Why Sleep Is Your Ultimate Longevity Tool at Every Age

Welcome back to the EVERYDAY Longevity Collective. In today’s episode, Dr. John Thomas and Dr. Shoma Datta-Thomas dive deep into one of the most overlooked pillars of longevity: sleep and recovery. While many of us invest in supplements, intense training, or cutting-edge wellness devices, it turns out you can’t "out-supplement" or "out-train" poor sleep. The doctors break down how sleep isn’t just about feeling rested; it’s the body’s performance engine that influences everything from metabolic health and hormones to brain function and immunity.

Throughout this episode, you’ll learn why consistent, high-quality sleep is essential at every stage of life, how sleep needs and challenges shift by decade and between men and women, and the practical, high-yield strategies for improving your nightly recovery. Whether you’re seeking better athletic performance, sharper cognition, or greater independence as you age, Dr. John Thomas and Dr. Shoma Datta-Thomas offer actionable advice and the latest clinical perspectives on building lasting health starting with your sleep.

Timestamps:

00:00 Importance of sleep for health

05:00 Importance of sleep for metabolism

10:05 Unplugging and managing stress

13:29 Hormone-related sleep disruption in 40s

15:27 Sleep apnea and hormone connection

19:16 Common sleep issues and aging

21:39 Sleep tips for caregivers and gender differences

25:25 Creating a bedtime routine

28:11 Importance of sleep for recovery

Show's Website - https://everydaylongevity.co/

Dr. Shoma Datta-Thomas LinkedIn - https://www.linkedin.com/in/shomadattamd/

Dr. John Thomas LinkedIn - https://www.linkedin.com/in/john-thomas-8543426/

Podcast Partner - TopHealth - https://tophealth.care/

“Disclaimer: Informational only. Not medical advice. Consult your doctor for guidance.”

Transcript

0:00

You cannot out-supplement bad sleep. When we talk about sleep, most people think about just feeling rested. But clinically, we know sleep is much bigger than that. Your sleep schedule is a metabolic signal. Sleep is not recovery sidekick, sleep is the recovery system. You can have the perfect workout, the perfect nutrition plan, and the perfect supplement stack. But if your sleep is broken, adaptation is compromised. What we find though is that most people aren't under motivated, they're under-recovered. If your nervous system never downshifts, your body never fully repairs. Sleep is the original performance enhancers. The takeaway really is that longevity is not just what you do awake. It is how well you recover while you are asleep. And I'm Dr. Shoma Dada Thomas. I'm a board-certified OBG Mayan and minimally invasive surgeon. I now practice as a longevity physician and a national VP of medical operations. Today we're going to talk about one of the most important and most disrespected pillars of longevity, and that's sleep and recovery. People will spend money on supplements, peptides, cold plunges, devices, and training programs, but then they sleep five and a half hours and they wake up exhausted and wonder why they're not adapting. I'm definitely guilty of some of that disrespect. This really matters for men and women though differently through the decades. Sleep, we know affects our hormones, our body composition, immune function, brain health, cardiovascular health, pain sensitivity, recovery, mood, metabolic function, the list could go on. The American Heart Association now includes healthy sleep as part of the life's essential eight for cardiovascular health, recommending seven to nine hours of nightly sleep for adults. So today we're reframing sleep. It's not laziness, it's not weakness, it's not optional. Sleep is one of the highest return longevity behaviors we have. All right. So to get started, why did we even include sleep as one of our longevity pillars? I don't think we're surprised by this, but I do think, like you said, it can be undervalued. When we talk about sleep, most people think about just feeling rested. But clinically, we know sleep is much bigger than that because it supports a whole host of things, like I just mentioned. It truly supports our cardiovascular health. We see this in our blood pressure control. I always talk about testing our blood sugar and insulin metabolism because we can see it affect those parameters as well. Our immune response and chronic inflammation, how we repair even our tissue from acute or chronic injury or even on a cellular level. Hormone regulation, of course, both for men and women. We know sleep has a huge effect on this, either supportive or really interfering and can be very suppressive and lead to lower things, like especially our lower testosterone levels, is a great example. We can also feel this in our memory and emotional processing. This becomes much harder, because much more emotionally labile or erratic when we have poor sleep, poor sleep patterns. And then also we well, one thing we've talked about a lot here is our recovery from training. So it can affect our training performance, exercise tolerance, but also how we recover from all of that. So both the short and long sleep duration have been associated with higher all-cause mortality risk, meaning all causes of death in large prospective studies. And sleep regularity is now one of the powerful predictors of mortality and heart health outcomes. And the way I explain this to clients and patients is simple. You don't get stronger from training, you get stronger from recovering from training. So training is the stimulus, but sleep is when adaptation actually happens. So sleep is not recovery sidekick, sleep is the recovery system. So for years, everyone's focused on sleep duration. Did you get seven or eight hours of sleep? And that still matters, but the newer conversation is sleep regularity. Going to bed and waking up at consistent times is really a key. Right. And this is now what you said, that new longevity conversation. A UK biobank analysis found that sleep regularity also predicted all-cause cardiovascular and cancer mortality risk. So, in other words, the body needs not just enough sleep, but it likes the predictable sleep. This is a huge practical takeaway. The body loves rhythm. So consistent wake time, consistent bedtime windows, getting exposure to morning light when you first get up, evening windown, make sure you're kind of having regular meal timing, a regular training rhythm. So all of that is gonna equate to a good bedtime and prep routine. And when we think about our metabolism and our hormones, the rhythm of that sleep routine is really what supports our circadian biology. So it will show up in our temperature regulation, our blood pressure, and our recovery and really sets our metabolic routine for the whole day. So your bedtime is a longevity behavior. Okay. So as we've done in the past, we want to think through how this pillar is shows up at every decade of life, starting from establishing good habits. So in our 20s, speaking of habits, is usually when our body is very forgiving. And if you don't have those habits in place yet, that's where we see we usually push it. We sleep poorly, we may possibly be training really hard, eating inconsistently, and still functioning. But this will only last for so long. This is exactly the trap, right? Your youth hides poor recovery. In your 20s, poor sleep usually shows up as worse training adaptations, more injuries, poor focus, they'll have cravings. Uh, you might have some emotional volatility, inconsistent body composition, and lower immune resilience. So if you're seeing yourself getting sick more often or being less balanced emotionally, that could be a good sign of it. For young women, even in the teens and in the 20s, this is where we see problems with underfueling, overtraining, maybe intensive sports or just exercise as an individual, menstrual disruption, so either irregular periods or even going to the point of losing a period, and poor sleep, they can all start interacting. For young men, poor sleep often gets normalized around their social life, their work life, alcohol, screens, and also can lead to late night eating for many. Yeah. And so in your 20s, your goal is simple. Build sleep discipline before life gets harder. And we know after your 20s, it just every each part of that stage gets more difficult. So here your goals are these are some practical targets, seven to nine hours on most nights, right? Consistent wake time, limit your alcohol-related sleep disruptions, um, avoid treating caffeine like a sleep replacement. Train hard, but recover harder, right? So make sure that you're creating that balance of both. I mean, we again, we know in our 20s we're enjoying those being able to recover from these things. But the key is, you know, if we can feed ourselves on the back end, this will this will help prep us for the next decade. I would just add to that list, we had mentioned the late night eating, really leaving a two to three hour window between your last food intake and going to sleep can be very helpful as well. So your 20s are not the decade to borrow energy from your future self. So that's kind of our focus takeaway there. The 30s, right? This is where life load really explodes, right? This is when your career is building, kids are starting to come onto the scene, financial stress, you have less time and definitely more responsibility. So you got to keep this in focus. As we're building on this, these are the new stresses that you'll have to adjust for. Right. And this is where, you know, people start confusing exhaustion with aging. Life is busy, you're feeling very tired, often have sleep disruption, but it's attributed to, oh, you know, I'm getting older, my metabolism is just slowing down, I can't recover the way I used to, or I'm just getting old. But often the real issue is actually chronic sleep debt now with added stress. Yeah. And in your 30s, recovery has to become intentional. So this is when you need to really be more mindful about it. You may not always get perfect sleep, especially with young kids, but you can protect the system. So, you know, we have this uh again, we run into this as well. Um, the key is, you know, even with these limited or disrupted nights, we'll make sure when we get up that we're exposing ourselves to good morning light. We're getting, again, still setting that consistent wake time. So our bodies are getting used to that, how we start our circadian rhythm, realistic training volume. So we may have to adjust our volume of time for training, but we're still getting it in, even if we're having to reduce the quantity. We're still focusing on protein intake, making sure we're getting our walking. So if you have the option, you know, skip taking the elevator, skip, you know, jumping on the bus, you know, to walk those extra steps. I'm always surprised at how much I still see when there's a stair option and an escalator, everyone is on the escalator. It always surprises me. As much as we talk about just take the extra steps, people are still just taking the escalator option. And even if you just take it down this, you know, down the stairs. If you don't want to do the work of going up, at least take them going downstairs. The other thing we were talking about is definitely, you know, you want to focus on stress downshifting, right? Is don't keep escalating your stress levels. Find ways to downshift between that and whether that's taking a walk, you know, breathing exercises, meditating, things like that, just to break that level, that cycle of stress. And try to, if you can, on these days where you may have issues with longer durations of sleep, see if you can take short naps when appropriate. Ideally, earlier in the day, before two or three o'clock. So again, it doesn't throw off your sleep pattern. And ideally, no more than, you know, 30 minutes. And also, you know, really trying to unplug because those racing thoughts are a big complaint we hear of what keeps people up at night. That's when all the worries seem to hit. So thoughtfully and intentionally, you know, getting offline, getting off your phone, getting off email, letting you either your teams, your family kind of know that you're just gonna be winding down and really off of those sources of stress and stimulation. Um, one point to mention is especially, you know, getting into kind of 30s and beyond is the postpartum period. And this is when we know, of course, sleep disruption is absolutely profound. And recovery programming should incorporate the physical side of things like the pelvic floor, the core function, your hormone status, emotional load, but also addressing sleep fragmentation and thinking of how to, you know, recover through that, how to work through that to offset as much as possible. The reality is it's a very difficult time to do that, but paying attention where you can and taking opportunities when it's possible. And if it's not, just, you know, it's it's it's not some, it's not a stage that lasts forever. So, you know, we'll we'll we'll take it for what we can and and keep things moving. What we find though is that most people aren't under motivated, they're under-recovered. So this emphasis on sleep can really help there. Right. A lot of times, you know, people think that, you know, I don't really have the motivation to work out that day. But the reality is you just may be, you know, sleep deprived, and it's hard to get motivated when you're tired. Right. I've had a number of patients curious if you've heard this. I mean, it's especially with all the wearables and the tracking that patients are doing now, it's really becoming more obvious that performance and recovery are really so much worse if they've had a bad night of sleep. Yeah, no question. We definitely see that on the gym floor. It's if they've had a bad night's sleep, we definitely have to accommodate for that, where they adjust what they eat when they eat before they train. And or we may, again, download the workout so that it can manage their level of fatigue so that they don't pre-fatigue, even not only a nervous system-wise, but physically. But we still get the training in. And and anything, right? Even if it's a short window, any form of movement. I think you you've kind of opened my eyes to that, that even if it's not the perfect workout, just getting a small window and really does still count and very meaningful. Yeah, you get credit there, and not only do you, you know, do you get credit for the exercise, but it again also preps your body for sleep that night. So moving on in our decades of life going into the 40s. So this is the stress recovery gap that we see here. So this is when maybe we are at the height of managing family, maybe professionally, you know, obligations are going up. So a very, very full plate is often what we see. And you really no longer can ignore poor sleep and still expect normal energy, body composition, mood, training response. You really have to start connecting the dots. Right. This is a decade where I see people train harder because they feel worse. So when they when what they actually need is better recovery. So a lot of that is like, you know, you feel like because you feel bad, you know, you want to train more, you want to do more. But if we can work actually in the reverse, if we can make sure we're resting better, if we're getting better quality sleep, if we're managing stress better, all of those things will allow us to take on, you know, harder, more difficult training programs. Um, but we will usually, again, take it in reverse, focus on teaching them how to recover better and then setting themselves up for a better training program. And when we think of our how our hormone metabolism shows up in relation to sleep, especially in the 40s, for men, I often will get the feedback on just feeling not well rested. You know, like I used to get this much sleep and I could push through the day, but feeling waking up tired. The afternoon nap is really a buzzy term that comes up a lot when men are talking about changes in energy and that we later can tie to low testosterone in the labs. So that's a really interesting pattern of fatigue and sleep and more sleep disruption. Um, for women, this is definitely a very big issue with perimenopause and menopause, which you know can start, we know is early in the late 30s and going into the 40s. Sleep disruption often becomes more common, either trouble falling asleep, trouble staying asleep. But we know this is a period of time where there's a lot of disruption from hormone fluctuation, night sweats, anxiety, temperature changes, temperature change in response to stress, and menopause-related sleep disturbances are recognized as a core symptom area and are actively studied in recent reviews. So for men, the 40s often bring you get more abdominal fat or you'll see more abdominal fat, higher stress, lower recovery capacity, possible sleep apnea risk, reduced testosterone signaling, and more alcohol-related sleep disruption. So, and one big clinical point: if a man is tired, gaining weight, snoring, and waking unrefreshed, do not just blame the testosterone. You know, you want to screen for sleep apnea. Because a lot of times, again, we will often go for potentially the quick fix on this and look outside in rather than inside out in regards. So, what can we be correcting first? So before we recommend, even after testing, before we recommend, you know, adding anything like supplemental testosterone, we would say, you know, let's fix the things we can control within our habits and lifestyle, and then let's look outside to support that. The sleep apnea we know is so huge. And, you know, maybe a little bit of a feel like people, if they get recommended CPAP or things to resolve, sleep apnea, that's sometimes not the easiest solutions, but definitely getting better. We're seeing new, you know, new masks and new testing modalities. But this is really such a foundational issue with sleep apnea in terms of what we see for metabolic and cardiovascular outcomes. So before you blame your hormones, audit your sleep. To keep it moving, we're now thinking of the 50s. So what are we seeing here, especially for hormones in relation to sleep? Our body composition and our deeper recovery needs is all again very connected to our sleep. The 50s are a major transition decade for everybody, especially, I especially see, to be honest, a lot of struggle, especially for women. Menopause can really affect sleep quality, body composition, temperature regulation, mood, and recovery. Yeah, this is where the old advice just eat less and do more cardio can really backfire. Poor sleep can worsen cravings, your insulin resistance, your pain sensitivity, definitely inflammation, training recovery, your central fat gain, and your muscle loss risk. So all those things can definitely create these issues. So you want to be, you know, focused on those and make those adjustments. Right. One important message I talk about here with my women, but obviously this applies to men too, is the importance of sleep for our cognitive and brain health. This is often a topic that a lot of patients come in as an initial motivation for doing higher levels of wellness checks and lab testing, maybe because of family history, maybe because they're feeling some cognitive changes already. But sleep is that time when we have such detox and clear out of metabolic debris through the lymphatic system. So sleep is absolutely pivotal in dementia risk. We know how much training and food and all of those will affect our metabolic health, but we can really tie sleep directly to our cognitive health as well. For those who have genetic predispositions, now that we have testing as a bigger offering in terms of ApoE testing or just a very prevalent family history. And again, this is something we see favors women more than men, but sleep isn't absolute non-negotiable if any of these are particular risk areas for you. For men, the 50s are where recovery becomes a programming variable. You may still be strong, but the body does not tolerate random intensity as well. So the question you have to ask yourself is not can I do this workout, but can I recover, adapt, and repeat it? So this is the way we approach and we prepare for our workouts, is with that kind of mindset. In midlife, the recovery is not what you do after the program. Recovery is part of the program. So this is becomes a more major focus in how we do our program design, is we definitely build in really smart recovery into the programming so that it matches and that we make sure that, again, in order to prepare for the next workout or program, that we've had enough rest and recovery. So moving on in decades, in your 60s and 70s, this is more sleep for independence, just like movement is for independence in these ages, in these decades. In later decades, sleep becomes deeply connected to your independence. So poor sleep affects your balance, your reaction time, your fall risk, cognition, mood, your pain, even your immune resilience. So physical function will also be depleted with depleted sleep. So you want to make sure, again, this becomes a non-negotiable, like we talked about, because the risk of what can happen when you are sleep deprived within these decades, the risk factor just increases exponentially. And while there are some common sleep patterns associated with aging, like earlier waking, possible sleep disruption, you also don't want to dismiss it as normal. And so there are some factors you can look into. One we already talked about, which I think is probably the most important to evaluate, especially if you snore, if you're feeling, you know, you're not feeling well rested, um things like your neck circumference, if you're noticing high blood pressure, you know, all of those should prompt you to look into the possibility of sleep apnea. Now, also reviewing medications. Is there anything that is has more of a stimulant effect or any negative interactions that are causing sleep disruption? Obviously, we see a lot with chronic pain that sleep can be something that's very disrupted just in terms of staying comfortable. Uh, bladder function is a big one, and obviously this can change a lot with natural aging. So is there frequent urination? Is it something that is has gotten to the point of daily, you know, nightly disruption? That's something you can consult with urologists or a gynecologist. I do also flag pelvic floor disorders for that scenario. Outside of just weak bladder, you can also have the other aspect of that, which is pelvic floor spasm. So especially in my intense, more intense athletes and especially things like cyclists, running, sometimes we come into that a little bit more. So it may not be on your radar, but think about that. We know alcohol and late night eating can be disruptive for sleep and also a couple of medical considerations like restless leg, emotional health, like anxiety. Again, the standard of care to address insomnia is actually cognitive behavioral therapy. So you can look for a therapist focused in this area. And then just think about your daily routine, the circadian rhythm disruption and how you are bringing in the regularity of light and dark into your routine. Yeah, and older adults really need rhythm. You know, you want a consistent wake time, like we talked about, daylight, as soon as you can wake up and expose yourself to it. Get regular movement, regular protein with every meal, resistance training at least two to three days a week, and evening downshifting. So start prepping your brain, whether it's reducing screen time, whether it's reducing other stimulus, at least a couple hours before bed. That way you're really starting to downshift not only your brain and your nervous system, and you're preparing yourself for a good quality night's sleep. I would also make one special note if you happen to be a caretaker for someone in these later decades of life, the routine and the regularity of wake time, sleep time, and even just, you know, the whole day really mapped out can really also protect sleep and protect some of the confusion or cognitive disruption. So just a note, you know, in that sense as well. But Overall, from a longevity standpoint, you know, recovery really protects capacity, and that is what protects our independence. So independence is built during the day and protected at night. One question we get asked a lot is especially what is the difference for sleep for men and women? Because there does seem to be some different experiences between genders. So men and women both do need sufficient, consistent, high-quality sleep, but the obstacles that are getting in the way can often differ. And of course, we see this may present very differently for women. So things like even premenstrual symptoms or actual, you know, period of time during mencise, sleep can be very disrupted. Pregnancy and postpartum phases, perimenopause and menopause, especially those hot flashes and night sweats, and those really do have metabolic consequences. Caregiving load, which I just happened to mention, also can be a time where your sleep has to be sacrificed for other generations, and higher rates of insomnia symptoms, typically for women. For men, we can obviously also see a lot of sleep disruption, but they more statistically are seen in the population as sleep apnea risks, alcohol or food-related sleep disruption, work stress patterns, under recognition of fatigue or even mood disorders like depression, and then the more metabolic focused issues like testosterone, visceral fat, and how they affect health outcomes and sleep interaction. And I would add for both sexes, sleep is not just about feeling rested. It impacts the exact things that people actually care about, like your ability to lose fat, your ability to gain muscle, your libido energy, even your mood and your injury recovery. And a lot of times it'll even affect your cognitive sharpness and your overall longevity. So again, it affects all the things that you would be really focused on and want to do something about. These would be the bigger things that overall that we want to include. Okay. So one the first point is that we'd mentioned protecting the sleep window. Most adults should aim for about seven to nine hours as recommended by the American Heart Association in the Life Essentials 8. Right. And you want to definitely stabilize your wake time. So you want to have wake time anchors that support your circadian rhythm. Three, getting that morning light. That really signals to us the sleep and wake cycles and especially stimulating at the pineal gland and regulating our cortisol and melatonin levels. And you want to train, but not chronically overreach. So training without recovery becomes stress accumulation. So really, again, focused recovery post-training is the goal here. The caffeine cutoff. We all love our coffee, but most people should stop caffeine a good eight to 10 hours before bedtime. And alcohol is definitely not recovery. So alcohol may make you sleepy, but it fragments sleep quality. Seven, if you are having disrupted sleep, look for the red flags. Snoring, any witnessed apnea, sleep disruption where it sounds like a choking or gagging, morning headaches, daytime sleepiness, hypertension developing, and waking up feeling unrefreshed. These definitely deserve further evaluation from either a sleep specialist or even if you have a wearable to be tracking it now, it can be something you can do at home as well. But addressing sleep apnea is a major health issue. And you want to build a wind-down ritual before bed. So again, we want to try to schedule it around the same time. You want to have the same cues and whether that's also reducing blue light, reducing screen time, whether that's reading before bed, meditation before bed, you want to lower the light, you want to start cooling the room, and you want to lower your stimulation. Sometimes if your brain is still racing, what we recommend is keeping like a journaling book or a way to write down all your thoughts before you go to sleep and then put that away for the night. Again, when you have all that going on in your brain, it's nice to get it down on paper and then put it away and then a nice restful sleep. And if that wind down isn't happening naturally, again, the standard of care for insomnia is cognitive behavioral therapy. So you can look for a therapist with the designation CPT-I, meaning they're an insomnia specialist. And so here are some of our key takeaways that we want you to remember from the sleep focus here. Um, sleep is the original performance enhancer. So above all, we're kind of, again, resetting and making sure that we're getting good rest. When you think about how many hours and what happens during sleep, your ability to perform the next day is so reliant on that. So make that a focus. You cannot supplement bad sleep. So we know that sometimes people are more prone to reach for certain supplements, things like melatonin, ashwagandha, magnesium, alphaanine, and they can be helpful, but we want to make sure all of the appropriate sleep hygiene is in place first and any medical causes of sleep disruption are ruled out. Right. And then once you start getting later in decades, recovery is not optional after 40. So it has to be part of the strategy. So you really need to be focusing this in as part of your main part of your program. Your sleep schedule is a metabolic signal. This will set you up from the moment you wake up to how your hormones and your metabolic signals will progress and course through the next, through your entire day. And then what you want to remember is the body does not adapt under stress, it actually adapts after stress. So if you're entering an activity under stress, it's gonna be harder for your body to adapt. So make sure, again, you're going into these activities properly rested, yeah, with that necessary reserve. If your nervous system never downshifts, your body never fully repairs. So again, remember what an important time for recovery of the body, the mind, the brain, the hormones, the metabolism, all of it is truly happening with sleep, especially for children. But as we discussed throughout all decades of life, so create that intentional unplugging to allow yourself to fully repair. And what we want you to think of is that sleep is where training becomes transformation, right? This is where we actually training is where we actually do these micro traumas, these small damages to our tissues. You know, again, where the transformation happened is actually when we're rested and we're properly fueling. So give your body that chance to properly recover. The takeaway really is that longevity is not just what you do awake, it is how well you recover while you are asleep. The big message today is that sleep is not separate from longevity. It is central to it and it affects your heart, brain, metabolism, immune system, hormones, recovery, and quality of life. And from the performance side, sleep is where the body earns the benefit of training. You can have the perfect workout, the perfect nutrition plan, and the perfect supplement stack. But if your sleep is broken, adaptation is compromised. Like many things that actually build longevity, the goal is not perfection. Rhythm, consistency, and respect for recovery are really key here. Right. And because the strongest, healthiest people are not just the ones who work hard, they are the ones who recover well enough to keep going for the next day. Thanks for joining us today for our discussion on sleep. This is Everyday Longevity Collective. Thank you for joining us. And we look forward to the next conversation. Have a great day.