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THE DOCTOR AND THE DJ
Join Johnjay, the charismatic host of the top-rated Johnjay and Rich show on iHeartRadio, and his trusted doctor Dr. Carrie Bordinko as they delve into the fascinating world of alternative medicine.
In this podcast, Johnjay asks the questions we've all been curious about
Why do some people seem to have found the fountain of youth?
Is Big Medicine really trying to keep us sick?
What's the truth about stem cells, mushrooms, ketamine, and more?
Dr. Carrie provides science-backed insights, helping to separate fact from fiction.
Along the way, they talk to well-known celebrities who seem to know the secret to health and fitness, award-winning doctors, mental health experts, and more.
Tune in as the DJ and the doctor challenge conventional wisdom and explore the possibilities of alternative medicine.
THE DOCTOR AND THE DJ
Unlocking Better Sleep: Insights from a Sleep Disorder Specialist
Unlock the secrets to better sleep as we welcome Dr. Michael Breus , a distinguished PhD in clinical psychology and a medically board-certified sleep disorder specialist. Discover how enhancing your sleep quality can transform your life, from boosting athletic performance to fortifying emotional resilience. Dr Breus sheds light on the profound effects of sleep deprivation and unravels the mysteries behind insomnia, while providing practical strategies to align with your natural sleep rhythms. Explore the nuances of deep sleep, the significance of REM sleep, and the common misconceptions around sleep aids like alcohol.
Explore the intriguing landscape of melatonin and CBD, delving into their roles, optimal usage, and potential drawbacks. Dr. Breus shares a wealth of knowledge on how these substances can impact sleep health, drawing insights from both personal experiences and medical expertise. The conversation touches on the realms of cannabis, shedding light on the balance between THC, CBD, and CBN, and why understanding these components is crucial for effective sleep management. From the pitfalls of long-term medication use to the importance of sleep hygiene, Michael offers a comprehensive guide to natural and effective sleep solutions.
As we conclude our enlightening discussion, Dr Breus ventures into the world of sleep apnea treatments and the potential benefits of lifestyle choices that can elevate your sleep experience. From the innovative Excite OSA device to the art of balancing caffeine, exercise, and diet, this episode covers it all. Adding a playful twist, Dr Breus shares insights on the benefits of sex before bed, highlighting how personal and relational wellness intertwine with sleep health. Tune in to "Experimental" for a mix of humor, expert advice, and transformative tips that promise to enrich your approach to sleep and overall well-being.
we're with the sleep doctor that's me and and I think you're not just a sleep doctor, I mean right. I remember when I first met you, you passed the medical board right, sure so.
Speaker 2:So there's a lot of different kinds of sleep doctors out there. Some sleep doctors are medical doctors that specialize in particular areas of specialty. The most popular would be pulmonologists. Now, I don't understand exactly why, because you know pulmonologists are lung doctors, right? So they're kind of areas from here to here. Most people go to them for snoring, which is kind of an ENT issue, right, it's an ear, nose and throat issue. But pulmonologists for the large part maybe 70% to 80% of sleep specialists are pulmonary. Then you got about maybe 10% 15% are neurology, for narcolepsy, restless leg syndrome, things like that. Then there's a whole mishmash of different types of doctors who've decided to get into sleep.
Speaker 2:I fall into that category. I have a PhD in clinical psychology, but I'm medically board certified in clinical sleep disorders. So a lot of people like wait a second, you just said you had a PhD and you're a psychologist. Now you're saying you're medically certified. How does something like that happen? So I took the medical boards without going to medical school and passed. I'm one of 168 people in the world that have ever done it, and Carrie went to medical school, took the medical boards and passed.
Speaker 1:And passed that's right, and I have sleeping disorders. So this is the perfect. This is the perfect combination of people, and I'm obsessed with sleep. I mean, how important is sleep to the human?
Speaker 2:body. So when we look at it, here's what's interesting is we don't exactly know the exact function of sleep, but what we do know is that, in fact, if we don't sleep, really bad stuff has a tendency to happen, or death.
Speaker 2:Or death. Death is definitely one of the several things. So with a lot of people, if they become so sleep deprived, like a lot of people think, well, can you sleep deprive yourself to death? Well, you can, if you fall asleep while driving a vehicle, right, and that happens more. I mean, how many times in your practice have you talked to somebody where you're trying to diagnose some sort of sleep disorder and they say, oh, I fell asleep at a stoplight?
Speaker 3:Oh, I mean, it happens all the time. Unfortunately, people don't like to report that happening.
Speaker 2:Right, especially truck drivers, by the way. Yes, anyone with a commercial license Right Is certainly not going to be interested in doing any of that. But we know that if we don't sleep, certain things are going to happen on the physical side, on the emotional side as well as on the cognitive side. So physically, we know, reaction time slows down significantly. As a matter of fact, when I deal with athletes, one of the things that they tell me all the time is they're like oh dude, if I'm sleep deprived, like I'm not moving, in practice, I'm not doing well in the game. When you actually look at the data, they're about a third slower.
Speaker 3:Yeah, the reaction time is actually measurable.
Speaker 2:Right. And then when you look at their testosterone levels, specifically in the, in the male players and they're sleep deprived, they tank tanks. So a 22 year old who is sleep deprived is playing like a 33 year old in in a lot of instances, and so sleep turns out to be incredibly important Also, I mean not just in sports, but I mean sports is kind of a fun analogy to look at. I mean, if you want to remember the plays, you better have had a good night's sleep, right. So memory consolidation, things like that. And then, emotionally speaking, your emotions are highly driven by sleep. As a matter of fact, I would argue that almost every emotional state gets exaggerated with sleep deprivation. Depression gets more depression, anxiety makes more anxiety. I mean, I say it all the time, but it's really true Literally everything you do you do better with a good night's sleep.
Speaker 3:Can we walk it back, though? Because I think sleep is a word that is misunderstood and misused, and I have a saying that I say to people all the time. They say, oh well, it's not my sleep. I, you know, I'm in bed eight hours, I go. Well, you may be lying in bed, you may not even know that you're awake half the time, because we have what's called light sleep, deep sleep. We'll go into all that, but, you know, I think we need to define what are the stages of sleep, what are the amount?
Speaker 3:of times that a healthy's only a few stages that are really important for you to kind of start to understand more about, and that's stages three and four deep sleep, as you correctly identified, and then REM sleep or REM sleep, right?
Speaker 2:So stage three and four, deep sleep, that's the wake up and feel great. That's the physical restoration. Okay, Turns out that happens in the first third of the night. Okay, turns out that happens in the first third of the night. So whoever created this unit that we're all living in, um decided that we need deep sleep at the front end of the night to really get that physical restoration going. Then we have a period of time where there's a lot of kind of extra and then we got more rem sleep towards the end of the night. Rem sleep is that mental restoration.
Speaker 2:So you want to do things to either positively accentuate deep sleep and REM sleep or, for the very least, don't add anything that takes away from either one of those Two big insulters, caffeine and alcohol. Okay, and so when we start to look at these things, those are the sleep stages that turn out to be the most important. If you were looking at them like on a tracker, I would say you would want those to be somewhere, depending upon your age, in the maybe 18 to 25% for either one of those, either deep sleep or REM sleep, roughly in younger people so we're talking 18 to 25, should be about 25% of your night. Can you give that in hours? So if you, as an example, if you did slept, slept eight hours, then it would be two hours of deep and two hours of REM. That's for a younger, for a young person, 18 to 25. Now I'm 55 years old.
Speaker 1:There's no universe where I get that much of either one of those what's the most deep sleep you get at 55 years old as a sleep doctor?
Speaker 2:so it depends on several different factors. It can depend upon my hormone levels, it can depend upon my stress levels, it can depend upon my stress levels.
Speaker 1:How much?
Speaker 2:caffeine did I have? Oh, my personal one. I rarely get more than probably. I'm trying to think I could pull it up on my thing Maybe, maybe 65 to 70 minutes.
Speaker 1:Okay, yeah, can that go up? Because that's that's roughly where I my big nights, is that.
Speaker 3:Yeah, so. So it's a great question, but your sleep cycle is really short.
Speaker 1:Right, but I mean right now I'm on vacation. So I'm really trying to do everything I can to get as much deep sleep as possible. I hit a 94 the other day that's awesome On my ordering and the things I do to get that sleep. I want to run by you Please Something and some of you said so at her facility. I work out there, right. Me too, and I did this thing. Have you done the lights yet?
Speaker 3:The light bed. Okay, oh yeah, the red bed. Oh, I love that thing.
Speaker 1:No, not the red bed no, no, the blue lights.
Speaker 3:Oh, he hasn't done the blue lights Okay.
Speaker 1:So she has this new thing. Now it's freaking. Nuts have to hit the blue lights a certain time. Got it Now. You know, I do a radio show and I don't sleep a lot, right I I I've learned a lot about sleep in the last couple of years. I'm increasing my sleep, but for 30 years I'm getting four and a half hours sleep and I think I've made horrible decisions in the past and done terrible things because of the lack of sleep, right, I'm sure eating bad food. So anyway, I've been on vacation about a week now, 10, 15 days, right and I got great sleep on my ring.
Speaker 3:Okay.
Speaker 1:I go do the blue lights with her. Her place Right and I got my all-time personal record, which is the second highest record in the building.
Speaker 3:Oh, wow, we don't want to keep rubbing that in.
Speaker 1:And I think it's because I got a good night's sleep. I mean, you know what I mean.
Speaker 3:So your reaction time.
Speaker 1:Right.
Speaker 3:Was so much faster. Yeah, because that thing, that skill, if you want to call it, that is all about reaction time, right, that's what's crazy, because I got a deep, I got good sleep.
Speaker 1:I had about an hour and 10 minutes of deep sleep, right, about 70 minutes, yeah, and I was like, I was like blown away that I got that much, because when I look at the rain, it's all blue and I get all blue looks great. Most of the time I'm red, red, red, red, red, red, right right. So that's how important sleep is. I mean, it's a game changer. Lebron James talks about it. He has to get at least eight hours of sleep a night.
Speaker 2:Yeah, and I mean not the best example of athlete, but an interesting one, lance Armstrong. He would say every single time before a race he was getting 10, 11, 12 hours of sleep because he had such a major expenditure of energy during races that he felt like he absolutely had to have that kind of level of recovery. But how do you get that much sleep?
Speaker 3:Yeah, was he augmenting to get that much sleep?
Speaker 2:Well, he was augmenting a lot of things, so it's kind of hard to figure that one out.
Speaker 2:But, like at the end of the day, here's the good news is, your body will only sleep as much as it needs, right? So there's never a time where your body is going to sleep too much right now. Now I will tell you that there are some times where people are like well, dr Bruce, is it okay that I sleep nine and a half hours a night? 10 hours a night, that's a little much, right? So, on average for an adult, we want to see somewhere between seven and nine hours. Me personally, I never get more than about 615.
Speaker 2:Just don't just is my body go to bed at exactly the same time every night. My body just wakes me up. It's natural, it's kind of how I work. But we're looking for generally between seven and nine hours. When somebody says they get more than nine hours, then I'm looking at a quality issue. So far we've only been talking about quantity minutes, hours, things like that right, but it's really about the quality of the minutes during the sleep that really make up, I would argue, the bulk of what it is that we're kind of looking here for, which is optimization.
Speaker 3:So when we talk about sleep efficiency, which we haven't touched on, and that's something you specialize in which I find incredibly unique so he actually will take individuals, prominent CEOs, athletes, who say I only have six hours to sleep, and that's a real statement for some people how do you still get the quality of the sleep and condense the amount of time that you're spending in bed? And so that's what you're touching on, right?
Speaker 2:now Correct, Correct, so I have a secret weapon. So in my third book called the Power of when I started looking at these things called chronotypes so a chronotype is a genetic predetermined sleep schedule I can actually look at your 23andMe data or your Ancestrycom data and I can go toa very specific part of the human genome, PER3 area in particular. And if it's switched one way, you're automatically a night owl. If it's switched another way, you're automatically an early bird. If it's where it's supposed to be, you're kind of in the middle. And then there's one that's just kind of random. If you fall into one of those four categories which, by the way, almost every single person on earth does, if I get you to sleep when your body wants to, genetically you sleep more efficiently.
Speaker 1:But what if you're a night owl but your career is an early bird?
Speaker 2:Okay, so that's a great question, right? So let's take you for an example. Let's just claim that you're a night owl, but you got to get up at the butt crack of dawn to start your radio show, right? So how do we deal with somebody like that? So number one is we have you still going to bed at a night owl's bedtime. You would wake up after a certain period of time, probably.
Speaker 2:I would probably do 90 minute segments, so I'd probably do three 90 minute segments for you. So I'd say you'd sleep for four and a half hours. I'd have you wake up, shower, do your thing, go do your radio show, get there in the morning, and then, when you came back, I'd have you take a nap in the afternoon. Wow, right. So I would parse out your sleep that way. I know you're getting the bulk of the physical restoration that night so you can perform, and then during the nap time during the day, I can get you to get a little extra sleep in there. And it's not as hard as you might think. People are like I don't have time for a nap, michael. Like what are you talking about? You would be shocked. It's not a one for one ratio. I don't have to give you two hours nap of sleep during the daytime for it to actually catch up to a lot of the sleep that you need, because I'm giving it to you at the right time for your genetics. But what if you?
Speaker 1:are in the situation where you just described. Could those pieces of the puzzle fall into place organically? Because you just described pretty much what happens. I get up early, I go to work and then I'll come home and do a 10, 20 minute nap, if I can, just automatically, without even talking to you, and I'm kind of like, oh, that is my schedule.
Speaker 2:So what that tells me is you are particularly in tune with your body.
Speaker 1:I'm trying right, I've been trying the last couple of years Right.
Speaker 2:Well, I mean that's what she did for both of us right, I mean.
Speaker 2:I had a massive body change as well, working with Dr Brudinko. So, like I get it. But your body will start to adapt to what it's naturally supposed to do, right? So it's almost like you're not adapting. You're kind of going backwards to like the origins of sleep, because your body wants to sleep and it knows when it wants to sleep, and you feel so good when you get a good night's sleep, right. But it's a game changer, dude. It's huge. But we have these things called caffeine that make us think that we don't need sleep, right, you know. And then we have adrenaline and cortisol that kick in due to stress, and then we feel like we don't need sleep and then, all of a sudden, we're kind of wandering into this universe of insomnia, right? So that's my area of specialty, that's where I have a tendency to play.
Speaker 2:Insomnia is your thing, my biggest thing, is insomnia. Well, because I have a PhD in clinical psychology and I believe there's a large psychological side to insomnia. But having the medical background, I know the biology behind the insomnia as well, and so when you can take those two together now you're in something different. Now you're kind of thinking through a few different ideas here. Now I will tell you that a lot of people try to treat their own insomnia right With supplementation or medication which is number one would be alcohol.
Speaker 1:Yes, it would. So you mean they take alcohol to help them go to sleep, they believe.
Speaker 3:They believe that alcohol actually gets them to sleep, and it does. Alcohol does get you to sleep. It doesn't get you to quality sleep, right, and then it also allows you to wake up midstream, which is a big problem. But alcohol is probably the number one tool that people turn to to treat insomnia on their own.
Speaker 1:See, I know people that they say they have insomnia and they drink, right. And I say, well, you're drinking In so many words, same thing you said, so insomnia is a real thing.
Speaker 2:So there's no question insomnia is a real thing.
Speaker 2:Yeah, so a lot of people. At one time people used to think, oh, insomnia is just a mental health issue. There is true biology to insomnia. Let me explain. So when you're falling asleep at night, your core body temperature rises, rises, rises till about 1030, hits a peak and then it begins to drop. That drop has to happen in order for your brain to release melatonin. So as soon as it recognizes the temperature drop, your pineal gland kicks off some melatonin and you start to fall asleep. Now your core body temperature keeps dropping, but if it keeps dropping all night long, you go to this thing called hypothermia. Not good, right. So your body wants to warm back up. Now most people, when they turn to me and they say they have insomnia, it's rare that they say I can't fall asleep. It's usually I fall asleep, fine, but I wake up somewhere between one and three o'clock in the morning and I'm up for three hours. What the hell is that, michael? I'll give you one guess what time most people's core body temperature starts to heat up.
Speaker 3:Between one and three, between one and three in the morning, exactly.
Speaker 2:And so what happens is you automatically go into a lighter stage of sleep. I'm here to tell you, every person on earth wakes up between 1 and 3 in the morning. You just don't know it Exactly, right, because you have to be up long enough for your body to recognize it. So what most people do is they wake up, they roll over and they fall back asleep. The problem comes is when they wake up and they say, hmm, I wonder what time it is, and they look at the clock.
Speaker 3:Big mistake and they instantly do the mental math.
Speaker 2:And then they say oh shit, it's three o'clock in the morning, I got to be up at six. Sleep, sleep, sleep. And they try to mentally force themselves to sleep. Now I want to be honest with you, john Jay in the history of time, no one has ever mentally forced themselves to sleep. Nobody has.
Speaker 2:Because you're doing literally the opposite of what you want the brain to do. You want the brain to calm down, not heat up. And so when you're sitting there telling yourself, go to sleep, go to sleep, go to sleep, you're firing all these neurons and you're doing exactly the opposite of what we want you to do. So what do you do? A sleep meditation. Exactly what you wanna do is you wanna lower your heart rate. So I'm going to teach everybody right now the easiest way to lower your heart rate in the middle of the night. It's called four, seven, eight, breathing. Okay, this was developed by Dr Andrew Weil. Uh, this is a very interesting technique. It's very simple and you can do it in bed in the middle of the night. So you breathe in slowly for a count of four, you hold for a count of seven and then you push out for a count of eight. All right Now, if you can't do exactly that, you can do four, five, six right Until you get there. But what it does?
Speaker 2:So it was originally developed, believe it or not, for Navy SEALs, specifically snipers. So when you're shooting downrange right, if your heart's beating too fast, you can actually change the trajectory of the bullet. So we teach those guys and gals to shoot in between heartbeats. The only way we can do that is to slow their heartbeat down. So this is the method that's used to slow their heartbeat below 60 so they can shoot. What most people don't know is, in order to enter into a state of unconsciousness, you need a heart rate of 60 or below. So this is the perfect technique to use in the middle of the night to be able to allow yourself to kind of get yourself back to sleep. Now there's another problem that happens in the middle of the night Urination.
Speaker 3:Okay, very very prominent issue.
Speaker 1:Right, I deal with that right now. I went four times last night.
Speaker 2:Okay, so we can talk about that in just a second. But here's the thing is I tell this to people all the time Do you really have to pee? That's the question I ask people. And here's why? Because here's what happened. Remember, got to have a heart rate of 60.
Speaker 2:Most people are like, well, I'm up, I might as well see if I have to go. And then they go from a lying position to a seated position, to a standing position. Guess what? They just jacked their heart rate up. They probably went into the bathroom and flipped on the light, which told their brain it's morning.
Speaker 2:So no more melatonin, right? If you got to pee, please go pee. I'm not telling you not to go pee, but if you really don't have to pee, stay in bed. Try the breathing. Okay, Michael, I don't have to pee. I tried your damn breathing. I did it eight times. My heart rate's lower. But you know what? I'm not falling asleep. What's going on? Here's the good news there's now been research on something called non-sleep, deep rest. This is just quiescent. So in the dark, quiet, nothing going on, just lying there. It turns out it's rejuvenative Not the same as sleep. Right, it's worth about an hour of that is worth about 20 minutes of sleep. So if you have a patient who's lying there for three hours, they're actually getting about an hour's worth of sleep. So once you educate them on that fact and they let they know that, then their anxiety starts to go down. This is an anxiety issue in the middle of the night, that's it.
Speaker 1:That's what I was saying when I went like this, because I always feel that people I know they can't sleep, they're dealing with a lot of stuff in the daylight hours.
Speaker 2:Well, and that's that's. The other thing is, what happens is is, once they start thinking, they start thinking about stressful things. What I try to get them to do is again focus on the breathing. What's nice about the breathing is it forces you to count. It's very difficult to count and have negative thoughts at the same time. To actually try to do that, it's very difficult to do, that's why they say count sheep Exactly.
Speaker 2:Now, by the way, if you want another method for counting sheep I was talking about it today the old one, two, three over the fence doesn't really work, but if you count backwards from 300 by threes, oh that's tough, it doesn't it's mathematically so complicated you can't think of anything else, and it's so damn boring.
Speaker 1:You're out like a light. You know what I do to help go to sleep. I have two things I do. One is I try I pray and I just continue to to pray, I love that I think that's great, or. I have this one visual that works every time. This is so weird. I picture myself bowling in a street Bowling in a street A bowling ball.
Speaker 3:Did you used?
Speaker 1:to do that as a kid. No, I think I've always wanted to, though. The bowling ball goes to the middle of the street, just a normal neighborhood. My vision is I'm following the ball and you can hear the the bowling ball hit the gravel. Yeah, yeah, I'm listening to it and I just follow this?
Speaker 3:are there pins in this video just going, it's like, it's like infinity bowling.
Speaker 1:Yes, and every time I'm just picturing this bowling ball in the hearing.
Speaker 2:You can hear the sound that's the last thing I remember, and then you're off in la la yeah yeah, it works, every time it it works every time. For me it's almost like a mantra right, so a lot of people will have For a simple person.
Speaker 3:Yeah, absolutely.
Speaker 2:So, remember, mantras don't have to be complicated. Mantras are not even, sometimes, full words. So having a visual mantra which is again so, it fits the purpose, and here's why it lowers your anxiety. Right, okay, your anxiety, right, okay, and that's really what we're talking about here is biology wakes us up. Anxiety keeps us up, okay, so don't so understand that you didn't do anything wrong to wake up. But now it is kind of your job to stay chill and be able to get yourself back to sleep. And how do we do that? By lowering our heart rate and letting anxiety reduce, so the natural sleep process can couple months ago you're on my show and we were talking about melatonin.
Speaker 1:You just brought up melatonin, I know.
Speaker 2:Let's talk about it.
Speaker 1:I was so I was like sometimes I was taking extra melatonin.
Speaker 2:Please don't do that.
Speaker 1:I know he warns people every day about that, I thought see, I thought so now I only take the two that I normally take, perfect. But then I started I don't, I haven't run this by anybody but I started taking CBD.
Speaker 2:So you just hit on the two big topics that I wanted to talk about within insomnia, which is melatonin and cannabis. Oh good, All right. So so let's address both of those, because, uh, Carrie and I were talking about that on the ride over and we were thinking, you know, these are two things that a lot of people use externally for sleep.
Speaker 3:And they use them without any medical guidance. So we want to give them medical.
Speaker 1:Like me with my doctor right here Exactly, I have not run this by her at all.
Speaker 3:Yeah, I'm just finding this out right now.
Speaker 2:Yeah. So let's start with melatonin, since it's very easy to grab a hold of and it's legal in all 50 states. So, first of all, melatonin is a hormone. A lot of people don't realize that. They think, oh, it's a root or a supplement or a thing. I don't know exactly what it is. It's a hormone. So there's a really good reason why you don't go down to the local drugstore and get testosterone and estrogen as hormones, because those have to be regulated, because hormones tell your body all kinds of messages to do all kinds of things, and that really is something that a healthcare provider should be, you know, monitoring and seeing what's happening. And unfortunately, melatonin the FDA decided to not make melatonin classified as a hormone in 1974, I think it was in the Supplement Act and so now you can get it everywhere. Here's what's crazy. Did you know it's by prescription only in most places outside of the US Go to other countries.
Speaker 3:Dhea, melatonin all the things that we just use over the counter are prescription.
Speaker 2:Yeah, and here's another one that a lot of people don't know is high doses of melatonin are used for contraception.
Speaker 1:You mean?
Speaker 2:they make you fertile. They do the opposite. They do the opposite. They don't allow you to be fertile. So here's where it gets weird for me, right, is there are lots and lots of pediatricians out there who turn to parents and they say oh, your child isn't sleeping, give them some melatonin, it's not going to hurt them. I personally can't think of anything worse than entering a contraceptive into a young female body when there's no immediate need for it Makes no sense to me, right? So, number one nobody under the age of 18 should be using melatonin. By the way, children up to that age have roughly four times the amount of melatonin that they require. They don't need it, they don't need it. There's one group of children where I like melatonin in, and that's children on the autism spectrum. There's been significant data to show that higher dosages we're talking about four, five, six milligrams will work well in that particular population. Now, you probably just heard me say a high dose of four, five or six milligrams and people are taking 10, 15 over the counter.
Speaker 2:Right, and that's part of the problem is it's readily available and people are taking way too much. Oddly enough, there was a really interesting study done about nine months ago where they pulled 25 different melatonin brands off the shelf and tested what was in the bottles. Not a single bottle had what was on the label not one. It was either too much or not enough. So, buyer beware, there's a lot of hanky panky going on in the melatonin universe. Okay, now let's be fair. There's really only three reasons you would need melatonin shift work. You, by the way, are a shift worker. Okay, you don't have any choice. You got to get up at what Four o'clock in the morning to get to your show earlier Right so you're up at two 45 in the morning.
Speaker 2:That makes you a shift worker. Melatonin makes sense for a person like you, okay, but for somebody who's just says I've got insomniaomnia, melatonin's not what they're looking for an athlete not good for an athlete.
Speaker 2:Generally speaking, I don't like in in athletes because the hormone has, uh, other other effects that are in their bodies and, to be fair, most athletes should sleep like a stone. I mean, they put out so much energy, they are such good shape. They really should be doing you know pretty well. Um, the right dose, by the way, is somewhere between a half and one and a half milligrams, which also is almost impossible to find outside in the universe right.
Speaker 3:Yeah, I think three milligrams is commercially. What you see is the lowest dose out there.
Speaker 2:Yeah, like threes, fives, tens, and so what I tell people is if you're going to get a gummy which most people do chop it in half. Also, by the way, gummies or tablets it takes almost 90 minutes for melatonin to get up and in, whereas if you do it sublingually, so if you take a dropper like a tincture and you put it underneath your tongue, you can get it up and in about 20 minutes.
Speaker 1:Well, that brings me to CBD. Yeah, so I was taking some CBD pills to go to sleep, yep. And then my trainer, who is at Benacer, said he takes CBD for other issues he has. And I said, yeah, I take these pills. And he goes. They're like 90% of it doesn't work. When you take a pill form or something like that, it doesn't get in your system to wherever you take the tincture. So now I do a tincture before bed, perfect, but I've never run it by anybody. I don't know if it helps me sleep, because I heard that it does.
Speaker 2:So I don't know. Let's talk about CBD and sleep.
Speaker 3:Well, as I say, we could be tracking that because we wear trackers, so you would be tagging on your tracker when you're using it. When you started using it, look for the difference in the data.
Speaker 1:I've never tagged it. I don't tag all the time.
Speaker 3:I don't tag all the time, but I tag when something is unique.
Speaker 1:But do you tag like? You wake up in the morning.
Speaker 3:I tag hyperbaric when I do hyperbaric, but do you?
Speaker 1:tag what happened yesterday, or you tag when you go into bed. You go here's what happened today.
Speaker 3:I tag when I go to bed. Here's what happened today. Okay, Impacting what's going to happen that night when I clutch my dad.
Speaker 1:I've never done that before so I should tag.
Speaker 2:Well, it would just be helpful, just because we can start to look at the data and see where there might be some data differences. As a general guideline, cannabis and sleep do mix and they mix okay, but there's a lot of things you need to understand. So number one the higher the level of THC, the worse the sleep.
Speaker 1:I don't think there's any THC in the there can be in CBD.
Speaker 2:yes, there can be very, very trace amounts but also I want to give people an understanding of cannabis in total, and then I'm going to break it down into the different constituents and just so that we're clear, I personally am okay with THC, but you need to have a small amount. So when you have large amounts of THC, it raises your heart rate and it lowers REM sleep. Those are two things we do not want to have happen. So going to bed stoned is never a good idea. Okay, now, if you use a medicinal product right, and what I would say is you would have a small amount of THC, then you would have something called CBN as in nighttime. So there is actually only one study literally in the published literature that shows that CBD does anything for sleep. What CBD does a great job of is lowering anxiety and helping with pain If you have a pain issue or an anxiety issue that's messing up your sleep.
Speaker 3:You're not sleeping.
Speaker 2:Right, then that's what it's going to attack. But I want to be very, very clear CBD in and of itself really does not have a tremendous effect on sleep. It has effect on.
Speaker 1:So you treat the anxiety and then maybe you can sleep better.
Speaker 2:Right. But what I would do is if I was going to be using a cannabis product for sleep and I recommend cannabis products for several of my patients what I would do is I would use a ratio, so I would say, for every one molecule of THC, I would want to have three of CBN and three of CBD right and so when? And you can buy products that have already got this setup in there, right and so what you do is you look for a sleep related product that's got CBD, cbn and a small amount of THC, and I think that's really where you're going to probably hit your best mark. Believe it or not, I actually take patients to dispensaries sometimes just to teach them. Mike can kind of see what's going on.
Speaker 2:Here's a really interesting. We were talking about prescription aids and cannabis. Here's a really interesting study out of the state of Colorado. So they found a county in Colorado where there were no dispensaries and they monitored the OTC sleep aids so the Benadryls, the Tylenol PMs, the Advil PMs and looked at consumption right, and then a dispensary opened up in that county. Guess what happened to the number of OTC sales? They dropped. They dropped dramatically, like by 25%. A second dispensary opened up in the same county and they dropped again. People are looking for a solution.
Speaker 3:Absolutely.
Speaker 2:Okay, and cannabis is the next Ambien.
Speaker 1:No question. But cannabis is also. They say it's natural, you're not going to get addicted, you're not going to get that type of thing.
Speaker 2:Look, at the end of the day, if you take something every single night, there's a level of addiction that's there, whether it's psychological or physiological. I don't think I want to split those hairs, but what I can tell you is there's also nothing wrong with needing something to help you sleep. Like, if you're a paranoid schizophrenic, you probably need to take Ambien. Okay, like that's just part of what happens in that regimen. If you're bipolar disorder, you may need something to help you sleep. Okay, if you have major depression, you might. Like there's no shame. I want to be very clear. There's no shame in taking a sleeping pill, but that is a relationship between you and your doctor and that's one that you have to be very tight on and understand how it works. Sleeping medication is not candy. A lot of people are like oh, I've got sleeping pills, you want one. You know, I mean, it's unbelievable. People pass out these things all the time. They can definitely be dangerous. Like you never mix them with alcohol, which a lot of people do.
Speaker 3:Everybody mixes them with alcohol.
Speaker 2:Right, and then you end up with real problems on your hands, like people getting into cars, cooking food, doing all kinds of crazy stuff in their sleep. So like you have to think through the idea. If you're not sleeping, well, okay, what are the things that are going on in my life that I might be able to improve? Caffeine, alcohol, stress would be the biggies. Understand what my chronotype is. So I go to bed at roughly the right time. Honestly, after that, if you could just do a little bit of exercise during the day, maybe get some sunshine, I think I'm good, you know, like that's really kind of what you need. But most people don't do all that right. They're stressed, they don't have an opportunity to, you know, work on a lot of these stressful things. They drink too much caffeine or alcohol.
Speaker 1:When should you stop?
Speaker 2:caffeine. I tell people to start stopping caffeine at around 2 PM. Oh wow, that late. Well, here's the thing. Caffeine has a half-life of between six and eight hours, so it's a good place to start. Now, what do I want? I would prefer it if people only had one cup of caffeinated beverage roughly an hour and a half after they woke up, and then they never had another one.
Speaker 1:You know, I was experimenting with that.
Speaker 1:I never drank coffee, and then Carrie, I started him on it she started me, dr Carrie started me on coffee, right for the whole fasting thing, yeah, and it got to the point where I don't like coffee and it kind of calms me down a little bit, but it was. It was working as far as the appetite suppressing, right. But what I started doing was I was drinking a cup of coffee every time we played commercials, every time we played a song. I'd get up. I was doing about 10 cups of coffee before 9am, right, and then I was. It was not good, I wasn't, I wasn't feeling it. So then I cut immediately down to one cup and that's it. And it's the same effects, like one cup Absolutely. And I feel like I discovered I did some sort of case study, clinical trial One cup of coffee is all you need, it's all it takes, that's all it takes.
Speaker 3:So I'm an anomaly. She is. So we joke about this all the time. It drives me crazy. I drink four espresso on my nightstand as I'm going to bed and he always says there's no way you're sleeping. So, we got an aura ring and I send him my sleep data and he's like damn, you go like into deep sleep within three minutes and you crash hard and I get we were talking about normals right For deep sleep. I get right around two to two and a half hours of deep sleep.
Speaker 1:an hour and a half to two hours per night, and rem.
Speaker 3:So I get over four hours, yeah, between every night, pretty much every night. Well, you know everything's not consistent, but 80 of the time 90 and he's like how is that possible with that espresso going to bed? And I'm like you know, I've done it since I think I was like five years old, honestly have you done the test on anybody else, so what, what I?
Speaker 2:think is going on and so. So it's very difficult when your doctor and you're a sleep doctor drinks espresso before she goes to bed.
Speaker 3:I don't counsel anyone else to do this. I just want to be really clear.
Speaker 2:And so you're talking with your doctor which I do on a regular basis because she's also my friend, not just my doctor and I'm like Carrie, there's no universe like, come on, cut the doctor. And I'm like Carrie, there's no universe Like, come on, cut the bullshit. And so we looked at her ring and she was right, and so what I think it is is I think that she does not produce the enzyme that metabolizes caffeine, and so I think it just runs right through her Um.
Speaker 3:I would agree.
Speaker 2:And so there's, there are people out there that do this. Now some people will take this enemy oh, caffeine. No, caffeine really does not affect her, at least not in the sleeping realm.
Speaker 3:Or in the heart rate or blood pressure.
Speaker 1:Which is quite remarkable. Does it suppress your appetite, though?
Speaker 3:No, not that much.
Speaker 1:It totally does that for me.
Speaker 3:I pretty much eat stuff all the time.
Speaker 2:Yeah, I was going to say you eat all the time.
Speaker 1:I can do a cup of coffee and not eat all day. It's really weird.
Speaker 2:Yeah, that does not happen to me. Yeah, that doesn't happen to me either. But I mean, look at the end of the day, when you're looking at the different things that are out there cannabis, melatonin, caffeine like you need to start thinking about, like whatever I'm putting in is going to have an effect, right. And so whatever you're trying to accomplish whether it's six, seven, eight hours of sleep, whether it's not waking up, whether it's more REM, more deep, whatever your goal happens to be my goal personally is just to wake up and feel good.
Speaker 1:That's the only goal.
Speaker 3:I have.
Speaker 1:Well, sometimes I wake up and I feel good and I look at my ring and it says I had a shit night's sleep. I'm like wait a minute, Right.
Speaker 2:So that happens more often than not, Right and so? So a lot of people don't like that. So what I tell people all the time is you should only look at your data once a week. You don't need your data every day. What good is it going to do you?
Speaker 3:You're still going to do what you need to do that day. You're not going back to bed.
Speaker 1:No way. Whenever I have a good night, what did I do last night?
Speaker 3:Well, you compete in the aura ring. Yes.
Speaker 2:I do. That's part of the week do I sleep the best? You might find that every single week, thursday nights is your best night, for whatever reason, because you've got something else that goes on, because Sunday nights have anxiety, because I've got a show to prep the next day that it's been a couple of days and I get pretty nervous.
Speaker 1:I also find this Sometimes, if I sleep, let's say, four hours, five hours a night, there are nights where I get the most deep sleep during that short amount of time, absolutely, and that's okay.
Speaker 2:Here's the thing to remember is, this unit that we live in is much smarter than we are and it will get what it needs when it needs it. And so there's some nights, nights and just to be clear, I'm the sleep doctor, right, there's some nights I don't sleep so good. Okay, there's nights I've had insomnia, right. Some nights my body is more interested in doing something else and sometimes you just have to be like, okay, it's not like your head's going to pop off, right, because you didn't get enough sleep that night, because that's probably happened to you tens, if not hundreds of times. So, just under, kind of understanding. It's really about acceptance in in an interesting sort of way, because I I talk with people about insomnia a lot and and one of the big things is, people are like it's the competition. My bed partner can fall asleep, why can't I? My co-worker says they get nine hours, I can't even get three. You know it's. It's. Look, I'm five foot nine. I'm never going to dunk a basketball.
Speaker 1:It's just not going to happen. Okay, it does happen. There are five foot nine. Trust me.
Speaker 2:Muggsy bows and, uh, you know, spud Webb was my favorite growing up, but I mean, at the end of the day, those they're outliers and I'm probably not right, and there's some things you just have to accept about yourself.
Speaker 1:Okay.
Speaker 2:And that's okay, right.
Speaker 1:Okay, very good.
Speaker 3:So I have a question because, obviously I deal with a lot of insomnia. I think the statistic I read you can weigh in on this was about one in three people will deal with insomnia at some point, or lifelong or situational. We've talked about situational impacting it, but there to me there are medications that are over prescribed by a lot of providers that I like to tell people. It's not just about saying no, you shouldn't do this, but that actually do long-term harm to patients. So can we touch on a couple of those? Because I think it's different than the occasional Unisom or Benadryl Advil PM, which is really just Benadryl, using those on occasion to follow sleep.
Speaker 3:It's the addiction, like you said, be there physiological, psychological, whichever way that I say you're actually not just taking a pill that you're addicted to. You're actually never getting actual sleep. Your brain is not registering the thing. So we do see early onset dementias, which is a big issue that I think is not as correlated to it as it should be. I don't think people talk about enough about sleep aids and early onset dementia. Um, hopefully we'll start talking about it more. But if you had to say what are the big three pills that you say, you know what if you can avoid these, or you can find a way to get off of them. What would you advise?
Speaker 2:So the easiest way to answer that question is to tell you about a patient that I have. So I have a patient who was taking Sonata to fall asleep, ambien in the middle of the night, waking up and taking Adderall to start the day XR, like the extended release, and then taking an IR at three o'clock. Okay, this person was 78 years old, okay, and they came to me. They're a very famous consultant in the entrepreneurial world. Do we have their name? I cannot say their name. And he came to me and he said I've been going to my neurologist who's been prescribing different medications for a while and he's been trying to tell me that I need to get off of these. And he turned to me and he told me that at 78, if I stay on these, my brain will turn to mush. And I said that is probably one of the more accurate statements that I have heard.
Speaker 2:So to to long way around. To say, long-term use of these medications, again with your doctor and understanding what's going on, may be appropriate in a small percentage of cases, but there are very few people in the universe that have what I call a broken sleeper right, that have to be on drug forever, right, I mean. And so just as a caveat to this story, so number one many people might not know this, but Ambien has a much longer half-life than Sonata, so he had the reverse. So the first thing I said was you're a mess, can you do me a favor, put the Ambien in the front of the night and the Sonata in the middle of the night? Because I was going to get rid of the middle of the night, sonata, eventually. So I got him off of the middle of the night, sonata, then I halved him on the Ambien, then I started working on the Adderall right and, by the way, this is all in conjunction with his physician.
Speaker 2:And so while we start doing lower the XR and move the IR to the beginning of the day, and all of a sudden I got him off of everything. Just click, boom, and he was motivated. And the reason he was so motivated was because he was like I can think it was fascinating. This guy makes his living off of creating these intellectual tools that he gives to entrepreneurs and he gets patents on them and things like that. He said, michael, since I've been working with you, my productivity rate has tripled. He said my staff is furious. He said I'm doing more work than they know what to do with at this point. And it's all because you got me off of those drugs, so he's off of everything and he's sleeping.
Speaker 2:Sleeps like a charm, no problem. So the point of the story is yes, we do know that many of these medications out there can have long-term effects, and it's not even the ones that we think. So anything with a PM is not a great idea, and I think that's where you were going with your question, because when we look at Benadryl, which is the PM, there is direct evidence now to show that daily use of Benadryl will in fact lead to Alzheimer's Correct. It's a very direct link. We know exactly what's going on now. This is not necessary Now. If your allergist has you on Benadryl for extended periods of time, that's a different story. You want to talk with them about that.
Speaker 3:But there's alternatives to using that as well.
Speaker 2:And there are alternatives to using that. But at the end of the day, if you are taking allergy medication every night to fall asleep, it's going to turn your brain into mush and that's really not the direction that we need to go in. When I use medications within the practice and you know this because we've worked together on many patients the physician will prescribe a medication to break the cycle of insomnia, not to leave people on drug for years and years and years. And, to be fair, sometimes it takes a while, right. Sometimes people need to be on drug for three, four, six months before we get a steady sleep cycle. Then we teach them how to sleep and we slowly taper off the medication and, lo and behold, they sleep. They sleep right. It's really has a lot to do with stress and your stress management and then just really understanding yourself, your body and your sleep cycle. What about?
Speaker 1:like with this insomnia, talk sex. Does sex help you sleep?
Speaker 2:So sex helps men sleep, not women. So, as the age old joke goes, you know, most men fall asleep after sex and women are up and ready to go. So there's actually been two studies, unfortunately all in Drosophila. So I don't know how close we are to fruit flies. But one of the things that happens with fruit flies male versus female is males have a tendency to relax and sleep, Females have a tendency to nest you mean they haven't studied this in humans. They have not.
Speaker 3:There's, I'm not aware it's time to start a study. Yeah, really.
Speaker 2:I mean, we could definitely do a fun survey and we could probably figure it out. But the question then becomes why, right? And so it may have something to do with orgasm, it may have something to do with sexual positioning. There's a whole host of different things that they think it could have something to do with. The position could help. So if you really want to get into it. So the process is physical exertion they're talking about. Oh so the, the goal, the, the thought process is men are exerting more physically than women, especially if you're in the classic, uh, missionary position with man on top, woman on bottom okay, because, like I, I'm so competitive with my aura ring that I'm looking at.
Speaker 1:okay, I got, let's say, 20 or 18 minutes of deep sleep, no orgasm the night before, oh hour and 10 minutes, guess what. We had sex, right. And so now I'm telling my wife, this is really going to help me get some deep sleep, and it doesn't do anything, she still shuts it down.
Speaker 2:So here's where I would go with that if I were you is. I wouldn't say that it would help you every night, but I would say that it would definitely probably be somewhat helpful, probably two to three nights a week, yeah.
Speaker 1:Okay. So then I thought, like for fun, but also seriously, as I'm monitoring, I'm like, okay, we didn't do it two nights ago, we did it tonight. And then nothing this day, something this day. And I'm literally thinking that is one of the important things in getting deeper sleep is an orgasm. And then it's like, well, I was in Hawaii last week by myself, got things under control, sleep wasn't that great. So is it not the orgasm you?
Speaker 2:know what I mean, right? So the question is is it the connection or is it the orgasm? The connection is another thing, and I think it's the connection.
Speaker 1:Well, I think it's a natural anti-anxiety drug for sure sex or yeah, sex yeah, but I mean just also the connection with the sex is the natural skin. The skin, yeah, it's like, yeah, it produces oxytocin and that's exactly where I was gonna go.
Speaker 3:I think it is the oxytocin right and I.
Speaker 2:So I I would argue because, like you know, if you look at it, if somebody just gives themselves an orgasm versus being with someone to have an orgasm, it's very different, right, and so that's kind of what you're talking about here. And, from a sleep perspective, it's not just the physical act of orgasm. I think that's allowing people to fall asleep. I think it has more to do with the connection.
Speaker 1:So then, that's so stated, though in the morning, every once in a while, as early as I get up, something happens.
Speaker 2:It hasn't happened in a long time, but when it does happen, before I go to work, you get up at 2.45,.
Speaker 1:Dude, I know, but sometimes something happens, and when it does I have the best day. Yes, you do, do you know?
Speaker 2:what.
Speaker 3:I mean, that's the oxytocin again, though For sure it's not only the oxytocin.
Speaker 1:It's. It's literally like smoking a great big oxytocin joint in the beginning of the morning and it's just, you're just got that high all day long because it lowers that stress. Then I thought it's gonna make me tired. That's why I remember they used to say there was that no sex before a fight boxers right, because it would make them tired right, which is not true oh, it's not because then I'm like oh wait, I don't know if I want to do this.
Speaker 1:I gotta go do a four hour, five hour show. I need to be on, I don't want to be tired, you'll be fine. Okay, good, I know my wife's coming here today for some stuff and I wish she was here now. But then it's like oh wait, this is going to be a podcast. I need you to zoom into this point here the podcast.
Speaker 2:Absolutely, don't you worry.
Speaker 1:Let's talk about sleep apnea. Sure, Since you're the sleep doctor, I'm an expert in sleep apnea. I haven't been tested.
Speaker 1:Now I'll just say I was getting a haircut for this broadcast today and my beard cleaned up and my barber says to me he goes, I snore, my wife is furious with me. I think it's starting to cause problems. He's like happy wife, happy life and he goes I might have sleep apnea. And I said to him, I said and I might be wrong I said if you go to the sleep doctor's website there's a sleep apnea test or something right, absolutely, that you can order.
Speaker 2:So you can order a home sleep test and figure it out yourself. You get to talk with a physician, so it's not like you're completely on your own or anything like that. But yeah, here's the bottom line when we start to think about sleep apnea and you had been correctly diagnosed with it. If you have undiagnosed sleep apnea, it leads to a whole host of so many different medical complications.
Speaker 3:Chronic medical diseases yes.
Speaker 2:Right. So hypertension, all kinds of cardiac problems, stroke, death, I mean, the list goes on and on. Literally every organ system gets affected by getting bad sleep, and so when you do that to the system, it kind of screams out at you, and so looking for treatment modalities turns out to be a really big, important thing. Now a lot of people know about this thing called CPAP, right, continuous positive airway pressure. So basically it's kind of like a hairdryer that blows up your nose and pushes air down into your lungs, right Kind of basics behind the physics of it. Um, about 40 to 50% of people do really good on CPAPs. I want to be clear though 99% of people it fixes them, but only 40, 50% of people will actually tolerate and wear it.
Speaker 2:So they now make oral appliances, which is a mouth guard kind of like you see the athletes wear, but it's an upper and a lower, and the lower comes out a little bit past the front and it opens up your posterior airway and allows for you to breathe a little bit better. The front and it opens up your posterior airway and allows for you to breathe a little bit better. So that's another option. There's also something now called Excite OSA, which is basically a TENS unit for your tongue. So this is something that you wear during the daytime for about 20, 25 minutes. It reduces the size of your tongue very small, does not affect taste, does not affect voice, nothing like that. Gives more space in the oral cavity, thereby allowing you to breathe better. Some people we get them off of CPAP for that.
Speaker 1:So they literally have a fat tongue. Exactly.
Speaker 2:Like you've been diagnosed.
Speaker 1:Oh yeah, absolutely you lay back, your tongue covers your airway.
Speaker 2:You nailed it. That's exactly right and it works by. The TENS unit shrinks your tongue. It's amazing. It's truly remarkable. I would argue it's probably the biggest innovation that we've seen in sleep apnea treatment in a very, very long time.
Speaker 1:Well, well, I mean, as a guy who has, I've had sleep apnea for maybe 15 years maybe, and I love my c-pap, I love it like you're again one and two, hate it well, the problem.
Speaker 1:The problem I have now are lines from like I in my radio show, I'm doing tv hits or they're filling stuff and I'd be on tv and I see the line right. So I started modifying things. Where you know, thank god for covid, when everyone's wearing masks? Yep, I found this mask for sale at a booth in san diego and it's like a ninja mask so you know where the eyes.
Speaker 1:I put the mask nice and where the eyes are, I pull it down to my mouth and then I put the tank, the mask over, and then it kind of gets rid of the.
Speaker 2:You got to take a picture.
Speaker 3:He has pictures At one point I put the mask on.
Speaker 1:Then I put a pair of underwear over my head Lululemon underwear Even better. And then it would help keep the marks away.
Speaker 2:So don't wrench the mask so tight, yeah, but the air comes out and then I have this beard. Okay, okay, no-transcript.
Speaker 1:Oh, come on. I wonder every drugstore in the universe?
Speaker 2:And what happens is, if you use a water-based lubricant, it'll form a seal like a gasket would on your face, so you don't have to wrench it tight, and so it actually blocks. Because right under your nose is where we have the most air leaks, because it's this crease or up here, then it gives me dry and it gives it in your eye.
Speaker 2:But again, if you have a little bit of ky and you put it on the mask itself and then when you place it on your face, it forms this gasket and it works beautifully, you don't have to wrench the mask so let me tell you my newest thing.
Speaker 1:All right, and I know you know about this, but sometimes you forget. A friend of mine had covet and was put in the hospital and she was like dying. She gets out of the hospital, they give her this oxygen tank, right, right. So she's fine now and she says I have this oxygen tank, do you want it? I'm like sure. So I have it hooked up to my c-pad. Yeah, right at level two and there, and, and it made too much noise so I could only use it when I was going to nap in the daytime because my wife couldn't sleep right. But now I got 50 feet of tubing and I put it down the closet.
Speaker 1:I turn it on, I close the closet door, then I close the bathroom door, the tubing comes all the way up and I just a little bit of oxygen and I feel that with my aura ring sleep that let's say I was going to have a 70 sleep, with the oxygen I think it takes me to an 80. Does that make sense? So it.
Speaker 2:So number one I would be well, it probably doesn't change your oxygen concentration all that much right, it's such a low flow right, I actually don't have that feature in my ring.
Speaker 1:I don't know.
Speaker 2:But. But I would say that, um, having oxygen in the system is always going to be good for deeper sleep. So if I had to guess and I don't think anybody's done a study where, like, we've administered oxygen at night to see if it increases deep sleep or increases REM sleep If I had to guess I would say it probably increases deep sleep.
Speaker 1:physical restoration Because I would think oxygen is good no matter what, any time. Pretty much, well, you can have too much oxygen.
Speaker 3:I think that's where he's hedging on, so normally good, no matter what, any time, right, pretty much you can have too much oxygen. I think that's where he's he's hedging on. So normally we prescribe oxygen as a bleed through into a c-pap if your oxygen levels drop below 88 is kind of the traditional benchmark. But that doesn't mean people don't benefit, if they have higher oxygen levels, from still having supplemental oxygen right so you could still be getting a gain. We just don't really know what that gain is, because we don't treat that normally.
Speaker 1:Because I was going to ask you too. You told me to put it at two. I feel like you should go higher.
Speaker 3:Well see, that's what we're getting into.
Speaker 1:So then, you can start but now what are you all prophyl like Michael Jackson, yeah.
Speaker 2:That's a whole different story.
Speaker 3:Well, yeah, you can actually get oxygen toxicity. You can decrease the respiratory drive by having too much oxygen, so you're going to tell your brain I don't want to breathe, and then you'll stop. Now you're on CPAP, which is forcing breaths.
Speaker 1:So there's a paradox there.
Speaker 3:To begin with, but you don't always want to over oxygenate.
Speaker 1:At what level is that?
Speaker 3:I think most of us healthy people walk around 96, 97%. I mean if you're tipped in 99, a hundred all night, long over time, that could cause some negative effects.
Speaker 2:Yeah, I mean, there's a reason why we don't sleep in a hyperbaric chamber, right, right.
Speaker 3:All night long but could you, though? You could not sleep in a medical grade hyperbaric chamber all night long, you would get what's called oxygen toxicity, which would induce seizures and you would not do well. So there is a theoretical limit of how much oxygen you can feed into your brain, into your organ system, before you start to see negative effects from what you're doing. So there's a balance.
Speaker 1:The tongue thing you were talking about. How do you, how does somebody do that?
Speaker 2:It's by prescription. You just go to exciteosacom and you punch in your zip code and they'll find a doctor near you who can. But how do you get diagnosed for having a fat tongue? Like, you literally go to your doctor and then you just have to have the diagnosis of sleep apnea. Oh, okay, because most people with sleep apnea have got larger tongues. Um, that's really, believe it or not, one of the big physiological markers. Um, that we look at a big tongue. That and weight loss uh, that and weight gain and weight loss because I've lost the weight.
Speaker 1:I feel pretty healthy. I think I am healthy according to you absolutely yeah, why do I still have sleep apnea?
Speaker 2:because it's not just a weight-driven disease. It's also got to do with your tissue and your, your anatomy, right and so, and also, don't forget, as you continue to lose weight, you'll lose more weight here in your neck, because, guys, we have a tendency to lose weight or gain it right here in our necks and then cut right around our bellies and that's kind of the last places that we have a tendency to lose it from. So once you continue on that journey, I think you'll find it gets better and better. It also begs the question that we were talking about earlier, which was these new GLP-1 drugs that everybody's getting on the Vigovis and the-.
Speaker 3:Manjaros Vigovis semaglutide.
Speaker 2:So a lot of people are looking at those and saying, hey, should I get on that and then can I get off my CPAP machine if I lose enough weight, and so the the potential is possibly, but we need to do a study on you after you've lost the weight to see.
Speaker 1:I don't really mind the CPAP. The only time the CPAP ever bothered me is when my son, a boy scout, became an eagle scout. We'd go camping, yep, and I'd have to bring it, or I'd get a portable one, you know, with a with a generator at one point and it was like that took up all the room in my backpack, right where all the other dads are pulling out hibachis and stuff like that my backpack was a c-pap.
Speaker 2:Yeah, it sucked absolutely, but you also did. You probably didn't keep everybody up all night long with your snoring.
Speaker 3:You're right, um, greatly appreciated by, appreciated by all, I'm sure.
Speaker 1:Okay, so real quick around the room. We'll correct about a more sleep out, because we know you got to catch a plane, yep, so what's up? Anything else?
Speaker 3:Well, I want to go back to the Wagovi question because I mean, I think that is really cutting edge, and a lot of people are trying to figure out how to repurpose this drug and the FDA is trying to not more years under different names. So we've been using it in medicine very long time and we weren't really paying attention to the side effects, but someone got really smart and said, hey gosh, people who take this drug for diabetes don't really want to eat that much anymore. And so then we figured out it was a weight loss drug, and I love the idea that they're now kind of correlating that with other diseases beyond just weight loss using it. Obviously, cardiovascular disease is hitting a lot of indications now, and people are saying this could reduce cardiovascular risk, which is stroke, heart attacks, and it's all tied to the same thing though Lose weight, be healthier.
Speaker 2:Correct.
Speaker 3:Eat better Correct, because it's not just weight loss. I always tell people the drug doesn't actually make you lose weight. It makes you make better choices about life, which you can do without a drug. So you don't have to have the drug, but the drug definitely tells the brain to act better, make better choices. I don't want fried foods, I don't want sugars, and by doing that you know what happens People lose weight. They start to feel better and they sleep better.
Speaker 1:Yeah, because we didn't even get into that before, about what to eat before you go to sleep. Right, you know that guy who's kind of a freak, brian Johnson. Yes, yes, you know that. Dude's last meal is 10 hours before he goes to sleep 10 hours.
Speaker 2:I got to be honest with you. I'm not a fan Right Agreed. I don't see what he's doing as helpful.
Speaker 2:Or healthy or healthy, I think. Unfortunately, he's showing every extreme that he possibly can as a very wealthy man. He's going out there and he's trying all these extremes and unfortunately I don't think he's setting the right precedent for people out there. And I don't really understand what his goal is. Like he wants to actually get younger. Is what he states in his videos Like that doesn't seem. I'm pretty sure that doesn't. It doesn't work that way. Um, and I just don't. I don't understand what his motives are and kind of where he's at. So I'm I'm concerned about a lot of his methodology. Also, he's not a physician, so he has no idea what the long-term consequences are of the stuff that he's doing.
Speaker 1:He doesn't look healthy to me.
Speaker 2:He doesn't look healthy to me either. I mean nothing against him aesthetically, like I mean he's a muscular man and he's an attractive person, but he does look quite pale. Maybe he just doesn't get a lot of sun, I don't know. But I mean he could probably use some vitamin D.
Speaker 1:But we jump into foods. So is there a time limit? Stop eating before you go to bed to get a good night's sleep?
Speaker 2:What I like to tell people is what I kind of do is what I say. It's a three, two, one rule. So stop alcohol three hours. Stop food two hours.
Speaker 1:Stop fluids one hour before you lights out as a general guideline One hour will stop you from peeing four times in a night.
Speaker 3:Well, there's a lot of caveats, Obviously talking to your physician if you're a person who does get up four times at night to urinate, which I did not know about- it was last night.
Speaker 1:It was the first time this hour.
Speaker 3:And that gets into the whole issue of insomnia. So we end up flipping back into that. But I mean, then you're going to stop fluid six hours before you go to?
Speaker 2:bed.
Speaker 3:And that's a state of dehydration which we don't want people to be in. But you have to pick and choose your battles, because getting up and truly having to urinate multiple times a night is not helping you get a good night's sleep. It's not getting that deep sleep, it's not getting the REM that we've been talking about.
Speaker 2:Right, but are there?
Speaker 1:foods.
Speaker 2:You shouldn't eat before Anything with high sugar, anything with caffeine in it, that kind of stuff, although I have to admit, my wife told me I can never tell people they cannot have chocolate because she eats chocolate every single day and it does have caffeine in it, you can have a small square of chocolate every day. The sleep doctor says it's okay.
Speaker 3:Carbohydrates tend to make you feel sleepier.
Speaker 2:Yes.
Speaker 3:But the truth is, for health, you should actually be eating protein before bed, 100%, because we don't get enough protein and our bodies become anabolic.
Speaker 1:So they eat up our muscle Before bed, like I'm eating protein. Good night, or eat protein is the last thing you eat.
Speaker 3:Well, if you, if you listen to Dr Bruce he's saying two hours before bed and I mean two hours is not that long of a time before you go to sleep. So a lot of people do have problems if they eat a large meal immediately go to bed. Then we get into issues with reflux and laryngeal regurgitation and not feeling well and they have to sleep sitting up and so you have a whole new saga of health problems. So we say don't eat a big meal and then go lay flat. The body's not really designed to accommodate processing a large meal and then not being in the upright position, Right either lying down?
Speaker 1:Yeah, so it's bad. Is there a better sleep position?
Speaker 2:So I would argue that the back is probably the best sleep position, unless you have sleep apnea, and then your side would be. Backs are great because it's the best way to displace weight across the skeletal frame without jacking your neck one way or another, being in some weird position.
Speaker 1:So a quick recap. You said sex every night before bed is great for you to get.
Speaker 2:I did say that as a matter of fact.
Speaker 3:Oh, my wife is here, sorry, blake.
Speaker 1:All right, thanks, doc. I know you got to go. Thanks for jumping on our podcast Experimental. It's a lot of fun. Thank you, thank you, thank you, thank you.