The Concierge Doc Podcast with Dr. Jason Littleton, M.D.
The Concierge Doc Podcast is hosted by Dr Jason Littleton, M.D., where he features medical content to make smart lifestyle choices for optimal health, wellness, energy, youthfulness, longevity, balance, and happiness.
The Concierge Doc Podcast with Dr. Jason Littleton, M.D.
“Beyond Restless: The New Science of Sleep, Longevity & Human Performance”
Dr. Sahil Chopra is reimagining sleep as the single most powerful lever we have to extend vitality and unlock human potential. The Harvard-trained sleep physician explains how his company is pioneering continuous longitudinal sleep testing using medical-grade wearables and AI to create personalized interventions for patients.
• Traditional medicine fails patients with sleep issues by prescribing medications without investigating root causes
• Most physicians receive only four hours of education on sleep during medical school
• Multi-night sleep testing at home provides more accurate data than single-night lab studies
• Effective sleep assessment requires asking specific questions about falling asleep, staying asleep, feeling rested, and daytime tiredness
• Melatonin supplementation is most effective for circadian rhythm disruptions at doses of 0.5-3mg
• Key sleep hygiene principles include consistent sleep/wake times, bedroom darkness, morning light exposure, and reserving the bedroom only for sleep
• The best approach for weaning off sleep medications involves gradual tapering while monitoring sleep data
• For shift workers, strategies include melatonin, timed eating, and appropriate use of FDA-approved stimulants
• Dr. Chopra maintains his own sleep health through regular exercise, time-restricted eating, and consistent sleep/wake times
Visit empowersleep.com to learn more about Dr. Chopra's approach to sleep medicine and his medical-grade sleep testing technology.
Visit Dr Jason Littleton's website: https://www.jasonmd.com/
Follow Dr Jason Littleton on Instagram and Facebook: https://www.instagram.com/therealdoctorjason/
Watch Dr Jason Littleton on YouTube: https://www.youtube.com/@therealdoctorjason3340
Disclaimer:
Access to the Information and materials contained in this podcast is at your own risk. The information contained is presented for the purpose of educating the consumer on a variety of wellness and health care topics (the “Information”). Nothing contained is intended to be instructional for medical diagnosis or treatment. The Information contained is compiled from a variety of sources. The Information should not be considered complete and not exhaustive and should not be in place of a visit or consultation with your own primary care doctor.
The views, opinions, and statements expressed by our guests are solely their own and do not necessarily reflect those of Dr. Jason Littleton or the Concierge Doc Podcast. We do not endorse or take responsibility for any statements, claims, or perspectives shared in this content. Viewers are encouraged to conduct their own research and form their own conclusions.
Dr. Jason Littleton:Access to the information and materials contained in this podcast is at your own risk. The information contained is presented for the purpose of educating the consumer on a variety of wellness and health care topics, the information. Nothing contained is intended to be instructional for medical diagnosis or treatment. The information contained is compiled from a variety of sources. The information should not be considered complete and exhaustive and should not be in place of a visit or consultation with your own primary care doctor. Welcome to the podcast. Today, we got a good friend of mine. I'm really excited. He's a Harvard-trained sleep physician and one of the leading voices at the intersection of sleep, longevity, and human performance. With expertise in critical care, pulmonary, and sleep medicine, he has witnessed firsthand how fragmented approaches to health limit both lifespan and health span. Today, he is reimagining sleep not as a nightly necessity, but as the single most powerful lever we have to extend vitality and unlock human potential. He's the co-founder and chief medical officer of Empower Sleep and has served thousands of patients globally. He's pioneering a new era of continuous longitudinal sleep testing using medical grade wearables and AI, and he's going to talk about that today in our podcast. His team has built one of the largest sleep data sets of its kind, enabling high personalized interventions that are reshaping outcomes for patients, high-performance leaders, and athletes. This approach challenges the outdated model of single-night sleep studies and instead frames sleep as a dynamic biomarker of aging, resilience, and recovery. Welcome to the Concierge Doc Podcast, Dr. Sahil Chopra.
Dr. Sahil Chopra:Thank you, Dr. Littleton. It's a it's a pleasure. It's a pleasure to chat with you today.
Dr. Jason Littleton:Listen, I you know, um I I love that you're here. I want to talk about sleep and I want to talk about your background and why you got into this and what made a difference because I know that you're intensivist, you know, trained, and you used to work in the ICUs, and now you're doing and helping people with sleep medicine. Tell us a little bit about that.
Dr. Sahil Chopra:Yeah, I still do about uh maybe 10% of my time in the ICU. I'll cover weekends and sometimes like a Friday, Saturday, Sunday, just to maintain ICU, you know, level of skills. But I I really like otherwise, I feel like 100% of my time I'm doing something related to sleep. And um, it's been a lot of fun. It's very fulfilling. Um, you know, in the ICU we take care of people who are at the end of their life sometimes, or most of the time. Um, but when we talk about sleep, we get to play a role much earlier on before someone ends up in a critically ill condition. So I really enjoy the ability to have conversations with people and uh look at health from a more preventative lens.
Dr. Jason Littleton:You know, I I think that um what you do is tremendously changing lives because I think the number one thing that I hear in practice is that people can't sleep, whether it's because of racing thought, whether it's because of sleep apnea, or they just can't stay asleep. I mean, multitude of things that are at work when it comes to helping people to get a great night's sleep. And I know you run across um these type of complaints as well and these type of concerns. Um how are you changing the game? Tell us a little bit about that. About how are you helping people to get sleep? Can what you do help anyone get better sleep?
Dr. Sahil Chopra:Yeah, the the the short answer is yes, and um, you know, traditional medicine, it's kind of uh like sleep medicine has not done a very good job at like spreading the word, right? Like in residency in med school, uh we get like four hours of education on sleep, we get just a few hours of education on nutrition, we get a few hours of education on exercise. So like a lot of these basic foundational things, we don't get a lot of education on. And I think as a result of that, we don't know we don't we don't know how to ask patients the appropriate questions to figure out what's the problem. We do a really good job. Like if someone comes in with chest pain or a cough, like we know exactly what to do, um, like what tests to order. And unfortunately, like when someone comes in with like a sleep complaint, like, hey, Doc, I don't sleep well, I don't feel rested, I wake up a lot in the middle of the night, many times we don't order the appropriate investigations. And it's very common for someone who has any kind of a symptom to automatically get some kind of a intervention, medication, supplement, new mattress, blackout curtains, eye mask. I mean, it's a very long list. And but if someone came to you for knee pain or chest pain, you would order blood test, echo, x-ray, something along those lines. And in sleep medicine, like that doesn't really happen. Um, someone says I don't sleep well, they get prescribed something uh without trying to understand like what's the root cause of that problem. And one of the things that I've been like really pushing is helping people order the appropriate investigation when someone has a complaint around their sleep. And in sleep medicine, that investigation is a sleep study, a sleep test. And um it can either happen at home, it can happen in a lab. And the way that you know, many, even the former version of myself, I used to think of a sleep test as a sleep apnea test, um, when in fact it's like much more beyond that. Like when you order a chest x-ray for someone who has a cough, it's not a pneumonia test, it's an x-ray. Right. You can see so many things, you can see heart size, effusions, pneumonias, broken ribs. There's so much that one can see on a chest x-ray. And similarly, a sleep study, a sleep test, is an assessment of what is the physiology of your sleep. How healthy is your sleep. And when we look at sleep testing that way, we can start to see things that we would have been sort of blinded to otherwise. Um, but but it sort of goes back to like someone has a complaint of something related to their sleep, and the basic thing to do is to do a sleep assessment, which is a mix of a history, a mix of um uh a study, a sleep study, and then sort of use that information to then provide like personalized guidance of like, oh, I this is why you're not sleeping well, rather than assuming being more precise and accurate of like this is why I think you're not sleeping well, and this is going to be the appropriate way to solve that problem.
Dr. Jason Littleton:Yeah, I love that. Now you said something that really stood out to me there. I said a lot of things that stood out, but one of the things is people aren't asking the right questions. What are the right questions?
Dr. Sahil Chopra:You know, it's like the screener that I like to use, and it's this is not validated, this is my personal opinion. There's there's a variety of different questionnaires that one can use depending on the complaint that the patient has. So there are uh screeners, like I the first sort of four questions that I ask everybody is, and it gives a clue into is there a sleep problem or not, is do you have a hard time falling asleep? Do you have a hard time staying asleep? Do you wake up unrested? And do you feel tired during the day? If anybody screens positive for any of those like symptoms, uh, any of those questions, that person needs a little bit more investigation. And what that means is like we need to then ask the appropriate questions to look for sleep apnea, we need to ask the appropriate questions to look for insomnia, we need to ask the appropriate questions to look for restless leg syndrome or uh someone's chronotype. Are they early to bed, early to rise, late to bed, late to rise? Um, so we can ask these very specific questions about looking for a possible sleep disorder, and then other questions obviously, you know, are medications, mental health, uh, and there's a variety of things that one can like a checklist that one can go down trying to tease out what could be the driver of a sleep issue.
Dr. Jason Littleton:I I I feel like when I'm working with patients who have difficulty sleeping, um it's very easy to go to a prescription medicine when you know you have to tweet out what's behind their insomnia when it comes to even mental health questions like um anxiety, depression, dealing with raising thoughts. And I think there is a pressure in the medical world to just prescribe a quick medicine and not deal with the organic causes um the thoughts people are having. Um you know, just the mental health aspect. And I think what is happening is we're just putting a band-aid over that. And that's a concern of mine. Would you not agree?
Dr. Sahil Chopra:Yeah, no, 100%. That's why I love your practice, right? I mean, that's why I love like what you guys are doing, where you have the time to have a conversation, you have the time to sort of like try to tease apart uh what what what's like the chicken or the egg here? Is it anxiety that resulted in a sleep issue, or is it a sleep issue that resulted in the anxiety? And but but you're totally spot on. Like it's our responsibility to try to figure this out. Um and if we do need to prescribe because there is an acute problem and the person needs to sleep, we prescribe with some kind of an exit strategy. Okay, like I know like there's a crisis right now, someone died, there's a health issue, there's something going on, and and I know that you need to sleep, but in addition to this like three-week, four-week prescription that I will give you, these are the behaviors that we need to incorporate, these are the strategies that we need to incorporate while we do this, so that this does not turn into a chronic problem. Yeah, and I think um you know, like there's a ton of opportunity to be able to help people that way.
Dr. Jason Littleton:Yeah, I like what you said, exit strategy. Um this sleep in itself obviously is a whole um discipline and department category, you know, because um, you know, really tweeting that out, having an exit strategy, having uh people understand what sleep hygiene is, and then playing that out is really key. Yeah, I like that. Um when you are referred a patient and you're meeting them for the first time, and you're doing your evaluation and you use some of your new technologies, the wearables, the AI. Walk us through what it's like for that new patient to first meet you and then go through the evaluation and then get to the testing and the wearables and your use of AI technology. Walk us through that.
Dr. Sahil Chopra:Yeah, it it starts off with a very detailed history, kind of like what you're doing in your practice, where you want to spend time to understand their overall medical health, mental health, their daytime routines, their evening routines, um, the time period over which they've developed a sleep issue, was there a precipitating event, what are some of the symptoms, what are some of the things that they screen positive for? And depending on what I think could be driving it, I will have some preliminary diagnosis in my head already, even while I order the sleep study for them. Right? Like when someone comes to you um with shortness of breath, when you when you get a history, you're either thinking of heart failure, COPD, pneumonia, something along, and you examine them and you have like something in your mind already of this is what I think is going on, I'm going to confirm it with a with some kind of imaging. Similarly, like we're doing the same thing when we have our patients go through sleep testing. And luckily, the the testing that we use for patients is mostly home-based testing, and it's multi-night testing. Where after we've gathered a lot of history, we'll mail patients a ring-based device, it's a medical grade home sleep testing system, and we'll have them get about seven to ten nights of baseline data to give me some context on what is their sleep health like with the routines that they have just described to me: exercise, alcohol, supplements, you know, meditation, whatever it is that is a part of their daily routine. I want to understand what is their sleep with those routines. Some of those habits we'll figure out over time are conducive to sleep. Some of those habits we'll learn over time are not conducive to sleep. And then accordingly, we can one identify what's the root cause, but then we can also identify what is what are the things that can be added and peeled off that over time will result in this person having substantially better sleep. Yeah. It's kind of like the CGM idea, right? Like if someone comes to you with a hemoglobin A1C of, I don't know, seven, um, like giving them a CGM trial for a couple of weeks is like really formative and very powerful before even doing anything. Because then it allows you as the doctor to give them guidance on like what to do from a nutritional standpoint, what to do from an exercise standpoint, what to do from a supplement medication management standpoint, and you can build a very personalized stack of systems for them. And we're doing the same thing with sleep. And because we have so much data over time, um, we need we used we get the help of like AI to help us sort of parse through the data in a more efficient way to help us see things that we wouldn't see otherwise and be able to provide the recommendations that would otherwise take a really long time to sort of put together.
Dr. Jason Littleton:Yeah, no, that's great for um people who don't know what CGM is. That's continuous glucose monitoring. And they help us uh quite a bit with understanding the trends and habits that people have when um they're going through their regular diet habits as it pertains to blood sugar, diabetes, pre-diabetes. Um I love how you said that. I love how you made that parallel. Um now how can we get people off some of these like acute um sleep medications? You know, what what I'm seeing, and you know the name brands and all that stuff, we we people are on acute sleep medications and they're using it long term. You know, people will come and they've been on them for years. There's no exit strategy. Sometimes people don't even want to hear it, you know, because it seems like a big leap. How do you work with that patient?
Dr. Sahil Chopra:Yeah, no, it's it's it's it's doable. You know, I first of all I always like to start off with giving hope. Like it's it's totally doable. Um but at the same time, like we have to try to figure out what was the driver of that problem in the first place.
Dr. Jason Littleton:Okay, so you gotta go back.
Dr. Sahil Chopra:So so you have to go back. You you going back to getting a good history of like what happened, what triggered this, um, and what do I think is the root cause of their insomnia? Is it like a behavioral problem? Is it a conditioned arousal? Is it a PTSD problem? Like, what is the what is the driver of that problem? And is it uh nutritional deficiency? Is it restless legs? Is it sleep apnea? Like, what's the driver? And many times it's not just one thing, right? It's a it's a multitude of things. And based on that, we can then have some kind of an idea or a timeline or a strategy of how we can wean this person off of this medication. And someone who's been on a sedative or a hypnotic for years, it's usually a many month journey, maybe six months, a year, uh, of like slowly tapering them off so they don't have any rebound symptoms, they don't have any withdrawal. Um, but if they've only been off of you know on it for a few weeks, it's much easier to do that. Um and the way that we've been doing it, it's this is not in the guidelines, but this is the strategy that we have developed as an organization internally, is that we give we track the data um from the medical grade sleep testing device over time while tapering the medications over time. And what that allows us to do is find out what is the lowest effective dose of a medication that this person would benefit from, and what is the the sort of rate of tapering that we can think about as we come off of this medication? Because, you know, I've had patients where uh we're tapering one off of, I mean, I'll just to use a a real example, uh, a patient um referred to us through one of our common uh colleagues uh who was on trazodone and lunesta twice in a night. So he would take tracedone and lunesta before going to bed, and then he would wake up in the middle of the night and take another tracedone and another lunesta to be able to go back to sleep. So um, and he had been on this for like maybe a decade, and over time the the doses were going up. And what we had learned was as we started to taper the medications, his sleep was kind of unchanged. He was more so taking this in fear that I won't be able to sleep if I don't take this. But when we looked at his sleep testing data across time, even as we were tapering the medications, his sleep architecture was kind of unchanged. So that gave me the confidence, and it gave him the confidence to easily come off of this medication. Um sometimes like you we come off of these medications and their sleep becomes horrible both symptomatically as well as objectively, and in those situations, maybe they're better off with a low dose of something, but at least we've we've gone to the lowest effective dose, and people aren't like just blindly on you know large doses of a sedative hypnotic, ambient, lunesta, trazodone, vertazepine. I mean, it's it's it can be a pretty long list of both FTA and non-ft approved medications for this, but that's that's that's basically the idea. It depends on what's wrong, and doing it over time using data, it allows us to do that with a much higher level of confidence and precision.
Dr. Jason Littleton:So you're able to get all of that with the wearable ring.
Dr. Sahil Chopra:Yeah, yeah, it's pretty powerful.
Dr. Jason Littleton:That's awesome. That's incredible. And as opposed to just doing a sleep study overnight where people have electrodes attached to their brain, this is over time. So you're getting more accurate data. Um, you're you're looking at trends, you're looking at sleep patterns, you're looking at um, you know, different modifiables that make a huge difference that really um really curate a plan for a person as opposed to just a one-night stand, so to speak, in a sleep lab with electrodes to your head. I don't understand that. I really don't, because that's it's just not natural. You know, you're not gonna get natural sleep. You're not gonna get natural data when you have electrodes to your head and uh you're asked to sleep, you know, watched for one night, as opposed to uh, you know, going weeks to a couple months with a wearable where we can actually look at a person's um, you know, data in their natural habitat with their daily lives and draw out and extrapolate that trend. I think that's amazing. I think that's amazing. Um, I cannot wait to um explore this with my patients because I think this is gonna make a huge difference, not just with people who have sleep apnea, but just sleep problems in general.
Dr. Sahil Chopra:Totally.
Dr. Jason Littleton:I gotta ask I gotta ask this question because a lot of times when people encounter sleep problems, the first supplement they reach to is melatonin. What do you think about that?
Dr. Sahil Chopra:Melatonin can work, but again, it depends on what's wrong, right? It's like uh if if the if I have knee pain and the first thing I jump to is glucosamine, like that would not be the most intelligent way to approach it.
Dr. Jason Littleton:Okay.
Dr. Sahil Chopra:Um, you know what I mean? So like similarly, it it depends on what's wrong. Where melatonin is extremely useful uh is in the setting of like when there is a uh circadian rhythm disruption, okay, either from jet lag or traveling across time zones or um coming off of like night shifts to day shifts. So you know when when when our circadian rhythm is disrupted in those situations, melatonin is uh is extremely useful um because it's retraining our circadian rhythm to to in-train it to where we want it to be. But generally speaking, um the way that I try to invite patients to think about this is like, why do you think you need melatonin? Like, tell me more about what's going on that makes you think that you need to take this. And if it um if it's not helping for whatever reason, uh don't just keep increasing the doses over time. Because our body makes melatonin. Right. Melatonin at the end of the day is a hormone.
Dr. Jason Littleton:Right.
Dr. Sahil Chopra:So whenever we take something that is a hormone that is a part of some kind of a feedback mechanism, some feedback loop, whenever we take something exogenously, it's manipulating some endogenous feedback process.
intro:Yeah.
Dr. Sahil Chopra:So um it's not wise to take it every day for unclear reasons. Um so like so sort of a long-winded way of saying, you know, I I I think there's a there's there's a utility for melatonin at the right dose at the right time in the right setting.
Dr. Jason Littleton:Yeah.
Dr. Sahil Chopra:But using it like, hey, I don't sleep well, I'm gonna take this for the whole six months, I don't I don't necessarily agree with that approach.
Dr. Jason Littleton:So another way to put it is maybe you're saying that the best approach is when a person's circadian rhythms are off. If they are changing time zones, if they have jet lag, that's a good time to implement that to get back on track. But once you get back on track, you know, put it away. It's almost kind of like considering vitamin C if you have a cold, kind of right?
Dr. Sahil Chopra:Yeah, yeah.
Dr. Jason Littleton:So what's what's what's a good dose that people should try if they're in one of those situations?
Dr. Sahil Chopra:Yeah, anywhere between uh 0.5 to 3 milligrams is enough melatonin to retrain the circadian rhythm. Okay. Like if we think about how much melatonin our body makes in a 24-hour period, it's like less than one milligram. And when you see people taking like these five milligram gummies or these ten milligram gummies, that's actually a a very super therapeutic dose.
intro:Yeah.
Dr. Sahil Chopra:And anything less than one to three milligrams is usually it should be sufficient. In fact, in the circadian literature, the dose that we recommend is 0.5 to 1 milligram.
Dr. Jason Littleton:Wow.
Dr. Sahil Chopra:The problem is sort of with the over-the-counter melatonin that is uh falls under the category of supplements, the standard deviation in the dosing is actually quite wide. So, like if we find a pill that says one milligram melatonin tablet, the standard deviation meaning it could be up to two milligrams and it could be like less less than like uh 0.5 milligrams. So it has a very wide standard deviation of what's actually in the pill.
Dr. Jason Littleton:Okay.
Dr. Sahil Chopra:And melatonin is actually quite potent. So, you know, anything under one to three milligrams should be sufficient.
Dr. Jason Littleton:Okay, so when a person picks up melatonin and says one or three milligrams, they're they're not necessarily getting three milligrams of melatonin, they're getting something um that's you know under that, but people don't need to do or more. Or more? Right. So okay, thank you. So people don't need to reach for that five or ten, they need to just stay somewhere around the one or three, or 0.5 to 3, like you said. I love that. I love that you said that. That's huge. That's gonna help a lot of people. Now, um let's talk about sleep hygiene for a second. What are your what are your sleep hygiene uh nuggets? And then I'm gonna get into asking you personally how you move, e drink, sleep, but I want to know what are your sleep hygiene nuggets? What do you what do you tell people to that they can take away and basic things that they can implement that every person should implement whether they get great sleep or they're struggling?
Dr. Sahil Chopra:I'll sort of start off with a little I like to like start off with education. I think when when we educate people, um it what we say makes a lot more sense and it allows one to triage why one thing is more important than the other. And so if we look at sleep, you know, sleep is regulated by two things. One is our circadian rhythm, and the second is how long we've been awake. Um so so then one asks the question, like what are things that I can do for my circadian rhythm? So for our circadian rhythm, waking up at the same time and going to bed at the same time, creating that circadian regularity, that circadian rhythmicity is critical. Okay. And that that means like having darkness in the evening hours and having bright light in the morning hours, these are the two things that control our circadian rhythms. So going to bed at the same time, making sure that there's some darkness before we go to bed, waking up around the same time, and making sure that there's an ample amount of light upon awakening, that's healthy for our circadian rhythm. For sleeping, um, the two things that are probably the most uh leveraged and the most uh effective are uh reserving the bedroom for sleep. Sleep or sex. You know, like we have heard that heard of this many times before, like reserving the bedroom for sleep or sex, because what we don't want to do is create the association that the bedroom is a place of anything else.
Dr. Jason Littleton:That's good. That's good. Okay, yeah.
Dr. Sahil Chopra:We kind of like when we go to the kitchen, even if we're not hungry, we might pick at something because we've associated the kitchen as a place of food, eating, consumption, something along those lines. So similarly, if we associate our bedroom to a place of sleeping, then sleep onset happens faster. And the other thing to do from a sleep and bedroom standpoint is to equalize how much time we think we sleep to the time that we spend in bed. And what that means is if I think I'm a seven-hour sleeper, I shouldn't be spending 10 hours in bed. I might spend an extra, you know, 30 minutes in bed because if I'm a seven-hour sleeper and I'm spending 10 hours in bed, I'm giving myself three hours of an opportunity to think about things that I should not be thinking about in bed. Those could be work, those could be family issues, those could be like anything. And so what what I'm trying to do is eliminate the possibility of being in the bedroom awake, thinking about non-sleep related things. That's one. And then the other thing is from a circadian rhythm standpoint, having regularity and darkness at nighttime and bright light in the morning. Those are probably like the most if one does that, their circadian rhythms will be pretty healthy, and the likelihood of developing insomnia is much lower. And if they do develop it, just doing something on Like this will substantially help them over time.
Dr. Jason Littleton:That that is powerful. Powerful what you just said. And you know these days we have TVs in our bedrooms. We watch a movie in our bedrooms. And that's gotta get in the way of what you just said. You know?
Dr. Sahil Chopra:Totally. And like, you know, I think phones make a big they influence us. It's it's not you know many times I catch myself like using my phone, watching something, responding to emails, responding to text before I go to bed, and um luckily it's okay because I'm a good sleeper. I'm generally a very good sleeper.
Dr. Jason Littleton:I would expect that like if you have something like that. You know, not be a good sleeper.
Dr. Sahil Chopra:That would be a dis disgrace to the organization if I was a bad sleeper.
Dr. Jason Littleton:Right, right.
Dr. Sahil Chopra:But but like what the point is, like if you know if one is not the greatest of sleepers, then and then we start incorporating habits that are not conducive to sleep, it can it'd be a very slippery slope downhill to develop even worse sleep. Yeah, and so um you know, just like eliminating, I totally agree, like eliminating the television. Uh if one is going through a sleep crisis, trying to eliminate the phone out of the bedroom, yeah, charge it downstairs, you know, do these doing these things actually make a pretty pretty substantial difference, and they don't always happen overnight. No. Sleep is one of the it's like nutrition, it's like diet. Like these things don't think things don't change overnight. It's it's a little bit of a process, and you do this for a week in a row, you see a little bit of results, and you may not think of like you're making progress, but when you look at, oh, like how was my sleep a week ago or two weeks ago or three weeks ago, and you ask yourself that question, it's like, oh yeah, you know what? Actually, I am sleeping a little bit better. I am like, I'm not awake as much as I was a few weeks ago. I'm actually falling asleep much faster as compared to a few weeks ago. Um, I'm waking up more rested as compared to a few weeks ago. It's it's it's it's it's a process. It's a it's it's slow. It's not essentially, you know, these overnight things, these overnight magical things that happen. It just takes a little bit of time.
Dr. Jason Littleton:Yeah. Um I mean charging your phone downstairs or out of your bedroom is brilliant, but it's probably punishment for some people. Like they're on punishment because they don't have their phone right next to them. That's but I I think it's a great idea and it's necessary. Um you know, um people it might be hard to phantom, but it is definitely um it definitely goes along with great sleep hygiene. Now what about what about the third shift worker? What do they do? I mean, because their circadian rhythms are just gonna be the opposite. I mean, they're what do you tell people like that?
Dr. Sahil Chopra:Yeah, it's hard. Um if someone is a shift worker, a nurse, a working a graveyard shift at a gas station, uh working on an oil rig, like it this the truck driver, you know, like the list goes on. Um there is no ideal solution, unfortunately. But what we can do is like we can think about like what can I do to um accelerate my time to getting resynchronized to where I want to be. That's uh that's really the framework to think of it. I mean, I have patients that go from SFO to Beijing twice a month. I mean, and that's a very wide you know, time zone shift, and uh it usually takes about one day per hour time zone shifted. So if someone is shifting 14, 15 hours, uh you basically like they need two weeks to re-acclimatize if there is no external intervention. Yeah, that makes sense. And uh and uh so like so the question becomes how do I shorten that to just a few days versus it being a two-week dragged out process.
intro:Yeah.
Dr. Sahil Chopra:And in these situations, um, there is no perfect situation, there's no perfect sort of solution here, but melatonin is extremely helpful. And uh modifying your dietary habits to get it to so that your circadian rhythms can entrain faster is is again very helpful. Uh so lightness, light, and darkness are critical. Food timing is critical. And then the last thing is if one is feeling tired during a night shift, is to use a stimulant medication so that one doesn't make any mistakes, doesn't, you know, um it doesn't result in any injuries, and there's a whole bunch of different ones that can be used. These are FDE-approved medications that can be used for what's called shift work, shift work disorder, and um modafinil, Ritalin, uh, methylphenidase-based medications, these can be extremely helpful to reduce the likelihood of having injury to yourself or to someone else, and uh and they they they should be strongly considered, but there's really no good solution. Like we're basically going against our evolutionary circadian rhythms, and uh it's just really hard.
Dr. Jason Littleton:Now, um how do you move, eat, drink, sleep? That's my protocol that I put together to have and to help people have excellent health. You know, at baseline, people need to move, eat, drink, sleep. And you know, I know also if people do that, they're gonna also get good sleep, which is the S part. But because we we know that chronic health problems can cause people to have poor sleep. We know that. Now, um share with us personally, you know, that acronym in your own life. How do you move? What do you do for exercise?
Dr. Sahil Chopra:I go for a run. Um like three days a week or so. I go around the block. Uh it's a three and a half mile run. Um I try to do some push-ups or squats, like the days I I have a pretty busy life. I have three kids, um, eight, seven, and three. And before I jump in the shower, I'll just like try to do, you know, 15, 20, 30 push-ups. I try to like do that whenever I have like these little five-minute chunks of breaks in between. So I'll try to do push-ups um from an exercise standpoint or go for a run a couple of days a week. Um, and then from an eating standpoint, I it becomes hard. Um the last sort of four or five months, I've gone back to time-restricted eating where I try not to eat any calories before noon, and I try to stop eating after seven, so like at eight at seven to six to eight hour eating window. Um, and then from a sleep standpoint, um sometimes I'll end up doing a night shift for whatever reason, and if in those situations I'll like try to realign as quickly as possible using melatonin, the same things that we've discussed. But my sleep routine is kind of like I generally like to go to bed early and wake up early, but sometimes with a family and a startup, that's hard to do. Yeah, and I will end up um going to bed around 11 and waking up around sort of 6, 7 a.m. Like and get the kids ready for school and start the day.
Dr. Jason Littleton:And then when when it comes to hydration, the D part, because you talked about move, talked about eating, you know, the D part, was hydration?
Dr. Sahil Chopra:Uh from a hydration standpoint, I probably over consume caffeine, if I'm like being honest to myself. I'll drink at least like uh four cups a day, three to three like two to four cups a day, depending on the day. And uh I drink at least what is this, like two liters of water a day? Yeah. I have one of these uh bottles that are like marked.
Dr. Jason Littleton:Yeah.
Dr. Sahil Chopra:And I'll just sort of go through that over the course of or over over the course of today.
Dr. Jason Littleton:And that's part sleep. You talked you shared a little bit about that, but uh you said you get great sleep, so please share.
Dr. Sahil Chopra:Yeah, generally a really good sleeper. I typically don't have symptoms of insomnia unless if like something is burning down at the yeah at the hospital or in the clinic. And um I don't take any supplements. We have a very regular mattress. Uh we don't have any blackout curtains. I in fact I sleep with the blinds open because I feel like it helps me wake up around helps me wake up in the morning time. And uh nothing fancy. It's pretty simple. Like nothing. I've done multiple sleep studies on myself. If I have if I have a few extra drinks of alcohol, I'll have sleep apnea. If I mild sleep apnea, if I don't drink and I'm not congested, my breathing is pretty healthy.
Dr. Jason Littleton:Wow. And this is great because you've you've you've used your wearable and you know what your sleep trend is. Um this is amazing. This has been an amazing show, amazing podcast. I I cannot wait to have um my audience, my patients, uh, use the wearable to really get um some powerful data on how they sleep so that we can optimize their sleep. This is big, and this is something your company um I think is gonna make a huge difference. And yeah, no, thank you. I'm excited to introduce um your software to my audience and my patients. I think it's gonna make a huge difference, and this is powerful. I'm gonna have to try it myself. I'm pretty excited, and I'm I'm gonna have to have you back on because we can talk about this. Um we can we can we could we can talk about this for another hour. I mean, I I have so many questions as far as sleep for recovery, sleep for athletes, also so many things. And we'll we'll we'll dig into that another time. I I'm just so glad that we had you on, Sao. I'm so glad. Um, where can people find you?
Dr. Sahil Chopra:Yeah, I mean they they can uh go to empowersleep.com, empower sleep.com, and uh they can learn more about Empower Sleep there. Uh it's you know these consumer grade wearable devices have created a lot of awareness and they're phenomenal tools, but these medical grade devices are even more formative, uh, especially if someone has a sleep issue. If someone is a good sleeper and they don't have any suspected sleep issues, and well the using a medical grade device is probably more friction than it is comfort. But if someone has a sleep issue, instead of having to go to a lab to understand do they have sleep apnea or not, or all of the medical sort of disorders, then in these situations we can really create a lot of value and help them figure out what's going on and what's the root cause. And I'll send you a I'll send you a ring, Jason. I would love for you to try it. Always looking for feedback. And we'll get you anybody else in your practice, we can get them set up.
Dr. Jason Littleton:I'll try it. Thank you. I'm looking forward to that. Yes, please, please do that. Send that right over. Thank you. That I can't wait. I um, you know, I always say to people, you know, in my uh move, eat, drink, uh, sleep protocol that you want to make your bedroom like a spa. I think that's important because when you go to a spa, you go to relax. And I think that's important. You got to kick TV out, just like we talked about today. You got to move bills, newspapers out of your bedroom. You got to really make your bedroom like a spa. That's one of the baseline things you can do to get great sleep. Whatever you have to do, if you're not getting sleep, you know, reduce your caffeine. Make sure that you uh, you know, put your phone recharger downstairs. Do what you need to do so you can recharge your body, have optimum energy, and be in the best help that you can be. Okay, so you guys, until next time, uh thank you for listening to the Concierge Doc podcast. I want to remind you, you can find us in Apple, Amazon, Spotify, follow us on Facebook, Instagram, and then we're gonna go.
