Episode 3: Sleep: the 2nd Pillar to Live Long and Well

Ever wondered why you feel like a different person after a good night's sleep? Join me, Dr. Bobby Dubois, as I discuss the transformative power of sleep and its undeniable link to longevity. In our latest episode, we embark on a nocturnal odyssey, exploring the critical functions of sleep for brain health and memory, and dissecting the alarming decline in sleep duration among Americans. The consequences are stark - from heart disease to obesity and sleeping better helps us eat less - but fear not, as I arm you with a dozen strategies to reclaim the night and improve both the quality and quantity of your slumber. Plus, discover the concept of 'N of 1 studies' – a tailor-made approach to determining what sleep solutions work uniquely for you. Take stock of your sleep today; try something to improve your sleep, and see how it works!

As we traverse the landscape of sleep health, learn how to monitor your own sleep habits and feelings of restfulness with insightful questions that help establish a personal sleep baseline. Adjustments to caffeine and alcohol intake take center stage, as I share how to tweak these for better nights. Armed with this chapter's knowledge, you'll be equipped to fine-tune your rest through understanding your body's individual reactions, setting the stage for a restful revolution in your life.

We round off the journey with 12 practical lifestyle shifts that promise to overhaul your sleep experience. Embrace consistency in your bedtime routine, get sunlight in the morning to set your biologic clock, exercise during the day, avoid eating too close to bedtime, understand the unexpected perks of warming up before tucking in, and curate the perfect sleep-inducing bedroom environment. While the jury may still be out on the sleep-promoting benefits of socks and supplements, I shed light on their varied effectiveness and encourage personal experimentation. So synchronize your body clocks and get ready for an episode that could just lead you to a longer, more vibrant life. Join the conversation and share your sleep success stories – because when it comes to health, every minute of rest counts.

Transcript

Speaker 1: 0:04

Hi, I'm Dr Bobby Du Bois and welcome. To Live Long and Well a podcast where we will talk about what you can do to live as long as possible and with as much energy and vigor that you wish. Together, we will explore what practical and evidence-supported steps you can take. Come join me on this very important journey and I hope that you feel empowered along the way. I'm a physician, ironman, triathlete and have published several hundred scientific studies. I'm honored to be your guide. Several hundred scientific studies. I'm honored to be your guide. Welcome everyone.

Speaker 1: 0:57

Today's episode will focus on the second of the six pillars sleep. As a reminder, the other pillars are exercise in episode one, and then upcoming episodes will be on nutrition, mind-body harmony, exposure to heat and cold, and social relationships. Sleep is really important to live long and well, and the good news is you can improve it. So in this episode, we are going to first talk about why sleep is important, what it does for your brain and for other parts of the body, and I hope this part motivates you to think carefully about your own sleep. Next, we'll talk about how we can improve our sleep. The good news is, in this section we'll talk about 12 things you can do to help your sleep or not do that will change the quantity and quality of that time we sleep. We will talk about the scientific evidence when it exists to support each of these, and I'll do my best to point out when the evidence is not quite as convincing or available. Third, we have a bonus topic, because what works for one person may not work for another. We will explore how you can get your own evidence about what does or does not work for you. We call these N of 1 studies and we'll talk about them as it relates to sleep today, but in future episodes we'll talk about them using similar approaches for nutritional supplements or mind-body harmony or really many other topics. It's a very important concept and I hope you enjoy it and begin to use it in your life by the end of today's episode. I hope you'll be excited to improve your sleep and, most importantly, have the practical tools to do so.

Speaker 1: 2:55

Let's start with some sleep numbers. Unfortunately, most people in the United States don't get enough sleep. In the 1940s, americans got approximately 7.9 hours, obviously close to eight hours. That's fallen a lot over the decades and now it's less than seven hours. It's about 6.8 hours and lots of people maybe a third of people get, on average, less than six hours per night. Now, the problem here is that the number that comes from research studies is seven, meaning seven or more hours puts you generally in a good place, and less than seven hours puts you in a not so good place. Now we all know from life experiences when we don't get enough sleep, it affects our ability to both live long and well. When we don't get enough sleep, we don't have the energy or alertness or memory or happiness that next day. And as we explore, we'll talk about the data that shows that sleeping less than seven hours is associated with a 20% higher risk of heart attack, a 30% greater risk of obesity and a 30% greater risk of cognitive decline. And this came from an important British study.

Speaker 1: 4:20

Well, good stuff happens in the brain when we sleep. Now, if you're interested in sleep and you want to go deeply into it, there's a really great book by Matthew Walker called why we Sleep. Now he talks about all sorts of things, but one of the fascinating areas is about memory short-term memory and long-term memory, and what he explains, based on research, is that new memories are stored in a region of the brain called the hippocampus, and when we sleep those new memories go from the short-term place in the hippocampus to the long-term place in another part of the brain called the cortex or the outer part of the brain. So sleep clears the hippocampus short-term region so it's ready for more new learnings the next day. It's kind of like rebooting your computer. When things are running slowly and the memory is all used up. You reboot the computer and all of a sudden things run faster and better. Well, that's kind of like what sleep does. Now, the other thing that happens in sleep which is really important we're not going to dive too deeply into kind of the physiology and biochemistry is the brain uses a lot of energy throughout the day and when it uses energy it creates byproducts, things that you would really like to get rid of so that the brain can function as well as possible. Well, when you sleep there is a flushing process that gets rid of some of those chemical agents that build up during the day. And if you don't sleep, or you get too little sleep, that flushing process doesn't occur, and then the rebooting process we talked with the hippocampus also doesn't occur. So things happen in the brain that are good when we sleep and not so good when they don't.

Speaker 1: 6:18

Now let's look more broadly at what happens when we don't get enough sleep, broadly at what happens when we don't get enough sleep, and I like to highlight three problems here. First, too few hours of sleep is associated with increased mortality. There's a study of 3,000 people. It's a survey study that the US government does, it's called the NHANES study and what they found, which is consistent with what other groups have found, is that if you get less than six hours, you're at a higher risk, a significantly higher risk of stroke, heart attack and heart failure. So many studies have shown the number of hours is important and, as I mentioned earlier, the seven or more is the sweet spot.

Speaker 1: 7:03

But there's another piece of the puzzle, which is what's called sleep regularity, which in essence means going to bed at the same time each night, getting up in the morning at the same time, and what that means is that you tend to get similar hours of sleep day in and day out. Well, this was shown to be very important in a study done in Britain called the Biobanks Study, where they followed people for a very long period of time 61,000 people and we're going to talk about this in future episodes on different topics, but they also looked at sleep, and they had folks wear something like a Fitbit something they wore that was able to measure how much movement they had and what their sleep was like. And what the study showed is that people who had regular sleep meaning going to bed and getting up at similar hours day after day had a 20 to 48% lower risk of mortality compared to those whose regularity of sleep, their patterns of sleep, their times of going to bed and getting up, were much less regular. The second point I'd like to raise is that less sleep causes changes in the brain, and those changes are not good ones. So there was a study that looked at about 140 people that were about 73 years old, and these people had sleep apnea. So does it apply to regular people without sleep apnea? Perhaps, but this study was done in folks with sleep apnea, and what they did were two things. So the people had an MRI scan which showed what's going on in the brain. People had an MRI scan which showed what's going on in the brain, and then they had a sleep study where they measured the quality and quantity of sleep, and what they found was that the people who had less deep sleep, or what's often called slow wave sleep, had changes in their brain on the MRI scans. That was similar to folks at age. So we don't know if the poor sleep caused the changes in the brain. And if that's the case, that's a bit worrisome and as we'll talk about.

Speaker 1: 9:18

Sometimes there's reverse causation. Well, what do I mean by that? It's a big word. It could be that it had nothing to do with the sleep causing the brain defect. It could be the other way around, that people who have brain changes noticed on MRI don't sleep so well, so we don't know where the cart and the horse is and which one's in front. But if in fact the poor sleep leads to these changes, which are suggestive of aging, that's consistent with the data showing people who don't sleep well have a higher risk of cognitive decline. Is it definitively determined? No, do I worry about this? Absolutely yes, both for myself and for you, the listeners. Third, and this is a really fascinating thing, sleep affects how much we eat. Now, you probably know this, so from personal experience, if you don't get a lot of sleep the next day, often we're very emotional, our inhibitions may be down, we might argue with people more than we would, and you may eat more out of sort of comfort seeking because you don't feel completely yourself.

Speaker 1: 10:33

Now, in the next episode on nutrition, we're going to talk about the importance of proper weight, but this sleep study I'm about to share with you helps us to understand something important and something you may want to pay attention to. So here's a study that looked at people who were overweight. Now, they weren't massively obese. They were overweight, though, and these are folks that got typically less than six and a half hours per night, so they were under that magic number of seven significantly so and potentially a problem, and so what they did was they taught these people various techniques, some of which we're going to talk about in a little bit, and at the end of that intervention, the people who got less than 6.5 hours of sleep were now getting, on average, 1.2 hours of sleep more, or well, more than seven hours of sleep, and that's great. But what they also observed is that the people whose sleep improved ate less, and specifically 270 calories less, which may be 10 or 15% of what you eat every day, and over the course of 10 or 15 days, that could amount to a pound of weight gain, or weight not gained. So this is fascinating and yet another sort of motivation for why sleep matters.

Speaker 1: 12:01

All right, we're ready to switch gears and I'm hoping people are excited to go to this next step about what we can do about our sleep, because I hope we've built a case that the lack of sleep affects our brain. The lack of sleep affects our body and our mortality and clearly keeps us from being able to live long and live well, which is, of course, the title of this podcast. So in part two, we're now going to figure out how can we improve the length of our sleep and the quality of our sleep. Now, as a general rule and you're going to hear this over and over and over and over again in future podcasts anytime we hope to improve something. It could be our fitness, it could be our nutrition, it could be anything. It's a really good discipline to define where we are or do what you might call a baseline assessment. Then you can test and see what works. But if you don't have a baseline assessment, ideally in a quantified fashion, it's hard to know if things are getting better or just you perceptively think yeah, I think they're getting better or I think they're not.

Speaker 1: 13:13

Now many people have an Oura ring or a band or a smartwatch, and they provide numbers. Now, sleep numbers are not perfect on these devices. Certainly, if you did a formal sleep study, they might be more accurate, but the reality is, if you're wearing a funny thing on your head and you're sleeping in a strange place, the numbers might actually not be ideal, because that doesn't necessarily reflect what your normal experience will be. But these devices will help you understand how long did you sleep, how often were you interrupted with your sleep and how much REM or deep sleep you've had. Now another way to go is forget these devices is to ask yourself a series of questions, and there are questionnaires on the web that can do this in a quantitative fashion. The one's called the Pittsburgh questionnaire I'm sorry, it's called the LEED Sleep Evaluation Questionnaire and you can find it online and I can put it in the show notes.

Speaker 1: 14:14

But the kinds of questions you want to ask yourself on average, at my baseline, how many hours of sleep do I get? How difficult is it for me in general to fall asleep? Do I wake up at night and have difficulty falling back asleep? And how do I feel in the morning? Do I feel refreshed? Do I feel sleepy, do I feel sleepy in the afternoon? So you can quantify these, you can write them down and then you have a baseline to say whether things you try are making things better or making things worse. So, once we've quantified our baseline, now the great news is there are things we can do to improve our sleep. I try to divide these into things to avoid and things you might do, and between these two different categories, we have 12 or 13 things that we can do to really improve our sleep.

Speaker 1: 15:14

All right, first thing, to avoid caffeine. Now, I don't say that as a blanket statement, because some people are very sensitive to caffeine and some are not, but for those that do feel that caffeine kind of wakes them up, having caffeine late in the day can be a problem. Now, this isn't just my impression. There are studies out there that show that. There's an interesting study that was done in Brazil and it was an online questionnaire, so it was self-report. It's what the people experienced and what they found is the people with the highest caffeine intake 31% had insufficient sleep so below that seven number. That we think it's important.

Speaker 1: 16:00

As I alluded to before, and we'll come back to over and over again, what studies tell us may not be complete and we need to understand what are the limitations of this study. So this study is complicated by the reverse argument. Now I'm making the claim that maybe the caffeine intake worsened our sleep, but you could say the data supports an alternative hypothesis. People who don't sleep well need to drink coffee the next day and, as we all know, if we're feeling tired because we didn't sleep well, we might drink coffee. So we don't know the circularity of this. Is it that caffeine worsens our sleep or is it that sleep causes us to drink more caffeine? So that type of study doesn't answer the question.

Speaker 1: 16:52

But there are studies where they give people caffeine and then they see what happens and what they find is caffeine can prolong the time it takes to fall asleep. You know you're sort of wide awake and it takes you not five minutes to fall asleep but 45 minutes, which then leads to reduced number of hours of sleep and a worsening of how you felt about your sleep. So what's the take-home message here? The take-home message here is if you enjoy your coffee or tea, which many of us do, drink it if you can in the early parts of the day. The caveat here is if you feel that it affects your sleep. And since many people aren't caffeine sensitive, you can enjoy your caffeine any time of day. I, however, am extremely sensitive and if I have a full cup of coffee at 8 in the morning by nine or 10 at night, I'm having a hard time falling asleep. Other people can have an espresso at dinner and fall right to sleep. But do assess your own capabilities here and what affects you, and that can be your North Star about what to do.

Speaker 1: 18:06

The second thing to avoid and I'm afraid this may make me, at least at the moment, unpopular and that is try to minimize your alcohol intake, especially alcohol intake close to bedtime. Again, this really applies to people who have sleep troubles. If you sleep like a baby and you wake up and you feel wonderful, then alcohol may not be a problem. But for the vast majority of us who have challenges with sleep, looking at our alcohol intake and its effect on us could be very important. So what studies have shown and what most people know is if you've had a couple glasses of wine or whatever, we typically fall asleep pretty quickly. You know, we hit the pillow and before we know it, we are asleep, but what tends to happen is in a couple of hours we wake back up again and we have a hard time getting back to sleep. So here's an area where another study is helping us understand this. So they did a questionnaire of 500 people about alcohol and sleep, and what they showed was that the amount of alcohol correlated with sleep quality and sleep duration. Meaning those people who had a fair bit of alcohol found that their sleep duration was impaired and the sleep quality was also not as good.

Speaker 1: 19:35

Now, this is just a taste of the issues related to alcohol. No pun intended about taste, but in a future episode we're going to talk more in detail about alcohol and its effects more broadly and how we may want to approach drinking moving forward. Now, this may sound a little odd, but if you're going to drink alcohol, perhaps have it for lunch or early afternoon. And why do I say that? Because if alcohol affects you and you drink it earlier in the day, then by the time you go to bed it's probably completely worn off for most people and it won't affect their sleep. So in the old days people might have a martini for lunch, and that, of course, went out of fashion. And then the saying went well, it's five o'clock, we can now have our alcohol, but consider having your beer at lunch, because then it's much less likely to affect you. So keep that in mind.

Speaker 1: 20:32

The third area to avoid may be naps. Now, naps are wonderful, and occasionally I take a nap and I love it. But if you do a nap too late in the day three o'clock, four o'clock, five o'clock you may feel really, really tired, but it's going to have a consequence later on. There's a biochemical reason for this and I don't want to get lost in the physiology. But one of the ways that makes us want to go to sleep is, as the day rolls on, our body, our brain, makes adenosine, which is a chemical, and it builds up over time, and when it reaches a certain level, we say to ourselves gosh, I need to go to sleep. I feel really, really tired. The problem is, if you take a nap, especially if it's later in the day, that adenosine level, or sleep pressure, goes away, and so when it is time to go to sleep, then it may be difficult. Now there are studies that also look at this, and they found that late naps were associated with fragmented sleep, poor sleep efficiency, which is, you know how long you sleep and how quickly you get to sleep and how much you move around and how often you wake up in the middle of the night. So napping around and how often you wake up in the middle of the night, so napping probably a good thing, helps you feel good. But think about when you're doing it and if it affects your sleep.

Speaker 1: 21:54

Number four try to avoid eating near bedtime. You know, I think it's probably best to stop three, four, five hours if you can. You know, eat at five or six and then if you go to bed at 10, you've really had a lot of hours after sleeping. Now, this might be sort of our grandmother's recommendation, but there's science to support this. So they did a study of almost 800 people and they asked them about eating within three hours of going to sleep, and what they found is that people who did eat closer to bedtime had more wake-ups at night, it took them longer to fall asleep and they were more likely to sleep less than six hours. So this is something to keep in mind and to try out in yourself.

Speaker 1: 22:45

Number five put away your electronics, your screens, at least an hour before bedtime, maybe even further. Now, this could be due to your melatonin. Melatonin helps us to go to sleep and if you are looking at electronic screens, it can affect our melatonin release and our melatonin cycle. So this is one reason why this might happen. There are cross-sectional studies that really look at this and they found that people who use screens up until bed or have the most screen time, had the least sleep. Now again, this is one of those studies. That wasn't a randomized trial, so you don't really know. But there's an alternative view, which is they had very little sleep because they were up at night playing on their computer, and not that it affected their sleep, but they just had fewer hours before they had to get up in the morning. So that's another possibility.

Speaker 1: 23:45

But there are studies on blue light blocking glasses that suggest that these devices can by themselves make sleep more difficult. So there was a study now it was only in 15 people, it was in people who had problems with insomnia, but it was a randomized trial and what they found is that they put on the blue light blocking glasses two hours before bed. They had marked improvements in how long they slept, how sleepy they felt the next day and the quality of sleep. So this suggests that exposing ourselves to electronics can be problematic. Another study which makes it a little more likely that this is actually reality is what's called a dose-response relationship. So if you say to yourself, well, I wonder if those iPads and things affect my sleep, what you would like to see to make you more convinced is that if you have an hour of it, it affects your sleep a small amount. If you have three hours of exposure to these things, you get even worse sleep, and if you have five hours, it's even worse after that. And so they did a study of almost 10,000 adolescents, and what they found is that people who had less exposure to electronics had a much greater likelihood of seven or more hours of sleep. So this is a study that might support that theory. Now, whenever possible in today's episode and in the future ones, I'll try to identify when we have evidence, which is a lot of things I've already talked about today, but when we don't, so the next two items there is no great evidence, and if people can find some great, send it my way. That would be lovely, but they do make sense.

Speaker 1: 25:37

So if you get up at night to go to the toilet and often when you do that, it wakes you up and it's harder to get back to sleep. Consider not drinking water after 5 pm, after 6 pm, so that there's less of a need, less of an urge to go to the toilet and you might not then get up at night or have difficulty falling back asleep. The other thing that is a good thing to consider not doing is tossing and turning. If you're finding it difficult to get to sleep after 20, 25 minutes, get up, get out of bed, do something else and then come back and try it again later. Again, are there good scientific studies for this? No, but it seems like a good idea. Okay, let's switch gears now to things you can do positively that will help our sleep. The first is get sunlight early in the day. It helps to set our biologic clocks and it may make our melatonin levels higher later on, which will help us to sleep, and there are studies to support this. You know, perhaps go for a morning walk. If you have to walk the dog, that's a great thing to do.

Speaker 1: 26:52

Exercise is a wonderful thing in general, but it's also been shown in over a dozen studies that it helps sleep. They did a study of 4,000 or more adults and they followed them for about 10 years and they sort of looked at people who were physically active and by their definition in this study was two or more hours of exercise a week, and what they found is that folks that had exercise programs and were physically active multiple hours per week had a 40% less likelihood of a short sleep duration, which they defined as less than six hours, and much less likely to have insomnia. So exercising seemed to be associated with people having much, much better sleep having much, much better sleep, and in a meta-analysis of 22 clinical studies and a meta-analysis is really a summary of studies again they found that exercise was associated with better sleep and sleep quality. Okay, number three perhaps meditate or do another mind-body activity during the day, and there was 18 clinical studies with 1,600 or so people. When they compared those that meditate versus those that don't, they found that people who meditate had better sleep. What's interesting, but not definitive at this point, is the people who meditated longer had even more benefits. So that's something to consider if you don't already have meditation as one of your practices.

Speaker 1: 28:29

Number four and this is a really important one, and it's one that I've learned and relearned and relearned so many times which is going to bed at the same time each night really makes a difference For me. I wake up at five in the morning, so if I go to bed at you know nine, nine, 30, I'm going to get eight hours or close to it. If I go to bed at 10 o'clock, I'm going to get an hour less sleep. If I go to bed at 11, I'm lucky to get six hours of sleep. People think if you go to bed later, you'll just sleep later, but the reality is often it doesn't. There was a good study now. It wasn't huge, it only had 46 adolescents and they looked at kids that were going to bed each night which they called sleep regularity at the same time, and they showed they had longer sleep duration and they fell asleep quicker. And the converse was true, that if you didn't go to bed at the same time each night, these people did much worse with their sleep.

Speaker 1: 29:28

Number five try a sauna or a hot bath or a hot shower before bed. Ultimately, although it's counterintuitive, it helps your body to cool down, and cooling down helps us sleep. Now, why could that be? Well, when you're in a hot bath or a shower or sauna, your body gets hot and your blood vessels dilate and you get red of the skin. So when you get out of that hot experience, what happens is sort of the opposite, which is the body radiates heat. You can feel the heat coming off of you, but the blood vessels stay dilated even after you're back down to a normal temperature. So it actually, if people do this, they'll find that 15 minutes later they're actually chilly.

Speaker 1: 30:20

And there's a study that supports this where they took people who then had a hot bath or shower and that was about 105 degrees to 109 degrees and only 10 minutes. It didn't have to be a very long bath or hot shower and they found significant improvements in sleep. So something to do Related to this is setting your bedroom temperature below 70 degrees and in a very interesting study although let me say at the outset this was a study that was done and written about by people who own the patent for this device, so you have to take that with a grain of salt, but they had created this system where you have a heated pillow but a cold mattress, and the cold mattress obviously cools you off, and what they found is that people who use this device fell asleep much quicker and had improved sleep quality. Now this was only 11 volunteers that did the study and, as I said, it was done by the people who own the patent on this. So you have to use that as guidance for how much you agree about it. But again, the National Sleep Foundation and others do talk about the importance of a bedroom which has a lower temperature. Give yourself time to unwind and have a dark room without distractions. This is often talked about.

Speaker 1: 31:45

I wasn't able to find any direct evidence. There may well be, I just wasn't able to find it. And then the last one, the bonus one. So this is number seven, which, who knows if it's true, and it got a lot of sort of headlines recently, but it's wearing socks to bed may improve sleep. So they tried men this was only six people in the study, so it was tiny to wear socks and compare it to when they weren't wearing socks, and they found that people fell asleep quicker and they slept longer and they woke up less often.

Speaker 1: 32:22

I've tried doing it. Maybe it helps. You can try doing it and you will see what you think. Not huge amount of evidence, but interesting. Well, no discussion of sleep would be complete if I didn't at least mention something about supplements and sleep aids.

Speaker 1: 32:40

Bottom line is there's a million supplements people tout as being beneficial for sleep when they've done studies. The vast majority of these really don't work. There's a lot of advertising, there's a lot of hype, but most don't work really don't work. There's a lot of advertising, there's a lot of hype, but most don't work. Now, some people and that includes melatonin. Melatonin has been shown to maybe it helps on average, maybe 10 or 15 minutes of falling asleep quicker, but some people are more sensitive and more responsive to melatonin. So you might try it and we're going to talk about trying things. Ashwagandha is starting to get a lot of attention and it could turn out to be very helpful, but at the moment I don't think we know for sure.

Speaker 1: 33:26

All right, so those are the six or so things you might want to stop doing or at least think about, and six or seven things that you might want to stop doing or at least think about, and six or seven things that you might want to try. So we got 12 or 13 things that could improve our sleep. So that's why I'm excited that for folks who have some challenges, we can do things to make it better, and even people who sleep well. It'd be good to try those, you might sleep even better. Okay, so where do we start? Where do we go from here? And this is what I alluded to earlier, which is the bonus section, and we're going to talk about something called an N of 1 study. Now, that sounds fancy, but what it really means is testing something in yourself to determine if it does or doesn't work.

Speaker 1: 34:09

Now, my standard three-step approach and we're going to do this many, many, many times over the course of the upcoming podcast episodes but there are three steps to doing an N of 1 study. First, what's my baseline? What am I doing today? What am I experiencing today? Step two try something new, maybe adding something to improve your sleep or taking away something that might make it worse. Step three check and see if it makes a difference, and we can apply this for sleep, and how would that look Well?

Speaker 1: 34:43

Step one assess today's sleep, the quantity and quality, either from your aura ring or one of those things, or asking yourself the questions, questions, or using the questionnaire I alluded to earlier. So, step one figure out where you are today. Step two try something. It might be avoiding something like alcohol or eating late or whatever, or try adding something like the hot shower or the cool bedroom, and that's where the end of one experiment comes in. So you're going to have your baseline, you're going to try something new it might be avoiding alcohol for a couple of nights and then we're going to check and see if it made a difference.

Speaker 1: 35:25

Now, the good thing about sleep is it's pretty rapid in terms of being able to tell. So if you stop alcohol for a night or two, you'll know right away whether it works. If you, you know, try a hot bath or shower, you're going to know pretty well if it works. Now, if you want to do this really really well, is you do it multiple times? So you take a baseline, you try some hot showers, you see that you get better, then go back to your usual life and then do it again. You know, because maybe the first go around it was more of a placebo than anything else. But if you do it repeatedly and it has the same effect each time, all of a sudden now you have evidence, not evidence for what works for everybody, but, most importantly, what works for you. Most importantly, what works for you. All right, we're about to close out this episode.

Speaker 1: 36:20

Let me just say that sleep is really important to help us live long and well, and that, of course, is the goal of the podcast and the goal, I hope, for most of us in our life. There are many things we can do to improve our sleep, and we've talked about a dozen or so of them. If you try any of these, let me know what helps you or, frankly, what doesn't help you, either through our website or Instagram or email, whatever works best for you. Well, on the next episode, we're going to explore nutrition, which we might call the good, the bad and the ugly, and that will be a fun one. Well, let's end by saying may you live long and well. It is my hope for all of you. Thanks so much for listening to Live Long and Well with Dr Bobby. If you want to continue this journey or want to receive my newsletter on practical and scientific ways to improve your health and longevity, please visit me at drbobbylivelongandwellcom. That's drbobbylivelongandwellcom.