Why You Can't Sleep (And How to Fix It) | Dr. Daniella Marchetti

Most people think sleep is simple.

Go to bed. Close your eyes. Wake up refreshed.

But for millions of people, it doesn't work that way.

In this episode of More U, Dom and Dr. Ben sit down with sleep specialist Dr. Daniella Marchetti to uncover what actually affects sleep quality, why insomnia is so common, and the surprising mistakes people make that keep them exhausted.

From sleep hygiene and technology to nightmares, lucid dreaming, melatonin, and cognitive behavioral therapy for insomnia, this conversation dives into the science behind better sleep and how small changes can create massive improvements in your health, energy, and performance.

In this episode:

•  Why so many people struggle with sleep 
•  Cognitive Behavioral Therapy for Insomnia (CBT-I) 
•  The biggest sleep hygiene mistakes 
•  Sleep tracking devices: helpful or harmful? 
•  Nightmares, REM sleep, and lucid dreaming 
•  What recurring dreams really mean 
•  The truth about melatonin 
•  Practical strategies to improve sleep tonight 

If you're waking up tired, struggling to fall asleep, or trying to optimize your health, this episode is for you.

🎧 Subscribe to More U Podcast for conversations that help you become healthier, more intentional, and more aware.

📲 SOCIAL MEDIA

Podcast: @more_u_official

Hosts: @dominicmazzone1
@manyfacesofchicago

Guest: @drdaniellamarchetti

Transcript

SPEAKER_02 0:00

It's definitive. If you die if you don't sleep, right? I mean, it's a form of torture.

SPEAKER_00 0:03

You can go longer without food and water, but after a few days without sleep, that you can die of sepsis. A lot of people take drink alcohol or a nightcap because they think it's gonna help them fall asleep, but it's one of those things that's gonna hurt your sleep.

SPEAKER_01 0:16

What would you say is there um like a least common denominator when it comes to insomnia?

SPEAKER_00 0:24

We cannot command sleep like flipping a switch.

SPEAKER_01 0:34

Today we're gonna go deep. Deep, deep, deep into sleep, sleep, sleep is where we're gonna go. We have Dr. Daniela Marchetti with us. I said the name right because I'm Italian, and it is Dr. Daniela Marchetti. Pretty excited. Um Dr. Marchetti, she is a clinical psychologist, board certified in behavioral sleep medicine, which is amazing. Daniela, welcome. Welcome, welcome.

SPEAKER_00 0:59

Thank you. Happy to be here.

SPEAKER_01 1:01

We're super happy to be here. And I gotta tell you something. So when we prepare for these, um, you know, sometimes we're having to think about like uh like what kind of questions can I ask? I was stopping myself from how many questions I had. So this is gonna be a lot of questions, a lot of rapid fire. Um, I hope you're okay with that. But uh just so many questions. So so thank you so much for being here.

SPEAKER_00 1:25

No, it's my pleasure. Can't wait.

SPEAKER_01 1:28

Yeah. Can we take let's take a step? Just first of all, like how I want to just first understand how you got fascinated with sleep and how this really became your thing.

SPEAKER_00 1:39

Yes. Um, so I actually became fascinated with the treatment for sleep. Um, so myself, when I was learning um health psychology at the University of Miami, um, I am a researcher by by practice. And when I saw how large the effect sizes were for insomnia treatment, which we call CBTI or cognitive behavioral treatment for insomnia, I thought to myself, okay, this is something that first of all I need to become competent in because it's so effective. Um, and it also occurred at a time in my life when my own sleep was suffering. And so when I applied it to myself, I was pretty much sold.

SPEAKER_02 2:16

You know, sleep is having a moment right now. Like, right? I mean, the the longevity space, I mean, it goes, I don't know if it goes exercise then sleep or sleep then exercise as like one in the two things you can do to prolong your life. That's probably 95% of it, right? Sleep and exercise. You would probably argue sleep. I think exercise is right. I mean, they're they're like neck and neck, but sleep is having a moment, I think is a good way to say it.

SPEAKER_00 2:42

Absolutely. When you look at biohackers like Brian Johnson, for example, he says he says sleep is number one. Yeah. Um, and then you hear similar things from the likes of you know Andrew Huberman, Dave Asprey and that whole space. Um, so I would argue that sleep is edging out exercise by a hair, um, because good sleep improves your your ability to exercise.

SPEAKER_02 3:03

So good exercise improves your sleep, also. So, you know, it's chicken directly there. Bidirectional.

SPEAKER_00 3:10

For sure. Uh for sure.

SPEAKER_02 3:11

I okay, I don't know. For me, I would I would put exercise ahead for myself, um, but sleep is there.

SPEAKER_01 3:19

Ben's um Ben's super hardwired. So anything that has motion and action is Ben's sleep is on that side of it, right?

SPEAKER_02 3:28

I'm with sleep, uh sleep annoys me. I wish I didn't have to freaking sleep. I hate it. I hate sleep. It's for you know, it's just it's the worst part of my day.

SPEAKER_00 3:36

You know, a lot of people feel that way. Um, you know, a lot of great productive people in society actually feel that way. It's like, why why do I need to slow down and and rest? There's so much more I need to do. Um, so I can understand that perspective, absolutely.

SPEAKER_02 3:50

But it's definitive. It is it's definitive. It's it's I mean, it you you die if you don't sleep, right? I mean, it's a form of torture. I mean, it's those are all because it's that significant. So I I I bow down to the sleep, but I hate it.

SPEAKER_00 4:04

Yeah, you can go longer without food and water, but after a few days without sleep, that you can die of sepsis. So it's no joke.

SPEAKER_01 4:13

Sorry, let's take a second on that, because I don't think most people know that. Can you can you just dig into that a little bit more?

SPEAKER_02 4:19

As far as um, at what point sleep at what point does the lack of sleep kill somebody? Is that defined? Is that defined?

SPEAKER_00 4:28

Uh they so as far as like how many so sleep deprivation does not directly cause sepsis, but chronic lack of sleep can weaken the immune system. And I think the number now is like you know, 48 to 72 hours without sleep, you know, puts you at that point where you're you know disrig dysregulated.

SPEAKER_02 4:46

Yeah.

SPEAKER_00 4:47

And you're more likely and more susceptible to infections like sepsis.

SPEAKER_01 4:51

Um the and I also think I also think the other thing that's several cokeheads that would probably have taken it to that to that extent. I mean, it's probably fair that they've taken it. We we gotta have one of those guys on, Ben, to ask. Mathematics or something, yeah. I mean how many hours they went. Okay, sorry, go, Ben.

SPEAKER_02 5:10

Um I think the other thing that's also very interesting about you, uh uh Dr. Marchetti, not Marchetti, uh, is uh that that you're doing it with CBI um or CBT as opposed to medications. Or I mean I know you probably do use or promote medications when indicated type of thing, but the fact that you're you're helping people do it so much without medications is is uh powerful and also having a moment, I think, right now.

SPEAKER_00 5:36

Yes, so CBTI I always say has a really bad marketing problem or a publicity problem because everyone knows about sleeping medications, but no one really knows about CBTI, even within my own field. Um, a lot of psychologists, when I tell them I'm a sleep psychologist, ask me, how exactly do you do that then? Um but CBTI is first line treatment for insomnia.

SPEAKER_02 5:58

It's been found to be just to interrupt, I I think a lot of people aren't gonna know what that is. Like define it for a CBTI or cognitive behavioral therapy. Like give some context.

SPEAKER_00 6:08

Yes, so CBT, cognitive behavioral therapy, is a modality for um is a therapy option based off of you know working with behaviors and cognitions, right? So how are we thinking and feeling? How are we behaving? And CBT is commonly used for things like anxiety and depression, that's where we hear it mostly. But there is a separate protocol called CBT for insomnia or CBTI, where we not only work with you know how you're thinking and feeling about your sleep and your sleep behaviors, um, but we are targeting a health behavior. So we're also monitoring that pattern. We're giving you a sleep log or you're doing it digitally. There's so many ways to track sleep these days. Um and we are creating a time in bed window that's that um that matches your your needs depending on you know what your life is like, what demands you have, in order to increase your sleep pressure so we can get you to have um faster sleep onset times and consolidated sleep, better quality sleep. Um and so CBT um is like a is a big philosophy that was developed by um by Aaron Beck. Um, but we have taken this um offshoot protocol and it happens to be more effective than the others.

SPEAKER_02 7:23

So it's not just we can't just have a Negroni and go to bed? It doesn't work that way. We can't just to keep the Italian flair, we can't just have a Negroni and call it like that's gonna put me to sleep. I love a good Negroni before bed.

SPEAKER_00 7:36

I mean, I know that's probably not your guys' let me tell you, that's actually one of the things I have to tell people is a sleep myth. Um a lot of people take drink alcohol or a nightcap because they think it's gonna help them fall asleep, but it's one of those things that's gonna hurt your sleep.

SPEAKER_01 7:49

Yeah.

SPEAKER_00 7:50

Um so I have to I have to debunk that one.

SPEAKER_01 7:52

That one sucks. It's just for clarity's sake, when we look at alcohol and those types of things, it may you may get to sleep, but you're not actually getting good sleep. Is that is that is that the differentiation?

SPEAKER_00 8:03

Yeah, so alcohol has that superific effect initially, right? And so it may help with sleep onset, but it actually changes your sleep architecture. So it impedes your ability to get into REM sleep, which is one of those deeper stages of sleep. It's where 95% of our dreaming happens. Um, and it impedes our ability to get to that stage. Um, and not only that, but it causes more fitful sleep, more tossing and turning, more likely to wake up, use the restroom, not feel great the next day. Um, so I I call it a false friend.

SPEAKER_02 8:36

Okay, the thing I really want to get into because I I've kind of started to obsess about it a little bit myself. This is the aura ring. I know you've I've seen you kind of talk about that recently as I was kind of reading about you and stuff. Um, there's the watches, obviously. The ring I think is the best because it seems to be the least disruptive, at least to me. But I mean, you can really obsess about these things. And I love it. I love waking up and be like, boom, 88. How about that? I did it. Or if I get like the other day I had a 59. I was like, where the hell did that come from? You know, like my sleep score.

SPEAKER_00 9:05

I'm so glad that you brought that up. Um, you know, the aura ring, uh, the whoop. If I had to name any two uh wearables, I would say those two are probably the most accurate and reliable to use when you're tracking your sleep. But it is a double-edged sword, you know, depending on who you are. Um, there can be a little bit of this obsessiveness that comes with these scores, not knowing what they mean. What if I have two wearables and they conflict? Um, you know, and and is this creating anxiety for me at the end of the day?

SPEAKER_01 9:35

Yeah. It does. What I notice on the sleep tracking, which I think is crazy, is sometimes I'll go, God, I got an amazing night's sleep. And you look at the sleep tracking and it's awful. And you're like, should I feel awful now? Because I feel great, because I feel like I got a good night's sleep. So um I've seen that I've seen that just do the opposite, where it's like I could see how someone could talk themselves into one way or another of I got good sleep just based on whatever the tracker did instead instead of just how I feel when I wake up.

SPEAKER_00 10:08

Exactly. And the the tricky thing with that is that there is limit, there are limits to how accurate these things might be. You know, if you're in bed and you're just very still but awake, it may think that you've fallen asleep. And on the flip side, what if I'm a fitful sleeper? Maybe I toss and turn and it thinks I'm awake, but I'm actually asleep. And so oftentimes it might overestimate how much I'm sleeping. Um, and um, all wearables, not just the aura ring, tend to also underestimate sleep architecture too. Um, I often get folks in therapy that ask, you know, they or say rather, I know I'm not getting enough deep sleep. How can I get more deep sleep? And they often point to their wearables as the way that they know that.

SPEAKER_02 10:49

So, what what what do you think to that point? What is the best objective measure? Because none of us know how much we're sleeping, other than like Dom said, you know, you kind of feel good, you kind of feel like crap. What like what is the best way to do it?

SPEAKER_00 11:04

To determine how I do think it depends on personality profile a little bit. If you know that you run a little bit anxious and a little bit more of a worry wart, I would say maybe take a step back from some of the wearables and some of these metrics. Um, when I work with folks in the therapy room, I actually tell them, you know, disregard your Fitbit, your Aura ring, whatever other sleep tracker you have. Here is a paper and pencil. And I want you to write down the next morning when you went to sleep, how long you think it took you. I want your best estimate and how many times you can actually recall waking up in the middle of the night. And that's how we go about modifying the time in bed window.

SPEAKER_02 11:45

Okay.

SPEAKER_00 11:45

Um if you can use these things, you could blind yourself to the ring too.

SPEAKER_02 11:50

You could do that, wear the ring and just not look at the scores, and then see if you line up with the score. You know what I mean? So that's a good way to do it, right?

SPEAKER_00 11:59

Yeah, exactly. I use it as like a fact checker. Use it to fact check your sleep.

SPEAKER_01 12:04

So, Daniela, when we have so many questions, and I'm trying to think of the order of operations on these questions, which is you know, you're helping people more from a psychological perspective that are actually struggling with sleep. Um are you actually also helping them with like sleep hygiene and these kind of things as well?

SPEAKER_00 12:26

Yes, so sleep hygiene isn't is necessary but not sufficient for helping with insomnia. Oftentimes when people come to me, they've already done some of these things, like gotten blackout curtains, using airplugs, white noise machines. Um this is important. We want a good sleep environment, um, but it's not sufficient in moving the needle if there's true insomnia present. Um but I do go over all of that in my initial sessions with folks.

SPEAKER_01 12:53

Got it. And what would you say is there um like a least common denominator when it comes to insomnia? Like what what is the what is the underlying factor? Is it is it just anxiety and stress? Like what what is it?

SPEAKER_00 13:10

Yeah, I I'd say depend- I mean depending on who comes to me, I see different profiles, but the big one is uh the relationship that person has to sleep. Um do we view sleep as a performance metric? Um we talked about exercise versus sleep initially. Um exercise and sleep function very differently as health behaviors, right? With exercise, the more effort we put in, the more linearly we can see changes. Same with nutrition, you know, barring any, you know, accessibility issues. When it comes to sleep, the more effort we put into things, you know, sometimes the more sleep will elude us. Um and so depending on what your relationship is like with sleep, um, that's where I see insomnia crop up. Are we are we trying to control our sleep? Are we looking at it as a performance, like a number every day? Where is my number going? Um, you know, do I feel anxious to go to bed? Am I now delaying going to bed because I am anticipating I'm gonna have a bad night? You know, am I on speaking terms with sleep? Um, I would say that's the biggest piece, especially in um in a society where we are so productivity driven. Um, in a society where we do have so many outsized demands and expectations, um, I would say it's that sleep effort piece.

SPEAKER_01 14:24

That makes sense. Uh there's this idea around like the military kind of teaching their people to like fall asleep whenever they can. Um is there anything to that? I don't know if you're familiar with that, but I just had had read that recently that you know you might only have an hour and a half to sleep, and it's like you need to fall asleep right away. Um by the way, I think if it was in the military, I would I would definitely be dead because I I can never fall asleep that fast. Is there is there certain tricks to actually getting someone to just fall asleep right away?

SPEAKER_00 15:01

Yeah, so I'm gonna give you a little bit of a hot take there because I also work at the veterans hospital down here in South Florida, so I work with a lot of folks that were in the military. Um we cannot command sleep like flipping a switch. Sometimes that method does work if there's sufficient sleep pressure. If you've been sleep deprived for a few days and someone tells you sleep when you can, you are gonna be very likely to go to sleep when you need to. We see that also with a lot of folks in the in the healthcare industry that work night shifts. But if we've had a variable sleep schedule for a long time, working night shifts, rotating shifts, which we see in the military, um, then it's not it's not so straightforward. And in fact, I would tell you that our insomnia rates are even higher among amongst our service members and our veterans. So I'm not sure that that method works all the time. It is it is, I would say, wishful thinking.

unknown 15:57

Okay.

SPEAKER_02 15:57

I I work at the Jesse Brown VA in Chicago. Oh, I did for 10 years. I'm on staff there, I don't go there as much anymore, but I loved it there, yeah.

SPEAKER_01 16:05

Yeah. Um, I got a lot of rapid fire stuff here, and then it'll probably branch off. Is is temperature uh a major factor in getting good sleep?

SPEAKER_00 16:15

It it is, it does play a role. So our body our core body temperature needs to drop in order for sleep onset to begin. Um, there are some things that we can do to help facilitate that sleep, that drop in our body's temperature. Um, like um having a hot bath or shower three hours before bed. Um, going from a hot shower to ambient room temp can help facilitate that drop. Keeping lower temperatures have been found to be associated with better quality sleep.

SPEAKER_02 16:43

I talk about this all the time. I just put a sauna on my roof. Uh I freaking love it. And it's honestly helped me because I I run warm at night and like you're cold when you get out of the sauna because it's 90 degrees Celsius when you're in it, you know. So yeah, I think that's that makes sense. But three hours I do it a little too close to bedtime, I think.

SPEAKER_01 17:00

Yeah, I would give yourself some time. Ben's sawing. I actually that was one of my questions. So Ben's doing this infrared sauna.

SPEAKER_02 17:06

No, mine's hot, mine's heat, baby. No, no infrared nada. It's real. No, it's just hot.

SPEAKER_01 17:10

Okay. It's a real one. It's a real deal. Ben, next time I'm in Chicago, I'm gonna be up to the city. I'll heat it up. Um but Daniela is um is there something to that? Like what Ben's saying? Is it sauna itself, or is it the is it's just the heat, or what is it?

SPEAKER_00 17:28

It's the heat and the relaxation piece, right? So the more that we downshift our nervous system in those hours leading up to bed, the more likely we are to settle into sleep more easily and maintain deeper sleep. Um, so we see that with temperature as well. If you can have some kind of ritual towards the end of your evening, whether it's sauna, jacuzzi, heating pad, hot shower, hot bath, um, we see in some research that that also helps improve sleep quality.

SPEAKER_02 17:55

And you know, Dom, when you're in it, your body is so hot, your body goes into that cooling mode. So you're sweating, you're so that's why like when you get out, you're overly cold. It's it's it's like even at normal temperatures. You know, it's like if you if you if you're in your car and it's nice and warm, and then you go outside all of a sudden it's like freezing. So uh that's the that's the as far as I understand it, that's the mechanism that your body is turning on the air conditioner internally, which is what you want before you go to bed. Yeah.

SPEAKER_01 18:22

Daniela, I um I've recently gotten one of these mattress cooler things, and I've noticed my sleep has been fantastic ever since I got it. Um am I imagining that because I spent a lot of money on it, or is that a really thing?

SPEAKER_00 18:37

Um well, we do see you know the sleep industry, mattresses, sheets, all these things are are growing. Um, but there is something to it. Um, you know, having, especially if um a person experiences night sweats, which can wake them up in the middle of the night, having cooling sheets, cooling mattress toppers, these smart uh mattresses, these kinds of things can help maintain a uh a hospitable sleep environment. So I would say it's a part of good sleep hygiene. Um, is it enough to cure insomnia? I would say no, but I do think it's a part of a good healthy sleep regimen.

SPEAKER_02 19:12

Dom, which one did you get, man? Let's give him the sponsor of the pod.

SPEAKER_01 19:15

I don't, you know what? I don't I would love him to get him the sponsor of the pod. Um, but I don't I don't want to pump them up, but I I I have the eight sleep one.

SPEAKER_02 19:23

Oh man, that's not cheap.

SPEAKER_01 19:24

It's not. It's not a good one. I gotta tell you, I'm pretty happy.

SPEAKER_02 19:28

Really? Okay. I've been looking at it. I've been looking at it. So yeah, we gotta tell you.

SPEAKER_01 19:32

Okay, we'll take this off, we'll take it offline. I'll tell you. I'll tell you all the goods. Um is um, you know, you hear a lot about blue light, Daniela. Is that really a thing? Is that truly a thing?

SPEAKER_00 19:41

It is, it is. So when we look at our tablets, computers, phones, there is that blue light, and there's a photoreceptor in your eye called melanopsin. Um, it's not a hormone like melatonin, but you can think about it as doing the opposite of melatonin, which is it signals to your brain that it's the daytime. Um, so when we do, you know, consume a lot of media um via you know these screens, um, we're sending competing signals to the brain at night. Or it's say our melanopsin is saying, hey, it's daytime. The melatonin our body's trying to release because it's dark out is saying, no, no, it's it's nighttime. And then it can make sleep onset um a little bit more challenging.

SPEAKER_01 20:22

That's interesting. And uh I know a lot of time people are saying don't look at screens, you know, do these things, but if TV like calms you down, isn't that the kind of goal you want to get to? Like uh what would you tell your patients in that in that situation?

SPEAKER_00 20:37

Yeah, and this is a common one because so many people watch TV to unwind at night, uh, they watch TV while they're having dinner with their partner. Um, you know, what I I like to look at the whole picture, you know. So I I try to see, you know, what uh what squeeze is gonna get us the most juice. Oftentimes I don't start with a TV ritual at night. Um if there are other things that are impeding uh their ability to fall asleep, like variable wake times or spending a lot of time awake in bed, I try to target those first and then we might clean up some of this sleep hygiene later. Um so I would say, you know, if you're watching TV late at night, TV is at a distance from you, so it's not as bad as having a phone directly in your face. I would say if we had to pick one, watch your program as long as the content you're consuming isn't like jarring or stressful. Um, and choose that over like scrolling or consuming short form content on your phone.

SPEAKER_01 21:34

You know what? I was I was watching that show The Bear with my wife. Have you guys seen this show? Chicago show, man.

SPEAKER_02 21:40

I haven't seen it.

SPEAKER_01 21:41

It's real stressful. Like now that I'm thinking about it, when I was trying to go to bed, like it was r I was really thank you for that. I'm gonna walk be careful about what I watch before I go to bed because that was really stressful. Um you keep hearing about I I don't know, I'm keep hearing, I keep hearing about like couples that. That don't sleep in the same room. This seems like it's becoming a thing. Um what what are you hearing about this, Danielle? And is this is this like a something that people should look at? Which which, you know, I I think that would like get in the way with your social agenda, but you know what I mean? Just I I'm just saying, like, what are your thoughts there?

SPEAKER_00 22:18

That's a great question. So we call that sleep divorce um in in in sleep circles. That's amazing. Yeah, which is which is kind of a brutal name when you're talking about it.

SPEAKER_01 22:28

Yeah, it's a little aggressive, I think.

SPEAKER_00 22:31

Yeah, yeah. But you know what? It's very common. And in fact, um, a lot of the couples I work with, um, oftentimes a scenario I see is someone has a CPAP machine. Yeah. Um, it's make or you know, they have something going on at night that makes it difficult for the other partner, or someone is more of a night owl, someone's more of a morning lark, and they don't want to wake each other up in the middle of the night. In some situations, short-term sleeping in different bedrooms can be beneficial. It can help the sleep get back on track, um, which can then have carryover effects into the relationship. If if you're sleeping better and your partner's sleeping better, you're more likely to be regulated on both sides and then communicate more effectively. So it can help if you're engaging in that kind of behavior short term. Um there are some partners though that really just want to go to bed at the same time, wake up at the same time, and have that be, you know, shared uh a shared intimate moment. And so with those couples, then, you know, we have to get more creative about how we navigate whatever the whatever the the hiccup is, you know, if someone is waking you up or if it's a scheduling issue. Um, but it can be helpful for some.

SPEAKER_01 23:41

Okay, that makes sense. So I gotta ask this question because along the same line is is sex a sleep aid? That's what that's what the the folks want to know.

SPEAKER_00 23:51

Yeah, so that's a great question too, because everyone has a different relationship to sex. Uh for some people, it can be definitely very relaxing, a part of your nighttime routine, and makes you go to sleep easier. For others, it can be a very activating uh, you know, encounter to have and it might make you feel wired afterwards. So, what I often tell folks is if you're on the fence on whether or not this should be your right before bed activity, is you know, for a few days, test it out, you know, on a scale from one to 10, see how alert you feel afterward, you know, and and be your own judge. You know, if this is something that works for you and it works for your partner, then have it be a part of your routine. If it's something that uh makes you feel more activated and keeps you up at night, then maybe we get creative about how you go about your intimacy with your partner.

SPEAKER_01 24:44

I just got to say, Ben, like out of all the shows that we did, telling people and couples that they need to have sex at a bunch of different times to test it out is probably the best thing we could have ever done for anybody. Hey, this is a bit this is this is a bonus show.

SPEAKER_02 24:58

Have some sex and go to your own bedroom. Essentially, Zorgon, yeah. Go to your own bedroom.

SPEAKER_01 25:03

That's right.

SPEAKER_00 25:04

Yeah, it's just every you know, it's different for everyone. There's no hard and fast role.

SPEAKER_01 25:08

Yeah, that's right. Um I just want to ask um a few other things. So I noticed in your profile you talk about nightmares, um, and you're helping people that why does it seem and maybe I'm wrong about this, but it's just why does it seem that nightmares are happening uh more when you're a kid than it is when you're an adult? Or is that just more individual?

SPEAKER_00 25:32

Yeah, so so it depends. So when you're a child, you not only have nightmares, but you're more likely to have night terrors, and these things can sometimes get conflated.

SPEAKER_02 25:42

My son is having those right now, man. It's crazy. He he's I was gonna ask you about him to get a free consult. He's having like new sleep problems, but he I mean they really are night terrors. I told my wife, I'm like, it's normal like that adolescent boy is a classic, you know.

SPEAKER_00 25:56

Yeah. So in night terrors, those are usually scarier for the people it's waking up than the person actually having them. Yeah, exactly. You know, they're they're screaming, they're disoriented, you just ease them back to bed. Um, the next morning they may not even remember. But then you as a parent, you're now awake in the middle of the night and you're like, what do I do with that? Um, so it's you know, usually more work for the parents. Um, but so that sometimes is what might make it feel like kids are having, you know, more nightmares uh than adults. Um I would say how much REM sleep you're having is probably the biggest indicator of your likelihood for for vivid dreams or nightmares.

SPEAKER_01 26:34

Um and can you expand on that? Is it the more REM sleep you have, the the more the possibility is of course?

SPEAKER_00 26:42

Yeah, so 95% of our dreaming happens in REM sleep. That doesn't mean that all your dreams are gonna be nightmares, but if you are sleep deprived, for example, um, and you're having a hard time, uh, like you're anxious, and maybe you're sleep-deprived because of, I don't know, a stressor at work, your brain does something called REM rebound, where it gives you extra rem to compensate for that sleep loss. And so you couple that with whatever anxiety or stress you're going through during the day, and then you're more likely to have nightmares.

SPEAKER_01 27:14

Um I feel like I read something about this, Daniella's help help out with this that people that are um basically using cannabis all the time, supposedly when they stop they have like wicked like nightmares after because it was like a catch up. Does that is that kind of the same idea?

SPEAKER_00 27:37

You know, anecdotally, I've I've seen that um in session as well. Now, cannabis, just like um alcohol, just like nicotine, does alter your sleep architecture. So when you stop consuming a substance like that, you know, the brain um is going to is gonna change, it's gonna shift the way it's operating at night, um, particularly around REM. And so if you're having some more of that REM rebound, and then also um, you know, going over going through whatever changes are going you're going through, and there must have been a motivating reason for stopping or starting, you know, any kind of substance use, um, then yes, you could have a little bit more um more nightmares or vivid dreams. So I I do see that in clinic.

SPEAKER_01 28:21

Is there is there a reason why some people have more lucid dreams than say others?

SPEAKER_00 28:30

So some people can become lucid dreamers and some cannot. Um, and we still don't know, you know, as a field what that you know determinative factor is. Um but what we do know is um that folks who journal their dreams have a higher likelihood of becoming a lucid dreamer. So if that's something that someone wants to do or to become more in control of their dreams, we say keep a journal. Um, even if in the morning all you can remember is, oh, I saw the color blue. Start there. And then every day write down whatever you dreamt, you'll start remembering more and more and more. Um, and then you you get closer to being able to change the content of your dreams. And that to a certain extent is the foundation of um nightmare therapy, you know, any kind of rescription therapies for nightmares.

SPEAKER_02 29:19

I love I love when I can remember my dreams. I love it. So cool.

SPEAKER_01 29:24

I'm like, oh yeah, I thought about that last night. Does it mean anything if a dream just keeps recurring?

SPEAKER_00 29:32

So if there are dreams with certain themes, or if it's the same exact dream, um, then that's just a sign that there's something that the brain is still processing. You know, when we're dreaming the amygdala, which is, you know, the emotion detection center, the part of our brain that processes how we're feeling, and the hippocampus, which is, you know, uh where we store our memories, these two parts of the brain are the most active. Um and so dreaming is a way for us, um, at least this is the main evidence-based theory that we have at this point. Um, dreaming is our way of working through um trauma or difficult things or just you know, day-to-day life. Um so if you have recurring themes or recurring dreams, you know, to the T, then there's a sign that there's something there that may need daytime attention.

SPEAKER_01 30:20

Okay, okay, that's interesting. I I remember my mom uh uh she she used to like go to a dream group, you know what I mean, where these ladies would get together and talk about their dreams and everything. And it seemed like um, and tell me if this is right, Daniela, but it was almost like there was a legend, like a map legend of certain things mean certain things in dreams. I I is is that actually a real thing or is that not a real thing?

SPEAKER_00 30:50

So as far as the research goes, no. Um there that is very Freudian. You know, that is a Freudian philosophy, right? That certain things mean certain things in dream analysis. Um now, I don't want to get in the way of anyone's meaning making, like with their dreams. Um, but as far as like the research goes, we can't say, you know, if you dream of water, it definitely means XYZ, or um if there's like a predictive nature to dreams, like there's nothing founded in science that can tell us that. Um right now, you know, dreams are just our best way of you know making sense of our day-to-day life, um, which is funny because our prefrontal cortex is largely offline while we're dreaming, so that's why they don't always make sense. Um I see.

SPEAKER_01 31:35

Yeah, because I I I guess in your field it's gotta be tough in the sense of there's this is something that's happening every night, and it it seems like everybody's trying to pull meaning out of it, and we just don't know that much about it in in a lot of respects. Is that is that probably a fair statement?

SPEAKER_00 31:57

Yeah, I think it's normal to want to make meaning out of things. You know, why did I remember a certain person? Why uh do I keep seeing this scenario? I think that's a very human approach, you know, to the dreams that we're having. I would just say if there's anyone out there that's agonizing over their dreams, and and if it's creating anxiety or stress, I would say, you know, put the dream down. Um it's a collection of thoughts, memories, and emotions, you know, from your life. Um and again, the prefrontal cortex is offline, so it may not make sense. Um, and we may never make it make sense.

SPEAKER_02 32:32

Uh, you know, I know the answer to this, but uh I'm gonna ask it anyways. Um for like just the general person, like Dom and I, who are out there busting their chops all day, working hard, and they're trying to optimize their sleep, other than all of the things you're saying, the optimizing your bedtime, the the lack of electronics, the wake up and go to bedtime's the same, like those are the standards, and those are probably 90% of how you can improve your sleep. Is there um any of these supplements that you would promote? Uh like creatine, for instance, uh, I love. I've been doing that uh for over a year now, and I I think it has improved my sleep a little bit. Definitely makes me feel better overall, and I think I'm getting a little more gains at the gym. But is there anything, you know, other than healthy diet and healthy sleep habits that's like a magic pill?

SPEAKER_00 33:19

Sure. I mean, if we had to go down the road of supplements, um I definitely take those as more of like an insurance policy. Um, creatine is great when there's sleep loss. Um, creatine won't make you fall asleep faster or consolidate your sleep for you, but let's if you're taking it every day and then you go through um a bout of poor sleep, you will be more resilient to that sleep loss. Um, and so we see that creatine is helpful in that regard. Um, other supplements I would mention are like magnesium glycinate. Yeah. Um, that one's having also a pretty large moment. I would say exactly. Yeah. Yeah, because people are using it for a lot of things. Um, and so it definitely can help with um insomnia if you're having chronic pain, tension, anxiety. Through those mechanisms, it can help with sleep as well. Um, I would say take it orally, not um not a spray, not transdermal, um, you know, and taking it, you know, at least, you know, an hour or two before bed. Um, and that can be found to be helpful.

SPEAKER_02 34:21

And restless legs also that one's good for, right? Like kind of the jittery, kind of muscly. That that's where I think I kind of have a little bit of like restlessness, and I think it helps my muscles feel a little more chilled out.

SPEAKER_00 34:32

Absolutely, and iron for RLS as well. Very important.

SPEAKER_01 34:37

Daniela, um, I feel like the magnesium helps me stay asleep more than anything else. Is that is that in my head or is that uh is that real?

SPEAKER_00 34:50

No, that could definitely be the case, especially because we know so pain and tension and cramps, these things often wake people and rouse them out of slumber. Um so if you are taking something that's gonna help with that, you're more likely to stay asleep and have more consolidated sleep.

SPEAKER_01 35:07

Got it. How how soon before bed should you take magnesium?

SPEAKER_00 35:11

I say at least an hour. You want to give your body a chance to metabolize it. Um you can always look for magnesium um in certain foods as well. Um, but if you're taking a supplement, you know, at least an hour, maybe two, um, and just have it be a part of your your daily routine.

SPEAKER_01 35:27

Okay. Is there is there such a thing as catching up on sleep?

SPEAKER_00 35:33

I'm afraid not. So this is also a little bit, a little bit of a hot take, too. Um we can't bank our sleep. Um, and so oftentimes, you know, folks might sleep in on the weekends and think, okay, I'm gonna catch up, I'm gonna feel good. But often that ends up uh dysregulating our sleep more. Um when I sleep in because I had a poor night, now I've created circadian misalignment. I've slept in, I've shifted my schedule. So now I'm more likely to go to bed later or struggle going to sleep on time the next night. It might mess me up the next morning. And um, it's what we call social jet lag. Um, and for each hour of change that we introduce into our schedule, it can take about a day to a day and a half to recover from that change and feel totally good in our new in our new routine. Um so unfortunately, no. Whatever you lose, you've you've kind of lost.

SPEAKER_01 36:31

Okay, okay, good to know. Um, I got a few more questions, but I just want everybody to know if um if you're enjoying this. Um go to Daniell Marquetti.com. That's Daniela. I'm not gonna spell that for you, but Marchetti I am, M-A-R-C-H-E-T-T-I.com. Um Danielle, we always like to ask this question, but you know, you're starting to get this brand as the sleep expert. Um how has that journey been for you? You know, just being kind of creating your brand, kind of being an entrepreneur in sleep. Like, how's that working for you?

SPEAKER_00 37:05

Yeah, I used to tell all my friends I would never be an entrepreneur, which is funny. Um, but after I became board certified in behavioral sleep medicine and I realized how little people know about sleep or how little of us there are with this certification. Um, if you were to look at the DBSM list, there's maybe a couple hundred of us in the country that have achieved this um accreditation. Um I decided to do some more public-facing work. And so I started my my private practice, I've started my Instagram where I post things. Um, and it's been interesting. Um, it felt a little uncomfortable at first because nobody teaches you how to do that, how to be an entrepreneur, how to start a business. But you know, step by step I've I've gotten there.

SPEAKER_01 37:52

Has it affected your sleep?

SPEAKER_00 37:55

No, no. Um the thing that's probably impacted my sleep the most is that I have three children. Um there are you know, uh external sleep disruptors, I say are always easier to handle than the internal ones, um, like anxiety and and those pieces.

SPEAKER_01 38:13

But got it.

SPEAKER_00 38:15

Yeah, the accreditation has come in handy.

SPEAKER_01 38:17

So you're enjoying it. What's the what's the future sleep? Like what what is around the corner? Is there is there I don't know. Is there breakthroughs? Is there anything that you're watching just from a science perspective?

SPEAKER_00 38:31

Yeah, I see that we're starting to develop different profiles for folks within with insomnia issues. Like we're starting to see um you know patterns, like folks that just have insomnia and that it's driven by anxiety, folks that have what we say, we call it comesa, uh comorbid insomnia, and sleep apnea. Like that's a very different way of treating sleep. Um, but the public more and more has decided to turn away from pharmaceutical options in favor of things that are more cognitive behavioral. Um, so I think that we're gonna start seeing, you know, more and more research and looking at these different sleep profiles, um, just so that we can be more precise, you know, with with our with our treatment options.

SPEAKER_02 39:12

You know what's funny about that?

SPEAKER_00 39:14

Yeah.

SPEAKER_02 39:14

I would say the that's true. The the the um turn away from pharmaceuticals, I think is across the board in many ways, other than Ozempic and the GLP1s. People are like, yam it in me, give me more, you know. So it's a kind of a funny uh yeah, yeah. I did a couple posts on on like people bitching about the COVID vaccine, like, oh my god, I'm not gonna give myself that. And then it's like at the same time, they're paying thousands of dollars to shoot themselves up with a GLP one because it makes them lose 20 pounds. So it's just it's a funny dynamic.

SPEAKER_00 39:42

Well, we're not unaffected in the sleep world because now we've seen GLP1s be uh labeled a treatment for sleep apnea, and so I think that's also creating some um misinformation actually about how sleep apnea, yeah.

SPEAKER_02 39:57

Is that because of the obesity component of sleep apnea then? Is that how they get that cleared? Exactly or like neck circumference, I think is like the number one indicator of sleep apnea scores, right?

SPEAKER_00 40:07

Yeah, so we we see folks that are overweight and obese have large neck size. We see those folks tend to have sleep apnea more, but sleep apnea is not just a weight-driven um illness. Um, might have central. Well, a lot of people may have central sleep apnea, which is driven actually uh from by uh neurology. Um, and some people lose a ton of weight and they still have sleep apnea. Yeah, um, some craniofacial features may contribute, and so it's not one-to-one. You could take a GLP1, lose some weight, and still have sleep apnea at the end of the day.

SPEAKER_02 40:42

Yeah, yeah. Unfortunately, sleep apnea is one of those things there's not really a cure, right? I mean, you can improve your scores, but it's a hard thing to get gone. So that's why the the CPAPs or some sort of positive airway seems to be the way to optimize.

SPEAKER_00 40:55

Exactly. Yeah.

SPEAKER_01 40:57

Danielle, we always ask our guests this um in your field, um what would you say that is out there that is talked about a lot, but it's it's actually BS. Like it's it's it's it's not real, it's not the right thing to do. Is there is there anything out there you can you that comes to mind?

SPEAKER_00 41:16

Yeah, so one of the big ones is how people use melatonin. Um so that's a common over-the-counter. Sometimes I, you know, I even see prescribers prescribe it, even though you can get it at a farm uh at a pharmacy. Um and people think that it's a treatment for insomnia or just part of a healthy sleep regimen. Um, but insom but melatonin was never meant to be a long-term treatment, and it was never meant for insomnia. Uh it's meant for circadian misalignment. So issues with, let's say, jet lag if you're traveling again for short-term periods of time, um if you had a delayed sleep phase or any other kind of circadian uh issue, uh, that's when we would use melatonin. But it shouldn't be taken like vitamin C every day, uh, you know, or or something like that. Yeah.

SPEAKER_01 42:02

That's interesting. So for instance, like if I'm on the East Coast and I go to the West Coast, I notice God, I'm tired early, but then I pop awake um at you know four in the morning or whatever it is. That's kind of when you use it in in for the because I've I think I've maybe taken melatonin literally like once in my life, and it gave me a headache when I woke up and I never took it again. So how would you use it like in a jet lag situation?

SPEAKER_00 42:29

Yeah, so I would actually use it when I'm going east. Um, so like let's say, you know, I we're Italian, right? If we're going to Italy and there are six hours ahead, I'm I'm on Eastern time, um, then that first day that I'm there, I would say, you know, take um a milligram or two of melatonin three hours before you want to be asleep, um, and do that for the first couple days while you are getting adjusted to your new time zone. Um because we want we don't want to be taking it right as we get into bed. It's not a hypnotic drug. Um, it's what we in the sleep world call a chronobiotic, which means it draws your sleep forward. Um and it'll never say that on any melatonin bottle. It'll never say take it three hours before you want to be asleep. Um but that's how you should be taking it.

SPEAKER_02 43:15

Yeah, and the other thing people are doing, they they super hyperdose it, right? People are taking 20 milligrams crazy amounts, which is crazy. Yeah.

SPEAKER_00 43:23

Yes. And you know, your brain, your pineal gland, produces about half a milligram to a milligram every night to make you go to sleep. That's all your brain needs. And so when you see folks popping like five milligram, 10 milligram gummies, I've even had um folks tell me they've taken like 20 and 40, um, you're you're doing too much, you know, and it's probably not working the way that you want it to. Um, and while it may not be lethal to take too much, um, there are side effects that often mimic uh like sleep deprivation side effects like uh brain fog, uh fatigue, uh GI issues, like those that sort of thing.

SPEAKER_01 44:00

And is that along the same lines too with like all these people that are taking CBD for sleep and those kind of things? Is it similar kind of issues?

SPEAKER_00 44:09

Yeah, so CBD is another one that a lot of folks might uh dabble with um and and see if that improves their sleep. Uh the evidence right now is mixed, right? So it's we cannot formally recommend that that be taken to help with sleep. Um for some folks that have anxiety, we see some you know modest improvements. Um but with other folks that can make them more um anxious. And so I say know thyself. Um, and there are probably other things that are more effective than your CBD supplement.

SPEAKER_01 44:43

Got it. Um so we asked what was BS, and that was those were great answers, by the way. Now we know about melatonin, we know what it's for, we know when to take it. That was super helpful. What in your space is pure magic? Like, is there is there something you can put your finger on and go this is something that you can A count on? Not necessarily that it's gonna get you to sleep and cure your insomnia, but like this is absolutely like the right thing to do, and and it's something you would recommend all the time.

SPEAKER_00 45:13

Yeah, I don't have a silver bullet, um, but I would say the one unpopular recommendation I make that is the best one I can make is when you've been in bed for more than 20 minutes, um, get out of bed, do something else, distract yourself, and come back when you feel sleepy again. That is gonna strengthen the bed as a cue for sleep, which is all you need to do to um mitigate insomnia. We just need the brain to relearn its association of the bed with sleepiness. Um, and we call it stimulus control in this in the sleep world. I never actually tell my patients it's called stimulus control, but that's the name if you ever want to Google it. Um but that's that's the secret sauce. That's what makes CBTI more effective than medications.

SPEAKER_01 46:01

That's really important. I and sorry, let's say that word again because I thought that was really important.

SPEAKER_00 46:06

It's called stimulus control.

SPEAKER_01 46:08

Stimulus control, and you said doing with the bed. Sorry, I can't remember what you just said there about the bed.

SPEAKER_00 46:14

Yes, so we want to strengthen the bed as a cue for sleep. It's a form of conditioning, right? Um, and so we want to get out of bed if if it's been more than 20 minutes and we haven't fallen asleep yet, whether it's the beginning of the night or the middle of the night, get out of bed, do something else in dim light, no screens, read, stretch, fold laundry, and come back when you feel sleepiness come on again and just try again. And and if you do this over time, you're gonna strengthen that bed as a cue for sleep so the brain knows automatically head hits the pillow, it's time, it's time for me to power down.

SPEAKER_01 46:50

Okay. It's been 50 minutes, and I haven't told you my my sleep cure, and I just don't. I've been scared because I'm afraid you're gonna tell me that you shouldn't be doing this. So I kind of want to guess. I I it's I don't know, yeah. I was I was like nervous. Um, but it's the end. I gotta I gotta ask. I gotta ask. I just have to ask. I've been using audiobooks for like the longest time. I like listen to like a fun fiction audiobook, nothing serious. And it tends to whack me out within like 15 minutes every night. Uh is that a bad thing I'm doing for myself?

SPEAKER_00 47:27

I wouldn't, I don't, I don't think so. You know, if you know, it works almost similarly to TV. A lot of folks will put on a show they've seen a billion times, leave it on in the background, put a timer on, and then go to sleep. And um, it works, I think, similarly to that, um, in creating a little bit of white noise. If you're not having any kind of insomnia, then don't fix what isn't broken. Um, you know, you know, but if one day you do, then that might be low-hanging fruit, something that you could clean up a little bit. But honestly, no, I'm not concerned about your audiobook.

SPEAKER_01 47:59

The lesser, it's the lesser evil, my eyes are closed then than the rest. Okay.

SPEAKER_00 48:03

And it'll turn off eventually, yeah.

SPEAKER_01 48:05

I thought she was gonna tell me I can't do it. I I it's on a timer. I put it on a timer, and then I I just fall asleep, and then that's how it works. But uh, I was so afraid she was gonna tell me I gotta stop doing this right away. It's eating my brain, or something like that. So you do headphones with the DOM, or how do you do it? It's crossing me. I got a little like I got like a single little earbud that goes in my ear and it's on the lowest volume, and the story starts being told, and I get into it, and then all of a sudden I'm out, and then it shuts itself off.

SPEAKER_00 48:35

Yeah, yeah, it's working a little bit like white noise does. Yeah, yeah, exactly.

SPEAKER_02 48:39

I do that. I have a little noisemaker thing I need, yeah.

SPEAKER_01 48:42

Yeah, see, no drugs, no drugs. There you go. That's it.

SPEAKER_02 48:45

No, still a Negroni from time to time.

SPEAKER_01 48:47

I mean, come on. It's been an awesome episode. I learned a ton. Um, I feel like we we went in areas that a lot of people don't talk about too, which has been a lot of fun. And so thank you so much for joining us for everybody out there. Dr. Daniela Marchetti, um, daniella marchetti.com. Make sure you check her out.

SPEAKER_02 49:08

What's your what's your Instagram, Daniela? I don't think I've got it.

SPEAKER_00 49:11

It's at Dr. Daniela Marchetti. So that's D-R-D-A-N-I-E-L-L-A Marchetti. Um, and yeah, please come join me there.

SPEAKER_01 49:21

She's amazing. Get your sleep fixed by Dr. Daniela. You gotta go ASAP. Thank you, Daniela. Thanks for going.

SPEAKER_00 49:28

Thank you for having me.