? Well, one thing that I can point to is we actually recently had Dr Sachin Panda out of the Sulk Institute, and he's one of the premier thinkers in this area at the moment.

Mollie Eastman:

So decades of research out of the Sulk Institute on circadian meal timing. So one of the things that he has found in his research is certainly aiming to be aligned with some of these rhythms of nature. How could you align with circadian intermittent fasting, if you will, but that sounds more extreme than it really is. It's more just that you're giving yourself a little bit of digestive time breaks, in the evening especially. So out of his research is about three hours being around the time to have your last bite of food and how that can support and improve your sleep and help in train your circadian rhythm. Now, anecdotally, for seeing hundreds and hundreds of people's different wearable trackers, I have seen some really interesting improvements for people when they've tested things like four to five hours being the timeline for their last bite of food, and some people even more.

Mollie Eastman:

Now this is again anecdotal.

Mollie Eastman:

These are bio individual, so something to be aware of. But this can start to go into something that is called that circadian rhythm, intermittent fasting, and that's a bit more seasonal as well. So what would that look like? That you're eating when it's light out, not eating as much when it's dark out, and that makes a lot of sense in the summer, but in the winter for many people then suddenly it's dark at like 430. That can be a little more challenging for people, but it is really noteworthy that we do see a lot of changes and even when you spoke to the glucose and insulin piece and leptin and ghrelin levels, that all these things are working on their own circadian rhythm. So we do find that if people are eating something the same thing at 8am versus the same thing at 8pm, that there seems to be less than an ability to handle that in the same way at the 8pm group than the 8am group. So it seems to be that we're designed to be aligned with these rhythms of nature more than we might have realized.

Jack Heald:

Yeah, do you think?

Mollie Eastman:

Well, to that point, most people are eating most of their day and night. This is a problem. So we're seeing this over and over again. What is the problem for that? Well, it's impacting their glucose regulation, but it's also impacting their ability to get great sleep. So every time you eat, too, that's going to warm up your body temperature just a bit as well. So it's going to also impact your ability to fall asleep with ease stay asleep.

Mollie Eastman:

So many people that complain of wakeups at around 3am or what have you. They might want to look at what's going on with their glucose. They might want to put on the CGM that you're speaking to, as you're going to see that for many people it's a whole mess, and most people even talking about America, we see that wild numbers of people are eating all throughout the course of the day, so there's frequent eating. They might need to register it. Oh, is there another apple? Oh, here's some almonds, whatever, even if it's healthy, not healthy, it's a lot of eating, and every time you're turning on those digestive clocks, that's sending confusing signals. Okay, that's very good.

Jack Heald:

Now, that's a unique thought for me.

Mollie Eastman:

Right.

Jack Heald:

Yeah, it hadn't occurred to me that I've thought of meals as a rhythmic experience, sure, but I hadn't thought of eating as being something that starts the timer, biologically, on this whole range of chemical reactions. I just thought of it as digestion. I put food in it, right, my body goes to work and digest, and blah, blah, blah. Exactly that's a lot to think about. I want to hear stories, though, so give us a great before and after story from somebody came to you and had a problem and we fixed it. This was the result.

Mollie Eastman:

Sure.

Mollie Eastman:

I'm going to ask you a few specifics please? Yeah, let's see. So the first one that comes to mind is a dramatic poker player story of course, someone that had been going to bed, so they're online player, so they actually did have the opportunity to design their days a bit more. They'd had access to different games that are available at different times. So we were actually. When they came in, they were going to bed at around 4.35 in the morning every night. So that was just had bed like that for years and years, and they had had also their stats on the aura rang even before we were doing anything together, and so that was really helpful because we could see just years of data.

Mollie Eastman:

Then what we started doing was working together to one do what we were speaking about the piece on shift workers and kind of relating to them like a shift worker Okay, so if we're going to be going to bed at around that time, they had had so much variability too, so it would be like that one day and then the other day, oh, getting up earlier, another day getting up later. So that roller coaster, we see a lot of that. So even just beginning with stabilizing that from kind of a shift working perspective, help support the change in a number of their metrics their heart rate averages, their HRV, the quality of their sleep, et cetera. But then, as we started aligning there and helping them understand the power of this strong circadian rhythm piece, they started moving earlier and earlier and actually you know they were surprised by how much they were liking that.

Mollie Eastman:

Over time they started shifting over to these earlier online games so that they were able to then think, now live a lifestyle that is much more circadian, aligned, to the point that now they started going to bed around 11 o'clock, which for them was like, you know, as compared to the 5am and what have you, was a totally different reality, and now they're getting to experience time outside. This becomes a big component of this. That's actually part of the reason I moved to Austin was to get more sunlight and I'd been in, you know, grew up in Maine, lots you know Northern latitude location, went to school at Syracuse and then lived in Manhattan for years. So, you know, dealt with all those winter months and all the things where you might hibernate inside. So for them, they actually ended up moving to another location so that they could have more sun options and then having that more circadian, aligned lifestyle.

Jack Heald:

Um, latitude, um. The farther you are from the equator, the greater the variability in daylight versus night throughout the year. Are there any studies on how is the circadian rhythm? Does the circadian rhythm itself adjust based on the amount of daylight you're exposed to, or or is it just a regular clock that, if you're living in Helsinki, sometimes your, your your internal alarm clock goes up, goes off three hours before dark and sometimes it goes off three hours after dark?

Mollie Eastman:

Yeah, great question.

Jack Heald:

Do we, do, we know?

Mollie Eastman:

Yeah, so a couple of things that we know. So one um, this can fall under the domain of kind of health geography and so where we're living on the globe, impacting our health, which is really an interesting conversation. Um, but one thing we can point to that has, uh, you know, a decent amount of data around it that's novel and kind of illustrative is MS, um, so MS. We find that there seems to be a higher prevalence uh rates of MS the more north you are of the equator, particularly past the 37th parallel uh and the 37th parallel on the globe seems to be this kind of line of demarcation we start to see a rise up in rates of MS the further away you're getting into those northern latitude locations. Lots of theories on the Y Um, but it certainly does seem to be noteworthy enough that it's discussed and looked at. Um. So what could we extract from that as a kind of a mitochondrial based?

Jack Heald:

disease. Real quick, real quick. Yeah, go ahead. Where's the 37th parallel?

Mollie Eastman:

So actually it goes right. Um, you know we're talking about Vegas beforehand, uh, so it's right, kind of a long big uh, that Vegas being part of it in the United States, um right along, uh, la and then kind of near around the Carolinas, so you kind of just um kind of align it right down, so what I did was bulk of the United States.

Jack Heald:

Population is north of 37th parallel.

Mollie Eastman:

And what happens when you're north of the 37th parallel, you, um, one of the things that can be challenging is to get sufficient vitamin D, and we're finding more and more how much one vitamin D just in general um, covid, et cetera but how much. That seems to be a player in this sleep conversation. So, if you have insufficient vitamin D, we're finding correlations with poor sleep, or finding correlations with things like sleep apnea, and so there's a big question of what's going on there, uh, and so certainly, if you do have insufficient vitamin D levels and you are in those northern latitude locations, we want to be really aware of this so we can take certain steps. Now I will say, from a bio hacker perspective or things that you could do kind of gadget wise, if people are interested, there are two companies that have, uh, lights that you can generate vitamin D from a light, which is pretty novel, um, and so there's only two companies that I know of, of one's called Spurty, and you can some people can get that covered under their insurance if they're dealing with things like psoriasis, eczema, et cetera. Um, but then it can also be utilized for seasonal effective and what have you? There's that one, and it sold like hotcakes during COVID. Then there's another kind of newer one called chroma D, and they're also linking in red light within there as well, but you can literally like sunburn yourself with these things, uh. So just to call out, um, so some people in northern latitude locations will invest in things like this, uh, because there are certain benefits that can come from getting light exposed.

Mollie Eastman:

Vitamin D versus you know, supplement, um, you know taking supplements but certainly that might be something that we would consider is what type of, how much we're supplementing with. If we are in these northern latitude locations, particularly if we're talking about the United States, from around October uh, to going into the early spring months, that's where you're at a major disadvantage to be able to get sufficient vitamin D, because now the sun is having to stretch across the globe and the power of the sun becomes weaker during those months. So what would happen? You said a really great thing about you know kind of well what does our circadian rhythm kind of shift? One really practical thing is that when those days um change and we go into the winter months and the nights are longer, historically what we would have thought of is this kind of becomes a season of melatonin and a time where we would have slept more.

Mollie Eastman:

And if you're in particularly in those northern latitude locations, you could take advantage of the colder environment almost getting built in cold therapy, which can build up more mel, uh, mitochondrial, you know, kind of production from brown fat perspective. Um, so you can be gathering that in those northern latitude locations in the past, but now, since we have indoor living, um, certain stats point to that around 93% of our day in the United States has spent indoors. That was back in 2001, um, a stat out of the EPA and that was before pandemic. Smartphones, netflix, all the things, probably way more so. Most of us are no longer being exposed to some of those signs and cues that would signal this is winter, this is a time to sleep more, this is a time where we can kind of make up and change that circadian rhythms are a certain extent, um, as a way to kind of repair. We're not necessarily doing that as much anymore.

Dr. Phillip Ovadia:

Um, let um, I wanted to, uh, kind of jump in and talk about a little bit of a different aspect to sleep. We've talked a lot about sort of timing and getting to sleep. Um, how about staying asleep? Because I know this is a challenge for so many people. They'll go to sleep, they'll fall asleep, okay, and then, for whatever reason you know, they're waking up in the middle of the night and then have trouble getting back to sleep.

Mollie Eastman:

Yeah, totally, and one of the more common things that I hear people really, really just hitting their head on the wall about is they cannot, uh, deal with the another three AM wake up. Four AM wake up. Um, so there's a couple of things to say about that One, um, it's kind of differentiating between are some of these, you know, understandable and normal wakeups and that are totally fine and innocuous, or are we starting to go into a category of true, too frequent, of wakeups? Um, how long are we staying awake? So is it taking us a long, long time to fall back asleep? So, kind of just getting some data on this can be helpful, um, but beyond that, what are some of the common reasons for wakeups? Well, there are a bunch. So one um, even just the least sexy one, but probably the one that I see most often and no one likes to hear about, is just the plain old, boring um, regularity, bringing regularity to your sleep time. You go to bed around the same time, you wake up at around the same time. When you start deviating from that, then the body has some confusion on what to be doing and when, and then you can often find yourself waking up at different times with a quality of your sleep can be impacted. So that's like the least fun one but probably the one of the bigger uh lever movers you know in in the conversation. So there's that one, um. Another one would be the glucose piece that you spoke to so often. If some of the stats see, if some of the stats that we've seen come out recently, in recent years, around around 88% of Americans have a metabolic dysfunction, some pointing to even low nineties. You know, either way you cut it, probably a lot of people with some metabolic dysfunction. Uh, if that is the case, it would make sense that then we would also. However you are by day tends to get mirrored at night. So if you're roller coaster, ring on your glucose uh levels throughout the course of the day, then it's likely happening at night and we see, particularly when it's crashing, seeming to bring about a lot of wakeups, um, for people. And not only are those the type of, not only are those wakeups where you're awake and then you go back to sleep, but these tend to be kind of a stress response type wakeup, because now the body is, you know, had that glucose crash and that was a little stressful for it, and you kind of sound the alarms and now you're kind of awake and it 's going to maybe have some trouble going back to sleep. So that's another common one. Um, other ones that people don't like to hear. My husband always says I should have a you know show called Molly ruins everything. Because, uh, the other one people don't like are alcohol, thc. I'm sorry, I saw your cup. Uh, you know the. And listen, I, I'm all for it. Ta-da, exactly, um, you know.

Jack Heald:

So by the way, that's, that's coffee in that cup right there. That's coffee. Totally good for sleep.

Mollie Eastman:

Totally good for sleep, exactly, um. So pointing to things like THC, alcohol, uh, can certainly both help people fall asleep. We do see that, um in many studies often can help support sleep onset. For both of those, however, um, going into later in the night, we do tend to see more fragmentation, more overt fragmentation from alcohol, like clearly you're waking up and you know you're getting hotter and all these things, whereas THC seemed to have a little different effect from certain studies that we see. We'd love to see more studies, uh, but for some people there might be kind of more of this insidious kind of just poor sleep quality, um, and maybe some wakeups and some that they might not even log or remember. So that was a little tricky, but certainly the alcohol piece is very, very clear. So head Southern New York. Oh, okay, got it. Okay, I'll keep going.

Mollie Eastman:

Other wake-up reasons that can be a play heat temperature I mentioned the piece about cooling mattress pads is just one of the easiest ways that I see for people, if it's available in their budget, to help minimize the number of wake-ups you're having, particularly for women going through different stages of their cycle and potentially moving into menopause and hot flashes, but certainly even just at different periods, courses throughout their period.

Mollie Eastman:

We can see different wake-ups at different times, but then for all genders and all people, we do see that if your environment is too hot or you're getting too hot in that kind of rotisserie chicken thing I was talking about, where you're covered in duvet and you got, maybe, foam mattresses just so unnatural to how we would have slept for thousands of years as hunter-gatherers, what was likely, as we would have been sleeping on the ground, which would have been part of the coldest part of the environment, and with that that seemed to support quality sleep and less sleep fragmentation. Now they had other reasons to wake up and fearful of their environment or whatever, but the temperature piece could help support the quality of that sleep. So that's one, and then you can also get into other things like prescription medications, rest, anxiety, depression, other things. So there's a long list.

Jack Heald:

Is there a this is the single most recommended step I take to help people sleep better Like? Is there one that, Once you've checked with somebody, this is the one that most often you recommend and most often helps?

Mollie Eastman:

Sure, I would say.

Jack Heald:

Actually, that's a bad question. What is the one?

Mollie Eastman:

Okay.

Jack Heald:

Because you could just say yes and we go on.

Mollie Eastman:

Yeah, that's a good point, Okay so.

Jack Heald:

Yes, there is Next question.

Mollie Eastman:

Bye Later. So what I would say is and this I go you won't even, most people don't even believe that there are actual conferences around sleep, and there are ones coming up next year sleep 2024.

Jack Heald:

The jokes write themselves.

Mollie Eastman:

The jokes write themselves. We're here all night except Well hopefully not too much not impacting your sleep. So I go to these sleep conferences and some big takeaways from some of these conferences, with some of the brightest minds putting their head on the case of how to improve sleep, often come shake out to as simple as bright days, dark nights as simple as that. But what is the practical application of that look like? Well, we had a NASA subject matter expert on the podcast recently and he spoke to his estimations being that, globally, most people are experiencing 3X to dark of days and 3X to bright of nights. So what is that doing? Well, it's very much confusing our circadian rhythm because, especially the super charismatic nucleus is that main master clock in the brain who.

Mollie Eastman:

Yeah, exactly right. What is that? So the SCN, if easier to throw out there, is directly connected to the eyes, so that's why it's so important. The light piece, so it's sampling the environment constantly to get a sense of what should it be doing. When then it's communicating to all those peripheral clocks in every cell and organ in the body and telling it okay, it's around 9pm, so we're going to do XYZ. So, with that, if we are having the wrong signals constantly, and what does that look like in number terms?

Mollie Eastman:

Well, the average indoor environment most indoor environments tend to be around sub 1000 lux in the environment. Right, so you go into and I have people you can test this on your phone. You can download like a free app Lux is a popular one or Light Meter you can download these and you can test your environment. So how people do that? They might go into their Starbucks that they always work from and they spend a bunch of hours there. They test it and they say, oh, geez, wow, okay, there's only 300 lux in here. Why does that matter? Well, what we're looking for is high amplitude bright days, markedly dark nights. And so what would high amplitude bright days look like in nature? Around 100,000 lux is what it can get to outside when you're being exposed to light outdoors, certainly near the equator and really strong light in the summer.

Jack Heald:

In the Phoenix almost every day of the year.

Mollie Eastman:

Phoenix, right, Exactly so. Very bright, very bright amount of lux that would have been present because we would have been outdoor creatures for so long. Now that we've gone indoors, we've found these new diseases crop up over the years and we saw that there's a lot of really interesting kind of timelines that you can look at as people start moving indoors, weird things start to rickets and all these things start popping up and we have questions around. Well, what is going on? There seems that there could be a correlation between our environment and the effects.

Jack Heald:

Our light environment.

Mollie Eastman:

Our light environment. So you want to get your light right. So now, if you're upping the amount of bright light you're getting exposed to by day, then you want to markedly post sunset help mimic what would be happening in nature. So in our space my husband does not like it, but now he's turned. Now he's just accepts it that he calls me Darth Vader. So in the nights everything turns red, each night consistently. And so why do we do that? Because we're looking for spectrums of light that are devoid of particularly blue. We have some questions around could green impact things, but that's more speculative. But certainly blue light is clear impacts melatonin production. So how do we minimize that? You can have red lights, you can have amber, you know kind of coloring lights that are devoid of blue, candlelight, fire, etc.

Jack Heald:

Yeah, you know we're mimicking the light that we would have had pre electric lights.

Mollie Eastman:

Yes, exactly Because fire or bio hack yeah.

Mollie Eastman:

Because initially, for so long we didn't even have fire, and then we developed oh, we can make fire, we can kind of create it and keep that. Well, what was characteristic of fire? Fire has a large amount of infrared light, so it skews high on the red spectrum. If you are to take, you know, kind of a inventory of what type of light is in there, a lot of red, whereas many of us now find ourselves and actually just this year, what was made illegal in the United States was incandescent lights, that's the old light that you know Edison had created that little filament in it. It's kind of like romantic and you go to a cute restaurant and so like mood lighting.

Mollie Eastman:

Those are now illegal. So those are illegal. And now LED lights are what you are going to get, and so LED lights many. Now, that's not that they're all bad, because you can get LED lights that have warmer spectrum or you can get things like Philip Hughes that can be automated and then you can turn them into more orange or red. But unfortunately many people just have plain old LEDs and that has a huge shot of blue greens If you're in a fluorescent lights.

Mollie Eastman:

It's very alien to our normal type of lighting, so that has a ton of blues and yeah, so it can be super disruptive to your health.

Jack Heald:

That's fascinating. We're really close to the bottom of the hour and I really want to get this last question in. I want to go back to the shift workers. Sure, is it possible, if you're somebody who works at night and sleeps during the day, to mimic the day night shift in light, so that you're so at night working in an extremely bright environment and during the day, darken your environment as much as possible? Has there been any kind of studies done on that, and is it possible to mimic the biological effects by fixing your light environment that way?

Mollie Eastman:

Yeah, such a good question. So, first off, we haven't quite been able to mimic the type of light that we get from this like magical giant sun and this full spectrum light and the true arc that it has. So if you really get into the physics of light, you could spend a lot of time just studying that, of how different it is in the morning versus midday versus afternoon, versus the whole thing. However, people are on the case of aiming to create circadian lighting. Practical applications can look like hospitals, so to help support improved healing. So we do have studies that point to things like if patients are in rooms that have windows and so they're a bit more connected to these rhythms of nature, do they leave the hospital faster? It seems to result in that in certain studies. Now I will say windows are not a full fix, they're better. So all these windows I have behind me, these can still disrupt your circadian rhythm, because in the morning you want to get this bright light in your eyes and not from behind a window, because there are studies that point to 50 to 100 times longer to reset your master clock when you're getting that light from behind a window versus just going outside. So this is where you want to learn about what happens to this light. How is it adulterated? So even if you're someone that is a truck driver, even if you could just roll down the window quite a bit throughout your driving to get real true natural light in, that's going to be kind of a hack for you. Now for your real question, though, about how can you kind of manage as a shift worker, can you mimic these rhythms? You can certainly one get curious and start to learn about some of these things so that you can help support yourself as much as possible.

Mollie Eastman:

One book, that's. I don't have a lot of books to recommend, unfortunately, for shift workers, because there aren't a lot of them. But then this is why one just came out recently and got a lot of press called the sleep fix, and that got pressed because that was actually by an ABC correspondent who went from a kind of journalistic perspective where she was a shift worker journalist and then would have to be on air at odd hours 3am or whatever but loved her job, and everyone would say, well, sorry, you should quit your job. And she would say, well, I want to keep my job, so what can I do? So she started interviewing a lot of people, and so that's one book in a nice place altogether that can have a lot of strategies for people of how to help support your rhythms, even if your rhythms are upside down to a lot of the rest of the society and that can be really problematic and a struggle for people.

Mollie Eastman:

But once they become and get the education on it, then they get a lot of tools at their disposal to help enact this, and some of it can just go to the practicalities of making sure that their environment, when they get home, has certain structures in place. It'll black out. It's as cool as possible. We've communicated with the family to not go in there when you're sleeping and how can we keep this to be in place all week, seven days a week, all of those sort of things. So the answer is we can certainly minimize a lot of those impacts and then I think the more curious people can get, then they can really support these rhythms, maybe more than the average person is even aware of, and they might be doing just as much harm.

Jack Heald:

I really did not think we would get a solid hour of conversation and I would still have a whole lot of questions. I looked at this and I said to myself this is about a 12 minute conversation and. I'm bored out of my skull Wow.

Mollie Eastman:

Well, I hope that makes me very happy because truly, my mission on the planet is to help support people in this area with their sleep. So a passion point for me is because, truly, when I was going through this part of what was so earth shattering and moving to me was I really felt like I was losing my mind, and we know that mental health and sleep are very much interconnected. We don't have really a single mental health disorder that doesn't have the presence of disrupted sleep there. So for me, that was really, really important and what ended up coming out of it was, oh my gosh, my whole experience of life that I had been living for all those years with unnecessary, unbeknownst to me, anxiety, depression, all of these things that I was impacting my results, and I had no clue, and I think a lot of us don't. So I'm so happy to hear that, because anything I can do to help support people's interest and intrigue and hopefully fascination over this thing we do is really important to me.

Jack Heald:

All right.

Mollie Eastman:

Well, point our listeners.

Jack Heald:

Yeah, yeah, so point our listeners. Oh God Phil, we need somebody. Off camera I can tell this we need somebody off camera we need to have the little thing in our ears. Okay, Phil, now it's your turn.

Mollie Eastman:

Love it.

Dr. Phillip Ovadia:

I think we're both trying to get to the same thing, though, but for those in our audience who want to really be proactive about this aspect of their health, which is something we talk a lot about, how can they learn more about how to sleep better?

Mollie Eastman:

Sure, absolutely so. If they go to sleepisaskillcom, they can do a few things. So the first thing they can do is take a sleep assessment, so whatever is going on in their sleep, they can put that in there and then we'll auto-trigger back some kind of personalized things that they can do right away, the process that they can. Also, that will give them a couple of things. So a free optimized bedroom PDF. So that's 17 things high-tech, low-tech things that they can do to improve their environment and, as we talked about, environment really begets your results with your sleep in a lot of ways. So that is that free download. But it will also sign you up for our weekly newsletter. This newsletter I've been doing every Monday for five years or more at this point, and so with that we built this whole community of people that are interested in improving their sleep. We love to have you on there.

Mollie Eastman:

It's called Sleep Obsessions, and so we put screenshots of sleep stats and all kinds of things in there latest studies, et cetera. And then, if you're really struggling with your sleep, we do a couple of things. So one we have sleep wearable audits so we can audit your sleep stats. So if you're wearing a o-ring, a whoop band et cetera. Then we can take a look at those stats and give you some kind of tailored things that you can do. And we also have small group cohorts so that we can take you through. All of these do require an o-ring to participate, because we believe in the observer effect or the Hawthorne effect, which is that call out that when we know we're being watched we might behave slightly differently. So the compliance tends to go up with that element and so that's also the six-year-old boy effect.

Mollie Eastman:

Totally yeah, 100% right what.

Jack Heald:

You're watching me.

Mollie Eastman:

No, I guess I better clean my room. All right, fine, you know, we think we're so evolved, but turns out not so much. And then we also have one-on-ones. If you're really struggling and want some kind of more on-the-ground support, those are some ways to improve your sleep.

Jack Heald:

I have one last question. Are your poker players making more money now?

Mollie Eastman:

They are totally making more money. Now. I actually have one that's messaging me from Vegas right now and he's quite happy because so typically when he'll go to Vegas all things go off the charts. And this guy is just such a character. He's a well-known name in poker and right now he is so happy because now he just bagged quite a bit and yet he's maintaining his sleep throughout the course of that. In the past he might go off the rails when that would have either good or bad. So managing tilt for a poker player is kind of important, and so the ability to emotionally regulate. We know we have plenty of studies at point two. If you get great sleep you can improve your ability to emotionally regulate, and we see that at the poker table.

Jack Heald:

Amazing guest Phil.

Mollie Eastman:

Well, I am so grateful In a million years.

Jack Heald:

what I have guessed? This was really good. This was really good.

Mollie Eastman:

Well, cultyourbrandcom and iFix Hearts on the tagline for both of your names Fantastic, and I'm proud of you for all doing clearly important work. So thank you so much for having me.

Jack Heald:

Thanks so much, molly Eastman. So the website is sleepisaskillcom. Yes, it's all spelled the way it sounds like. We'll have all the connection information in the show notes for those of you listening. I guess we're good.

Mollie Eastman:

All right, well, thank you, I appreciate the time.

Jack Heald:

We'll talk to y'all next time. Bye.

Optimizing Sleep
Sleep Quality and Factors Affecting Patterns
Night Shift Work's Health Effects
Blue Blockers' Impact on Sleep and Eating Habits
Prevalence of MS and Sleep Issues
Optimizing Sleep Quality and Circadian Rhythm
Improving Sleep and Proactive Health Measures