The Art of Manliness - July 31, 2025


#661: Get Better Sleep by Stressing About It Less


Episode Stats

Length

52 minutes

Words per Minute

209.30188

Word Count

10,964

Sentence Count

682

Misogynist Sentences

2

Hate Speech Sentences

1


Summary

Dr. Chris Winter is a neurologist, sleep specialist, and the author of The Sleep Solution, Why Your Sleep Is Broken and How to Fix It. In this episode, Dr. Winter talks about why we get sleepy, how to deal with sleep problems, and what to do when you can t fall asleep.


Transcript

00:00:00.000 Brett McKay here and welcome to another edition of the Art of Manliness podcast.
00:00:11.100 So over the past decade, there's been an emerging focus on the importance of sleep.
00:00:14.440 Thousands of books and articles have been put out which drive home just how important
00:00:17.920 sleep is to our mental and physical health.
00:00:20.180 This emphasis on sleep has had the positive effect of motivating people to better prioritize
00:00:24.360 it.
00:00:24.820 But there's been a downside to all the sleep talk as well.
00:00:27.080 People are getting more stressed out if they're not getting the kind of sleep they think
00:00:30.380 they're supposed to.
00:00:31.520 My guest day says that ironically, stressing about sleep may be exactly what's hurting your
00:00:35.520 sleep.
00:00:35.940 His name is Dr. Chris Winter.
00:00:37.040 He's a neurologist, sleep specialist, and the author of The Sleep Solution, Why Your Sleep
00:00:40.700 is Broken and How to Fix It.
00:00:42.240 Chris and I begin our conversation with why we get sleepy and how sometimes people confuse
00:00:46.080 fatigue with sleepiness.
00:00:47.600 We then get into the real dangers of sleep deprivation, but how you probably shouldn't worry about them
00:00:51.520 if you have common problems with falling and staying asleep.
00:00:53.680 We then talk about how many hours of sleep you actually need and how you may be stressing
00:00:57.340 yourself out trying to get more than is necessary and why it's best to compare your varying hunger
00:01:01.500 for sleep for your varying hunger for food.
00:01:03.860 Chris unpacks what insomnia is, how it's not just an inability to sleep, but your response
00:01:07.580 to that inability and the extent to which insomnia is rooted in fear.
00:01:10.620 From there, we turn to the disparity that often exists between the perception, the reality
00:01:14.160 of how much sleep you're getting, and the fact there's a good chance you're actually
00:01:17.020 getting more sleep than you think.
00:01:18.440 We then discuss creating a plan for what to do when you can't sleep, which may involve spending
00:01:21.860 less time in bed, or in fact, relishing the time you spend lying away in your bed at night.
00:01:26.720 And we end our conversation with when you should and shouldn't take a nap, and when you should
00:01:29.920 see a sleep doctor about your sleep problems.
00:01:32.200 After the show's over, check out our show notes at aom.is slash sleep.
00:01:44.240 Alrighty, so you are a neurologist and a sleep specialist.
00:01:46.860 You have helped thousands of people from regular Joes to professional athletes improve the
00:01:51.560 quality of their sleep.
00:01:52.940 And I'm hoping in today's conversation, you can provide some insight, some advice to our
00:01:57.440 listeners who are having a hard time sleeping, so they can have a more restful night of sleep.
00:02:01.440 But before we get to the advice, I think it'd be useful to understand a little bit about
00:02:06.120 how sleep works.
00:02:07.900 Specifically, let's talk about what is going on in our body that makes us want to sleep
00:02:13.720 or makes us feel sleepy.
00:02:15.060 So there's a bunch of things.
00:02:17.480 The two things we think about most are the longer we're awake, the more we start to accumulate
00:02:23.440 a chemical called adenosine in our brain.
00:02:25.660 If you remember back from your biology days when you're studying the different parts of
00:02:30.660 the cell, one of them was the mitochondria.
00:02:33.520 The mitochondria is really sort of the energy furnace of the cell.
00:02:37.200 It's where we take, you know, theoretically food energy and transform it to energy.
00:02:42.300 We can actually do things like mow a lawn or, you know, run a race or something like that.
00:02:47.220 So when we talk about ATP, you know, capital ATP, going into that mitochondria, it explodes
00:02:53.300 with this, you know, fantastic chemical reaction.
00:02:56.100 And now we have energy.
00:02:57.660 What we don't talk about is that there's a byproduct of that response called adenosine.
00:03:02.600 And it's adenosine that accumulates in your brain that makes us want to seek sleep.
00:03:07.380 Therefore, the longer we're awake, the more we accumulate this chemical, the more we want
00:03:12.920 to sleep.
00:03:13.460 So that's really the homeostatic chemical for sleep, you know, which is why eventually everybody
00:03:19.340 sleeps.
00:03:20.020 You know, it's impossible just to make a decision.
00:03:22.140 I'm going to stay up forever because, you know, accumulate so much of this chemical that
00:03:25.820 eventually your brain will take the decision out of your hands and you'll just fall asleep
00:03:28.720 in whatever you do.
00:03:30.060 So that's one part of it.
00:03:32.040 Another part is melatonin, which is a chemical that really has to do with our relationship
00:03:37.400 with sleep and our environment.
00:03:39.820 So if we sit out on our back porch all day and read a book or do our Zoom meetings, eventually
00:03:45.100 as the sun starts to go down, we'll probably start to get a little sleepy.
00:03:48.920 And it's because as we lose light in our environment and our eyes see that loss of light, we start
00:03:54.980 to produce a chemical called melatonin.
00:03:56.800 So melatonin's job is to take the sleepiness we're all going to develop and try to regulate
00:04:02.740 it in terms of timing.
00:04:04.100 So theoretically, most humans are going to be more awake during the day and more sleepy
00:04:09.720 during the night.
00:04:11.160 You know, raccoons have the complete opposite response to melatonin.
00:04:13.760 They want to be awake in your garbage can at night and sleep during the day.
00:04:16.780 So those are sort of the biological underpinnings of sleep.
00:04:21.460 It's a primary drive.
00:04:22.960 It's something that we can't escape.
00:04:24.460 So even the worst sleeper out there is going to sleep.
00:04:28.900 I mean, humans are going to sleep about five to six hours of, you know, every 24 they're
00:04:32.960 alive and there's not a thing we can do about it.
00:04:35.600 So it's important to understand that, you know, for an individual who comes to tell me,
00:04:39.800 I had a guy tell me he'd been in Germany for nine and a half months and never slept the
00:04:43.560 time he was there.
00:04:44.980 That's not a true statement.
00:04:46.460 It may be true from his perception, but the idea that there are people out there going
00:04:50.780 nine and a half months without any sleep just doesn't happen.
00:04:53.440 Why is it, I think everyone's experienced this, like they feel really sleepy.
00:04:56.640 This happened to me this week.
00:04:58.580 I feel really sleepy.
00:05:00.040 I'm like, all right, time for bed.
00:05:01.380 And as soon as I get into bed, I feel wide awake and I can't go to sleep.
00:05:05.040 Like what, what happened, what's going on there with our sleep drive that causes that?
00:05:10.000 Yeah, it's probably a bunch of things.
00:05:11.640 I mean, I think number one, people poorly define the feeling of sleepy.
00:05:15.880 So to me, sleepiness is drive to sleep.
00:05:20.280 So if somebody says to me, I am so sleepy when I go to bed at nine o'clock every night
00:05:25.100 and I ask them, how long does it take you to fall asleep?
00:05:27.620 And they say two hours minimum.
00:05:29.620 I'm going to argue that at nine o'clock, they're not particularly sleepy.
00:05:33.160 So humans often use the feeling of fatigue as a surrogate for sleepy, meaning that you're
00:05:40.320 sitting there at night and you're exhausted.
00:05:42.220 You've got no energy.
00:05:44.040 If somebody came up to you and said, hey, let's go run a few miles or a few laps around
00:05:47.320 the track, you would say to them, look, I don't have any energy.
00:05:50.920 I don't have the energy to fold a load of laundry, let alone go for a run.
00:05:55.740 That's not the same thing as sleepiness.
00:05:58.580 In other words, when you're running in the marathon and you get to mile marker 19, you
00:06:03.760 might quit, but generally you're going to quit because of fatigue, not because of sleepiness.
00:06:09.300 I got to mile marker 19, doc, and I could barely keep my eyes open.
00:06:13.220 So I lay down in the middle of the road and took a nap.
00:06:15.040 Like that said, nobody ever, right?
00:06:17.340 So that could be part of it.
00:06:19.440 The second is sleep is a skill.
00:06:23.300 And like any other skill, there's a performance that goes along with it.
00:06:27.920 So maybe you are sleepy when you decide to go to bed at night.
00:06:31.640 And once you get into bed, you've got some sort of performance anxiety that's going to keep
00:06:37.200 you awake a little bit longer.
00:06:38.700 Meaning we've all come across an empty gymnasium with a basketball sitting there and started
00:06:44.060 shooting some hoops and maybe, oh my gosh, you just made 10 straight free throws.
00:06:48.360 Nobody's in the gym.
00:06:49.460 Nobody's watching you.
00:06:50.380 Nothing's on the line.
00:06:51.860 You just made 10 free throws.
00:06:53.720 Now put that same individual on the free throw line for the NBA championship.
00:06:59.600 You know, so the entire team and the entire community is looking to you to make these two
00:07:04.140 free throws.
00:07:04.660 If you do, you're the champion, you're going to get a massive bonus.
00:07:08.580 You're going to be a hero in that city for the rest of your life.
00:07:11.480 Miss it.
00:07:12.380 And everybody will remember you as the person who couldn't make the free throws to win the
00:07:15.800 championship.
00:07:16.620 So it's still no different than the activity that you were engaged in in that empty gym.
00:07:21.940 It's putting a rubber ball through an iron hoop.
00:07:24.440 But now you've engaged in a completely different psychological action than you were when nothing
00:07:31.340 was on the line.
00:07:32.280 And so for people who really struggle with their sleep, they put a tremendous amount on
00:07:38.960 the line when they get into bed.
00:07:41.040 And that's part of the problem that we have with our dialogues and discussions about sleep.
00:07:46.720 Yes, we know a lot more about sleep than we did even 10 years ago.
00:07:49.700 Yes, it's incredibly important for your health.
00:07:51.980 But when you start going to bed at night with this feeling of, I've got to go to bed now,
00:07:56.380 get my eight hours of sleep because some doctor said I needed to, and if I don't, I'm going
00:08:00.340 to develop dementia.
00:08:02.340 That's a really terrible way to initiate sleep at night.
00:08:05.980 So I always tell people, look, get into bed.
00:08:08.440 One of two things will happen.
00:08:09.760 You're going to fall asleep or you're not.
00:08:11.420 But you need to be equally comfortable and happy with either of those outcomes.
00:08:17.120 And if you're not, we need to get you to a place where you are because that's where sleep
00:08:22.060 problems really can dig their teeth into people when you start fearing that activity of going
00:08:28.260 to sleep at night and maybe not falling asleep immediately.
00:08:32.140 And we'll talk about some things that people can do to do that here in a bit.
00:08:34.540 But I want to go with this idea between the difference between sleepiness and fatigue because
00:08:36.920 I thought that was really interesting.
00:08:37.860 I think I've struggled with that distinction for a long time.
00:08:41.480 Sometimes I just, I think I'm sleepy when I'm actually fatigued.
00:08:44.400 Like, how do you tell the difference between the two?
00:08:47.020 I mean, I think it's really about behaviors.
00:08:49.700 If somebody says, I'm really sleepy, typically when I go to that five o'clock meeting on Friday
00:08:56.400 and they're saying, I've got to walk around or I have to eat goldfish crackers or M&Ms and
00:09:03.040 drink something.
00:09:03.920 Otherwise, I fall asleep and my principal makes fun of me.
00:09:08.580 I would say that you're exhibiting some signs of pretty excessive sleepiness at that time.
00:09:13.660 Somebody says that when they drive, they will often wake up at a stoplight to the sound of the
00:09:17.940 person behind them honking because the lights turn green.
00:09:21.540 Or they love to read, but it's a very frustrating procedure for them because every time they sit
00:09:26.680 down to read this book that they're really interested in, they get halfway through the first page and
00:09:30.640 they fall asleep. So they've been trying to read this book for the last six weeks. All they do is
00:09:34.840 read the same three pages over and over because every time they sit down to start to read,
00:09:38.800 they fall asleep. I had a young woman who built a desk on a treadmill because if she sat to do work,
00:09:44.040 she'd fall asleep. And she discovered that one trick was to be walking when she did work and
00:09:48.900 that would help her stay awake. I would say those are great signs of somebody who's excessively
00:09:53.200 sleepy. And if you're excessively sleepy, it's happening through one of two mechanisms only.
00:09:58.440 You are not getting enough sleep. You're not spending enough time in bed to get to sleep.
00:10:03.120 You like to stay up and watch Stephen Colbert. Then you watch Seth Meyers. So now it's 1.30 when you go
00:10:08.100 to bed. You have to be up at six o'clock the next morning to go to work or get on your Zoom meeting or
00:10:12.120 start your commute. So that individual is probably not giving himself or herself an adequate amount of
00:10:17.620 time to get sleep at night. Or you're somebody who's sleeping nine, 10 hours a night and feels
00:10:22.820 sleepy. Well, that's not an inadequate amount of sleep. That's probably coming because your sleep
00:10:28.040 is dysfunctional or there's something wrong with the quality of it. So you can kind of make up for
00:10:33.620 a lack of sleep quality with more sleep quantity to a point. But then it gets to a place where somebody
00:10:39.620 sleeping 12 hours and still can't control their drive to sleep during the day. And that's how some
00:10:46.200 people with severe sleep apnea and narcolepsy will get. They can't sleep enough. And even other
00:10:52.120 people will start to notice that family members, partners, like, gosh, honey, you slept 10 hours last
00:10:56.700 night, woke up, had breakfast, and you sat down to read the paper and you fell asleep again?
00:11:01.480 Like, what's going on? How are you able to sleep 10 hours and still be sleepy enough that you don't
00:11:06.660 want to go out and go on the hike with the rest of the family? You want to stay home and sleep.
00:11:10.800 Why? That doesn't make any sense. And it can really, these types of things can really drive a wedge
00:11:14.980 in relationships. So sleepiness is always going to be defined as your drive to sleep.
00:11:21.320 Again, somebody says to me, I am so sleepy and it takes me four hours to fall asleep every night. No,
00:11:25.680 you're not. That's the same thing as saying, I am so hungry and I offer you a sandwich and an apple
00:11:30.560 and you don't want it. No, you're not that hungry. Because if you were hungry, you'd eat the food I was
00:11:34.680 offering you. In fact, if you were really hungry, you might eat this food out of a trash can.
00:11:38.800 You know, so drive to sleep is really easy to figure out. Fatigue is different. Fatigue is more
00:11:44.460 of a body energy, motivation during the day. You know, kind of the way you might feel if you were
00:11:51.140 getting sick. You know, sure, you might want to go to bed because you don't feel well. But sometimes
00:11:55.620 you go to bed, you don't fall asleep. It just feels good just to be in the dark, quiet, lying there,
00:12:00.140 not having to do anything. So I always think about fatigue as the way you would feel
00:12:04.460 after you ran 10 miles or, you know, mowed a big lawn or engaged in a Spartan race or something
00:12:12.320 like that. You know, at the end of the Spartan race, yeah, you're done. You want your t-shirt
00:12:15.820 and want to get on social media and start bragging. But you're not necessarily thinking, oh, I've got to
00:12:21.160 lay down here in this field and take a nap before I can do anything. You know, it's not a sleepiness
00:12:25.960 that you're describing. All right. So a lot of people, they're confusing sleepiness with fatigue,
00:12:30.680 including me. And I can see how this can cause a lot of anxiety because you're tired at night.
00:12:35.520 You feel like, oh, it's time to go to bed. You go to bed. But because you're not sleepy,
00:12:39.160 you're just tired. You just lay there and you can't fall asleep. And then the anxiety compounds
00:12:43.780 because you start thinking like, oh my gosh, I've read these articles of all these bad things that
00:12:47.320 happen if you don't get enough sleep. Dementia, I could get in a car wreck. My working memory is going
00:12:52.320 to be bad. And then it just perpetuates and it makes it harder and harder to fall asleep.
00:12:56.640 Sleep. So two questions here. The first one is, what are the downsides of not sleeping? Like what
00:13:01.760 happens when you don't get enough sleep? You're sleep deprived. And the second part is, do most
00:13:05.560 people who can't fall asleep at night or have trouble every now and then, do they really need
00:13:08.980 to worry about this stuff?
00:13:10.540 Sure. So I think it's important to kind of understand that when we're talking about the
00:13:15.240 negatives of sleep deprivation, that we're truly talking about sleep deprivation, meaning that an
00:13:21.360 individual has the opportunity to get seven hours of sleep, but has decided or it's been decided for
00:13:27.200 them by their boss that they're only going to get two or three hours of sleep. I think it's important
00:13:32.100 to differentiate that from what we consider to be insomnia, where a person says, I'm going to bed at
00:13:37.560 11 o'clock every night and it takes me four hours to fall asleep. They're really two very different
00:13:42.640 things. But if somebody is truly sleep deprived, either on purpose, and we meet people like that all the
00:13:48.300 time who say, look, I go to bed at midnight, I get up at three o'clock to work out or something
00:13:53.100 ridiculous like that. And they'll tell you, well, I'm fine. I know it doesn't seem like a lot of
00:13:57.300 sleep. As long as I get my three hours of sleep, I'm really good to go. You're really not. You're
00:14:01.900 really harming yourself over time. So one of our little secret sayings, and we've got about 10 of
00:14:07.840 them in our clinic, is just because you can do it doesn't mean you should. And I think that sleep
00:14:13.120 deprivation kind of falls into that category because these are the people who are getting up at three
00:14:16.800 o'clock in the morning to train for triathlons and they die at age 51 and nobody can figure out why.
00:14:22.820 I mean, the effects of long-term sleep deprivation are absolutely profound. I mean, in addition to
00:14:28.780 just being sleepy all the time, such that every time you sit down to watch a TV show or read a book,
00:14:35.440 you fall asleep, you know, and obviously driving a car and being that sleepy aren't terribly compatible.
00:14:40.860 It just erodes at our cardiovascular health, makes us much more likely to develop high blood
00:14:47.160 pressure, heart attack, stroke. We tend to create issues with metabolism and gain weight. There's a
00:14:53.400 lot of cognitive issues that go along with sleep deprivation, including perhaps the development
00:14:58.920 and the acceleration of dementing illnesses like Alzheimer's disease. There's great evidence to
00:15:05.400 suggest that chronic sleep deprivation or chronic changing of schedules, kind of sleeping all over
00:15:12.040 the place could lead to cancer. So it's really difficult to find an organ system that's not
00:15:19.500 affected by sleep loss and sleep deprivation. Even the way we look has been shown that, you know,
00:15:26.480 our skin sags more, we wrinkle more, bags under our eyes, we look older, we age faster when we're not
00:15:33.340 sleeping the way we should. Again, I'm just going to stress one more time, just because I think it's
00:15:38.020 often lost when there are discussions about sleep. If you're listening to this and thinking,
00:15:43.000 oh my gosh, I go to bed at 10 o'clock every night and it never takes me any less than an hour or two
00:15:47.680 to fall asleep, we are not talking about you. This is nothing to do with the individual who's giving
00:15:53.400 themselves the opportunity to sleep, but they're not taking it. And that's important because when you
00:15:59.100 think of sleep deprivation, true sleep deprivation causes one thing above all else, it causes
00:16:06.400 sleepiness. It's like food deprivation causing hunger or fluid deprivation causing thirst.
00:16:13.960 So if somebody says to me that they go to bed every night at 10 o'clock and it takes them two hours to
00:16:18.740 fall asleep on a good night, it's hard to make a case that that individual is sleep deprived. They've
00:16:25.200 got a sleep problem. They've got difficulty initiating sleep or they wake up in the middle
00:16:29.380 of the night, they're up for a couple hours. But that sort of behavior is inconsistent with the
00:16:34.480 pattern that we see with sleep deprivation, which is my father who every time he sits down,
00:16:39.300 he goes right to sleep. That's what sleep deprivation looks like. And the problem is the
00:16:43.720 media message is all about insomnia. How long does it take you to fall asleep? Do you struggle to fall
00:16:48.780 asleep? Do you need a little moth to fly into your bedroom at night and kiss you on the cheek to make
00:16:52.900 you fall asleep as the drug ad would tell you? So when my father sees those ads, he thinks,
00:16:57.720 I don't know who those people are with sleep problems. I'm the best sleeper in the world
00:17:00.920 because every time I sit down, I fall asleep. Sleep science is actually more worried about the
00:17:05.800 person who falls asleep every time they sit down versus the individual who might take them a little
00:17:10.580 while to fall asleep. They're really two separate entities. We're going to take a quick break for your
00:17:14.280 word from our sponsors. And now back to the show. All right. So the downsides of not sleeping,
00:17:20.460 this comes from actual sleep deprivation. These are people who are sleeping two, three hours a
00:17:25.240 night for extended periods. It's not the people who are having a hard time falling asleep or they
00:17:29.960 wake up occasionally throughout the night. They don't have to worry about it too much about it because
00:17:33.760 what's going to happen, it sounds like, is that their body is just going to get sleepier and they're
00:17:38.920 going to sleep more and they're going to get the sleep they need. But I can still see this is going
00:17:42.500 to be nerve wracking for people even when they hear this because, as you said, we have this culture
00:17:47.540 around sleep that we've developed where we obsess about and try to optimize it. And one number,
00:17:52.820 one thing that people hone in on a lot when they're thinking about optimizing their sleep
00:17:56.100 is what's the number of hours of sleep I should get minimum? So sleep doctor, how much sleep do most
00:18:03.280 people need to get? So how much sleep most people need? I want you to think about that question and I
00:18:09.540 want your listeners to think about that question as a similar question to how much food do we need or how
00:18:15.880 many calories should I be consuming? The answer to that question depends incredibly on the eye.
00:18:21.540 Who are we talking to? Are you a 80-year-old retired accountant who's basically inside your home
00:18:27.540 because you're nervous to go out and get the coronavirus? Or are you a 18-year-old gymnast
00:18:34.180 in training for the Olympics? Or a 300-pound football player for the Baltimore Ravens? I mean,
00:18:41.820 so those questions have a context to them that we often don't dive into when we talk about sleep.
00:18:47.380 Oh, you need eight hours. Well, okay. Does the average person need eight hours? Maybe. I think
00:18:53.040 seven and a half is a better average for a general mid-range adult population, but there's nothing wrong
00:18:59.980 with eight. As long as people understand that eight is an average. It's like the average person
00:19:05.860 at a picnic eats two hot dogs and a hamburger. Okay. That doesn't mean everybody's buying or eating
00:19:11.540 two hot dogs and a hamburger. It's a nice number to have if you're planning a huge picnic. It might be
00:19:17.060 a nice number to have if you're seeing patients who have sleep problems. But one of the biggest causes
00:19:22.000 of, quote, insomnia in this country is an individual who needs six hours and 50 minutes of sleep
00:19:28.140 every night getting in bed and trying to get eight. You are genetically not programmed to get eight
00:19:33.680 hours of sleep. So you've got as much of a sleep problem as a person eating an extra large pizza
00:19:39.520 every night and not being able to finish it has an appetite problem. Sure, that person could go to
00:19:44.360 their doctor and say, I got something wrong with my appetite. I can never finish my dinner.
00:19:49.400 I think a bad doctor gives that patient an appetite stimulant and doesn't ask any more questions.
00:19:53.960 A good doctor would say, oh, I'm sorry to hear you're struggling. Tell me more about your dinner.
00:19:57.820 Well, it's an extra large pizza, thick crust, deep dish, tons of meat.
00:20:02.140 Well, listen, you're a five foot, 740 pound guy. I don't know that it's necessarily appropriate
00:20:11.380 for you to be eating that much food at dinner at night. So I'm not sure your struggles to finish
00:20:16.760 that pizza rise to the level of a medical problem that we need to treat. Even if the patient says,
00:20:23.100 well, my friend eats a whole extra large pizza and he's super healthy, I want to be like him.
00:20:28.680 Yeah, well, he's a linebacker for the Baltimore Ravens. That's a completely different situation.
00:20:34.780 But when it comes to sleep, we often lose those pieces of dialogue. In fact, I have people all
00:20:40.840 the time, oh, I'm writing for this magazine and we want some great tips for our readers to help them
00:20:46.980 if they wake up in the middle of the night, what are some tips they can use to get back to sleep?
00:20:50.500 And I asked one writer one time, I'll give you a tip, but I need a tip too. And she said,
00:20:55.100 what do you need a tip about? I said, well, sometimes I get halfway through my sandwich.
00:20:58.900 I get this sandwich every day from this restaurant for lunch and occasionally I get halfway through
00:21:03.260 it. I don't want to eat the rest of it. So what's a good tip for me to help finish that sandwich so
00:21:08.560 I don't starve to death? And she laughed and said, I don't think you need to finish the sandwich.
00:21:13.420 I don't think that's a problem if sometimes every now and then you don't finish that sandwich.
00:21:17.700 I said, well, I don't think the question you've brought to me is a problem either.
00:21:22.780 And I think we have to think about that as a society and a culture when we think about sleep,
00:21:27.520 that if somebody wakes up at four o'clock in the morning and can't get back to sleep,
00:21:31.960 why do we have to treat that? What are we treating? What are we concerned about?
00:21:37.460 Because to me, it might just be a brain that says it's got enough sleep and doesn't really want
00:21:41.820 to sleep right now. So I don't think that's a big issue. I think we make some problems into much
00:21:47.780 bigger issues than they are. And when you start fearing waking up at four o'clock in the morning
00:21:53.480 and wondering if your pill that your doctor's giving you or pills is going to do the trick,
00:21:59.200 I think we start to create more problems than we solve.
00:22:02.480 Well, is that fear of sleep and being able to fall asleep or stay asleep, is that what insomnia is?
00:22:07.860 Like, what is insomnia? If you were to ask me what my definition of insomnia would be,
00:22:14.100 I think for a lot of people, if you had to whittle it down to one word, it is that. It is a fear.
00:22:20.740 Insomnia, if you define it with medical professionals, is not an individual who can't
00:22:25.440 sleep. So if you go out to an outdoor mall and there's people walk by on a pretty day,
00:22:29.960 ask them, hey, can I ask you a real quick question for a survey? And they say, sure. If you ask them,
00:22:34.260 what's insomnia? They'll say, I don't know. It's when somebody can't sleep. That's the definition,
00:22:37.640 can't sleep. It's not really the definition of insomnia because can't sleep doesn't exist in
00:22:43.080 nature, really. It's an individual who's not sleeping in a way or a time in which they've
00:22:49.880 decided they want to. So they've decided 11 o'clock is their bedtime. They're going to bed 11. It takes
00:22:54.680 an hour or two to fall asleep. So that's part A. Part B is you have to have a negative response to
00:23:01.440 part A. So when somebody says to me, hey, Chris, I've heard you're a sleep doctor. So I go to bed
00:23:05.980 every night at 10 o'clock, takes me two hours to fall asleep. My first question is, how do you feel
00:23:10.220 about that? And if somebody says, oh, I don't mind, then I don't really think they have insomnia. I
00:23:15.620 don't think anything really needs to be done about that. In fact, I would say, yeah, sometimes it takes
00:23:20.040 me a while to fall asleep too. And I don't mind either. In fact, I like being in bed awake. I don't
00:23:24.960 have a problem with it at all. If you start having a problem with being in bed awake,
00:23:30.880 that's really the origin of insomnia. We talk about insomnia is sort of runs kind of in people
00:23:38.840 who are more predisposed to be a little bit anxious, a little bit more type A. These are
00:23:42.860 successful people. They're entrepreneurial in spirit. If there's a problem, they're going to
00:23:48.000 figure out a solution right away. I mean, these are traits that you want in a partner or a spouse
00:23:53.000 or an employee. They're not great traits to have when somebody goes to bed at night and then they
00:23:59.500 are struggling to fall asleep. Now, all of a sudden, the wheels start churning and they are
00:24:03.240 trying to solve the problem, which is unfortunate versus just, oh, well, I'm awake. I'm going to sit
00:24:09.680 here and use this time to think about what to buy for my husband for his birthday coming up.
00:24:14.780 Or I'm going to use this to think about a way that I could deal with an employee who has very unusual
00:24:20.480 political beliefs, but I've got to work with them. And I think that the way I've been kind of making
00:24:25.220 fun of them is not a great way to move forward. I'm going to really try to get inside
00:24:29.480 his head and come to some understanding about thinking about the way he thinks. I mean,
00:24:33.120 you can use that time. I mean, I embrace time in bed awake. I love it. And that's why I always,
00:24:39.420 when I lecture about insomnia, I always tell people, look, I'm never going to have insomnia
00:24:43.340 in my life. And there's always murmuring in the crowd. And I say, well, wait a minute.
00:24:47.520 I didn't say I wouldn't have sleepless nights. A sleepless night is part of the human condition.
00:24:53.020 We're all going to get in bed and struggle to fall asleep from time to time.
00:24:55.740 Insomnia is when we really care about it, when it's upsetting and frustrating. If you want to
00:25:01.340 really see a tour de force of insomnia or insomnia thinking, go on Amazon, find my book. It's called
00:25:08.940 The Sleep Solution. Go down where the ratings are and just look at the one-star reviews of the book.
00:25:15.600 And you really start to get a sense of the word that you use, Brett, which is a good word. It's fear.
00:25:20.780 There are people out there who are traumatized by the condition. So when I say that inability to
00:25:28.100 sleep or not being able to sleep doesn't exist, that doesn't mean insomnia doesn't exist. Insomnia
00:25:33.000 is a very real thing. We just often define it incorrectly, which leads to incorrect treatments.
00:25:40.220 Michael Jackson went to his doctors and said, I can't sleep. And instead of probing that and
00:25:46.120 redefining the problem, they said, okay, here's some drugs. And he came back and said, these drugs
00:25:51.700 don't work or don't work anymore. I need better drugs. And eventually they got to a point where
00:25:56.540 a surgeon was going to his house and anesthetizing him with a drug called propofol, which is completely
00:26:02.440 problematic and just a terrible way to deal with somebody who's got sleep problems.
00:26:08.480 And we killed him. The sleep community or the medical community, not the sleep community,
00:26:13.760 the medical community killed Michael Jackson, not on purpose, but they thought they were doing the
00:26:18.500 right thing. And that's where we've got to get out from under these things and understand that,
00:26:24.520 listen, I hear you when you are frustrated and fearful and dread going to sleep at night.
00:26:30.760 You've created almost a PTSD situation. And when you read those one-star reviews, you can feel that
00:26:37.220 PTSD. And one person whose Amazon name was tired69 said, it's hell on earth, which is a really
00:26:47.360 interesting thing to think about. If somebody said to me, Chris, what is your hell on earth situation?
00:26:52.980 I can give you a bunch of them, being captive in a hole or having a kid kidnapped or a kid going
00:27:01.020 through cancer or something. There's a lot of hell on earth scenarios I can give you.
00:27:05.020 One of mine is not, you're in a climate controlled bedroom at 68 degrees, the love of your life
00:27:11.500 sleeping next to you and you're awake and it's two o'clock in the morning. Like, okay, like that
00:27:17.500 might not be the scenario I really want to be in the most, but I don't care about that. It's not
00:27:24.160 really a hell on earth to me. And part of that comes with the belief that I know that just because
00:27:29.300 I'm awake at two o'clock in the morning, I'm going to sleep. So there's nothing to really be that
00:27:33.880 worried about. So that's where we've got to get people. So if you flip over and read the five-star
00:27:39.080 reviews of the book, you can see that change in thinking. I've had people say, like clinic patients
00:27:45.540 say, just by talking to you, I feel like my insomnia is better already because of the fears and
00:27:53.280 misunderstandings that people take to bed with them. So I think fear is a great way to describe
00:27:58.500 a lot of insomnia. Yeah. So it sounds like it's more of a psychological issue. It's not like there's
00:28:02.700 nothing medical you need to do for insomnia. It's more about changing cognitive behavioral therapy.
00:28:07.880 I mean, for a lot of people, there can be medical reasons for it. I mean, for a lot of people who have
00:28:12.520 restless leg syndrome, they don't come to me and say, hey, I got restless leg syndrome. They say,
00:28:17.360 I have trouble sleeping. So there is a psychological component to some of it, a lot of it,
00:28:23.880 but not all of it, which is why if you're like, look, Chris, I go to bed and I don't care if I
00:28:28.140 fall asleep or not, but these things are happening and I am super sleepy during the day. We always talk
00:28:34.720 about if you have knee pain, you might buy a little brace at Walgreens or you might ice your knee or take
00:28:40.540 some Advil or Motrin or something. But eventually, if you're feeling like, gosh, my knee is really
00:28:47.320 hurting more than it did a few weeks ago and none of the things I've bought at Walgreens or these
00:28:52.020 remedies I've tried are helping, you're probably going to go see your doctor and orthopedic
00:28:56.280 specialist. So to me, yeah, I mean, if you're feeling like, look, I've struggled with these
00:29:00.220 things for a long time, even if they're sort of fear-based kinds of situations, talk to a sleep
00:29:06.180 doctor. There is a much better solution than some sort of pill to knock you out at night.
00:29:11.380 You know, sedation and sleep are two very different things.
00:29:14.320 Well, related to insomnia, it is kind of like insomnia. It's not people are afraid of
00:29:17.020 sleep, but people who sleep or like people who think they're not sleeping or they're having bad
00:29:21.580 sleep, but then they come to you and say, doc, I'm not sleeping. My sleep's terrible.
00:29:25.580 And they do a sleep study and like their sleep's fine. Like what's going on there where the
00:29:29.460 perception is off between the quality and the quantity of sleep they're getting, but like what
00:29:33.840 they think they're getting. Sure. So a sleep study, particularly in these days when we've got home
00:29:39.040 sleep studies, it's not necessarily a guarantee that your sleep is normal. So, but your point is a good
00:29:46.560 one that another one of our secret sayings in the clinic is perception of sleep and reality are two
00:29:52.300 very different things. So when the patient comes to me and says, I've been in Germany for the last
00:29:56.880 nine and a half months and I haven't slept, he wasn't sitting at home the night before saying,
00:30:02.260 I've got this great idea, honey. I'm going to go to see this sleep doctor. I'm going to wait several
00:30:06.640 months for my visit. And when I finally get in to see him, I'm going to lie about my sleep and tell
00:30:10.980 him I'm not sleeping when in fact I really am. It'll be so much fun. Like nobody ever does that.
00:30:15.020 So when that individual comes or I had a circuit court judge, you know, right below Supreme Court,
00:30:21.080 she came in at one point and said, I'm not sleeping. You know, I said, when you say you're
00:30:25.400 not sleeping, what do you mean? She said, do I stutter? I don't sleep. You know, the husband had
00:30:31.020 a kind of a funny look on his face and the funny look was, I don't think that's necessarily true,
00:30:35.560 but I don't want to say anything because I'm living with her, et cetera. So, but that's her
00:30:39.200 perception. So we actually put her in a sleep center and she did a sleep study and she came back and
00:30:43.900 said, see, I told you I don't sleep. And I'm like, ma'am, you slept for six and a half hours.
00:30:48.540 I showed her the video. And she said, Chris, that is absolutely not my perception of what
00:30:53.640 happened that night. In fact, if I didn't know any better, I would think that you superimposed
00:30:58.040 my face digitally onto the body of somebody else who was actually sleeping because my experience was
00:31:04.000 I was awake all night. Now it starts to make sense when you understand that she's awake all night,
00:31:10.060 yet she's hearing court cases all day long, doesn't feel sleepy. In fact, when she tries to nap,
00:31:15.820 she can't. So that behavior makes sense now. And so it's important that we understand that how we
00:31:22.720 feel about our sleep doesn't always match up with the reality. In fact, that's one of the wonderful
00:31:28.260 things about some of the technology we have. Sure, it may not be great at determining REM sleep and deep
00:31:34.180 sleep. But if you're wearing an Apple watch or a Fitbit or a Withings band, trying to figure out
00:31:40.300 how much sleep you're getting, and you're waking up every morning and writing in your sleep diary,
00:31:44.660 I slept 28 minutes last night. But your Fitbit is saying you slept six hours and 17 minutes.
00:31:51.480 No offense to you. And I understand that a Fitbit can be off, but I actually believe the Fitbit more
00:31:57.140 than I do you. And I bet your bed partner does as well too. So it's sometimes nice to have an
00:32:03.360 objective measure because now that fear of, oh my gosh, I am sleeping 30 minutes a night and I have
00:32:11.400 so for the past eight days. I'm going to develop dementia by the end of the month. My sleep is so
00:32:16.160 bad. Now you have this objective voice saying, hey, don't worry. Maybe you didn't sleep great last
00:32:22.140 night, but you got six hours and 17 minutes sleep, which is a whole lot better than 28 minutes.
00:32:26.060 So these things have started to play a real positive role in people's lives that
00:32:31.140 they're actually sort of a referee. I can tell you, look, you're not in danger of sleeping 28
00:32:36.840 minutes a night. I had a parent who said their kid slept two hours a night. I'm like, no, he doesn't.
00:32:41.940 Not on average. I mean, maybe last night he did, but there's no way over a month's time
00:32:46.360 your 11-year-old son's averaging an hour or two of sleep. It just doesn't happen in nature.
00:32:52.140 And if you don't believe me, buy him a Fitbit, stick on his wrist, and we'll talk in a month.
00:32:56.380 Nobody ever brings me that Fitbit back that says, oh, wow, you're right. One hour.
00:33:01.420 You know, if that ever is the case, the medical sleep community is going to be up in arms because
00:33:08.180 we've been looking for that person for years, but have never been able to validate that somebody
00:33:12.580 like that could even exist.
00:33:14.640 Yeah. That was one of the biggest takeaways from this book that helped me really right away.
00:33:18.500 Like I've had those where you wake up in the morning and you don't feel great. You don't feel
00:33:21.420 refreshed and you think, ah, I didn't sleep last night. My sleep is horrible. And I was
00:33:25.180 like, well, I probably did sleep. And if I asked my wife, she'd be like, no, you were snoring
00:33:28.860 when I came into the bedroom to get into bed. So yeah, okay. I did sleep. I did get to sleep
00:33:33.120 by my body need. I might not feel like it, but I did.
00:33:36.360 Right. Or you might even say that sleep quality wasn't that great. So again, when a person comes
00:33:42.660 to my clinic, for a lot of people, you know, the first thing we have to agree on is you sleep. And
00:33:50.180 for 90% of people, that's not a problem. Like scientifically, sure. We have to eat, we have to
00:33:56.540 drink, we have to sleep. So when you say to your wife, oh, I slept terribly last night. And she said,
00:34:01.880 well, I think you slept better than you thought you did because that time you thought you were awake,
00:34:06.000 you were actually snoring. Sure, you did sleep. So if the question is, does Brett sleep or not?
00:34:11.820 I'm sure he does. Your wife agrees. There we go. Does that mean your sleep that night was
00:34:16.340 as good as it could be? Absolutely not. So when I'm telling a patient who has insomnia,
00:34:22.260 look, you sleep. I am not saying you sleep well, but we do have to get to a place in our relationship
00:34:29.920 where we can believe that you actually sleep. And like I said, if you go back to those one-star
00:34:35.620 reviews of the book, these are people who've read the book and are like, I don't care what this
00:34:41.680 smart-ass sleep doctor has to say. I haven't slept more than two hours a night. And I guess I'm the
00:34:49.180 exception. And his book really didn't help me figure out a way where I can get more than two
00:34:54.360 hours of sleep at night. No, it's not going to do that. In fact, I've always had a great idea for
00:34:59.440 a television show. I want to contact those one-hour sleepers and I'm going to move into their home for
00:35:05.780 the next 14 days. And now I'm in complete control of their schedule. We're going to hook some cameras
00:35:11.340 up in their bedroom and we're going to get down to figuring out the problems these individuals have.
00:35:16.800 But now we've got eyes on the situation. So if you're truly not sleeping at night,
00:35:21.440 we're going to see it. And I'm going to make sure you're up at six o'clock in the morning and eating
00:35:25.280 right and exercising and getting sunlight and doing all the secondary things we need to do for our
00:35:32.080 sleep versus just hiding behind. Well, I only sleep an hour and you're frustrating me by this
00:35:37.400 conversation. So goodbye, I'm going to find another sleep doctor. It'll just give me more ambient,
00:35:41.420 which is something that I wish I could control, but sometimes I can't because that perception can
00:35:45.540 be incredibly strong in people. Well, let's talk about things that people can do to one,
00:35:50.920 if they have insomnia, sort of mitigate that and sort of training themselves to sleep. Like you said,
00:35:55.860 sleep is a skill, what they can do, but also for people who are sleeping, they know they're
00:36:00.380 sleeping, they're not sleeping great. Some things they can do to improve their sleep.
00:36:04.940 And I think this goes under the rubric of, it's called sleep hygiene. So what does good sleep
00:36:09.900 hygiene look like? Yeah. I mean, I didn't put a lot of effort into talking about sleep hygiene in
00:36:16.740 my book just because I feel like, man, if you don't know a dark room is better than a bright room in
00:36:21.720 2020 for your sleep, you've been living under a rock. This is the stuff that everybody seems to focus on.
00:36:27.440 A dark bedroom, a cool bedroom, get a good comfortable mattress, make sure you're exercising
00:36:32.600 and make sure you don't have a computer screen in front of your face at night and make sure you're
00:36:37.160 not smoking and drinking a bunch of coffee right before you go to bed. I mean, the number of people
00:36:41.920 who come to my clinic who I am solving their sleep problems by giving them sleep hygiene tips
00:36:47.640 rounded to a whole number of zero, they've come in doing all those things. So to me, A,
00:36:54.540 do all those things. Exercise. Don't smoke when you go to bed at night. Don't have a computer screen
00:36:58.800 playing an episode of Friends right in front of your face as you're trying to fall asleep. Don't
00:37:02.340 watch any political television in the hour before going to bed because either side of the aisle you
00:37:07.120 sit on, you're going to be frustrated by the situation. So to me, once you've gotten past those
00:37:12.720 things, bedroom's dark, it's cool. Wife doesn't snore. We've kicked the dog out of the bedroom.
00:37:17.780 The kids sleep great, whatever. That's probably the time to come talk to somebody before you
00:37:23.280 plucked down another $3,000 on a state-of-the-art mattress because you've already bought two of
00:37:28.740 them in the last year. That's the time where you say, look, this might be a problem that's intrinsic
00:37:35.100 and medical that you can't fix. You can wear the knee brace. You can ice your knee. You can take
00:37:39.500 the aspirin. But if you've got a torn ligament, I'm not aware of a CVS fix-it-yourself torn MCL
00:37:46.380 ligament kit that's available where you just walk yourself through it on a YouTube video. You need
00:37:51.480 professional intervention at that time. And in that case, you might need a sleep study because
00:37:56.820 there is something intrinsically wrong with your sleep. Again, do you sleep? Everybody's listening
00:38:02.580 to this right now. I can tell you that you do. Do you sleep well? Is there something wrong with
00:38:07.580 your sleep? There very well could be. And the best way to figure that out is through some sort of sleep
00:38:11.920 study. All right. So let's do a quick recap here. Some people are going to need more or less sleep than
00:38:17.280 other people. It's different for everybody. And even the amount of sleep you need personally,
00:38:21.160 that's going to change or fluctuate throughout your life. Like some days you're going to need more
00:38:24.820 sleep. Other days you need less sleep. You're not sleepy. And I like the analogy made with food
00:38:29.000 because that really hit it home with me. Like some days you're hungrier. So you need more food.
00:38:33.660 Other days you're not as hungry. You need less food. Same thing with sleep. But regardless of the
00:38:38.000 fluctuations in your sleep, everyone is going to sleep. So the people with insomnia, and these are the
00:38:43.000 people who are afraid to fall asleep because they're afraid they can't fall asleep, or they're afraid
00:38:47.260 they're going to wake up in the middle of night. What they need to do is sort of manage their
00:38:51.240 expectations about sleep. Don't stress out about it. They can't fall asleep. Don't put pressure on
00:38:55.620 themselves that they need to fall asleep. And I mean, really just adjust their expectations for
00:39:00.080 these natural fluctuations that happen with our sleep throughout our life.
00:39:04.540 Absolutely. Or maybe you don't have as much time in bed. I mean, it's amazing. I mean,
00:39:08.940 people tell me that, you know, what time do you go to bed? Nine o'clock. How long does it take you to
00:39:11.980 fall asleep? Two hours. When do you wake up? Six o'clock. Okay. Well, you're seeking
00:39:17.120 nine hours of sleep. You don't go to bed until 11 o'clock. You know, most nights, why not make
00:39:22.360 11 o'clock your bedtime and keep six o'clock your wake up time? That's still seven hours. That's
00:39:27.380 plenty. So if somebody says they need nine hours, then by all means, get it. But if you're trying
00:39:33.960 to get nine, but you only need seven, those extra two hours, that difference is insomnia. So if
00:39:41.180 somebody, again, somebody says, well, I don't mind lying in bed for two hours before I fall asleep at 11,
00:39:44.880 then don't. If somebody says, yeah, it drives me crazy, then, hey, let me gift you the gift of two
00:39:51.620 more hours in the evening to get some things done or watch some more TV or finish up the Queen's
00:39:56.160 Gambit, whatever you're interested in doing. Like, don't go to the restaurant at five o'clock for
00:40:01.480 dinner when you're not hungry until seven. Sitting in the restaurant, annoying the waitresses,
00:40:05.860 everything that come out, what do you want to eat? I'm not hungry. And you go there every day at
00:40:09.360 five o'clock. Why do you go at five o'clock? Well, five o'clock is my dinner time. No, it's not.
00:40:12.640 You've determined it's your dinner time, but there's nothing about your behavior
00:40:16.480 that would say it's your dinner time. So if somebody says out there that they go to bed at
00:40:21.280 nine, go to bed at 11. Now keep your wake up time where it is, but that's perfectly fine.
00:40:26.560 So having those expectations and freeing yourself up from some schedule can be extremely liberating
00:40:34.800 for a lot of people.
00:40:36.200 And also, at one point you make in the book is if you're having trouble falling asleep,
00:40:39.040 don't immediately go through, well, I'm just going to pop an Advil PM or NyQuil. Because
00:40:44.080 one, they don't really do all that much. And you can also disrupt your sleep. And two,
00:40:49.700 there's also long-term consequences of taking sleep aids.
00:40:52.820 There can be. Absolutely. I mean, some of those, anything that has PM in the end of it,
00:40:57.220 it's probably just an antihistamine. And there's some evidence that chronic use of antihistamines
00:41:01.800 could lead to early dementia. Because a lot of antihistamines have an anticholinergic effect,
00:41:06.480 which means they block the chemical acetylcholine, which is integral in Alzheimer's dementia.
00:41:11.740 So to me, tonight, we're all going to go to bed at some point. Let's have a plan.
00:41:17.200 And the plan can't be, I'm going to have great sleep or else terrible things are going to happen.
00:41:21.060 The plan's either going to get in bed and fall right to sleep, or I'm not. And if I don't,
00:41:25.760 what's the plan? The plan could be a Sudoku puzzle. The plan could be, read my book. I always tell
00:41:30.320 people it's either the best book in the world in sleep and it'll help you figure out your problem,
00:41:33.740 or it's the worst book on sleep and it'll put you right to sleep. So have a good book next to
00:41:38.840 your bed when you're interested in reading. Like a Dan Brown, he's running around the Vatican trying
00:41:43.280 to figure out the killer's motives for all these little clues or whatever. There's all kinds of
00:41:48.440 good books out there to read. Something fun and light. It's not tax theory or something divisive or
00:41:56.500 upsetting. Something relaxing. Or the advice that always drives me crazy is if you're in bed and you
00:42:02.600 can't fall asleep, give yourself 15 minutes. And if you're still not asleep in 15 minutes,
00:42:06.940 get up and go do something else. Sure. I hate the 15 minutes or the 20 minute part because now it's
00:42:12.820 like a clock. Tick tock, tick tock, tick tock. You have 15 minutes to get yourself to sleep or else,
00:42:18.200 which never works. To me, it's just be in bed. And if you like being in bed, it's relaxing and your
00:42:24.980 eyes are closed and you're thinking pleasant thoughts and planning out your next trip once we can get out
00:42:29.600 from under this virus and travel again. Great. You sitting there resting, meditating is doing
00:42:35.700 something positive for your body. If it starts to frustrate you or bother you or you don't like
00:42:41.960 sitting there in bed awake with your eyes closed in the dark, yeah, then go up and go do something.
00:42:47.300 And don't worry about it. I mean, okay, it's midnight and you can't sleep. So you get out and
00:42:51.020 go out in the living room and check some emails or paint some little figurines or models that you like
00:42:58.440 to build or clean out your workroom or whatever you like to do. And if finally at three o'clock in
00:43:03.500 the morning, you're starting to feel sleepy, then go to bed. It's three o'clock, go to bed. Now,
00:43:07.340 you got to keep your wake up time set. That's the key. That just because you went to bed at three
00:43:12.380 doesn't allow you now to sleep until 11 and skip your first Zoom meeting of the day. Nope.
00:43:19.260 You got to wake up on time. And that's the thing that keeps our brains honest. I tell people all the
00:43:24.180 time. If I can't fix you, go join the military. There is a wonderful drill sergeant out there
00:43:29.140 and she will fix your sleep problem in about a week. It will not take her very long because she's
00:43:34.580 going to put you in your barracks at midnight. She'll wake you up with a beautiful horn at five
00:43:38.780 o'clock in the morning and she will not let you out from under her sight from five o'clock in the
00:43:42.880 morning till midnight. You will run and do pushups and eat these exact times every day. And there'll be
00:43:47.700 no opportunity for napping. There'll be no opportunity to say, hey, Sarge, I'm a little tired.
00:43:51.760 Mind if I go take a nap while you all go do this obstacle course and I'll meet up with you all
00:43:55.520 later? No, that's not going to happen. So you may have very different problems in a week,
00:43:59.540 but one of them will not be an inability to fall asleep because she's going to take care of that
00:44:03.460 very quickly. Well, speaking of naps, can naps get in the way of sleep? And if so, how do you nap
00:44:08.940 without it messing up your nightly sleep? I think naps are for efficient sleepers who are still tired
00:44:14.100 despite a decent night of sleep. So if somebody says to me, hey, I got my eight hours, my seven hours,
00:44:19.020 my six hours last night as normal, but I'm feeling a little tired today. For whatever reason,
00:44:24.000 I've been sleeping very well lately. I felt really tired yesterday. I'm not exactly sure why and
00:44:28.600 fell asleep like at eight o'clock watching TV, which is very unusual for me.
00:44:33.220 So if somebody is a good sleeper and for whatever reason on this Tuesday feels a little tired and
00:44:39.440 wants to take a nap, go for it. Keep it short. Try to keep it earlier in the day rather than later,
00:44:43.860 but there's nothing wrong with that. It's like a snack. I had breakfast and it was pretty good
00:44:47.620 breakfast, but I'm really hungry and don't think I can make it till lunch without having a few
00:44:51.600 crackers or a bite of an apple. Okay, great. Go ahead and have it. What napping is not for is the
00:44:56.520 person who says, I go to bed every night at nine o'clock, takes me until five o'clock in the morning
00:45:00.100 to fall asleep. And so I'm tired when I wake up because I go to bed at five o'clock, have to get up
00:45:05.220 at nine for work at four hours and I can barely keep my eyes open. Napping is not a great idea for
00:45:09.940 that individual. Your brain had ample opportunity to sleep at night and it chose not to, which is
00:45:15.660 perfectly fine. We told our kids when they were little, you need to be in your room at nine
00:45:19.820 o'clock, eight o'clock, 10 o'clock, whatever. But I don't care when you go to bed. You're eight years
00:45:24.500 old. You're practically an adult. You decide when you're going to go to bed at night. Now,
00:45:27.820 what I didn't tell them was stay up all night or go to bed on time. I'm still going to wake you up
00:45:32.040 every day at seven o'clock. It's not going to change. And I'm not going to be the parent that when you
00:45:37.040 say, oh, dad, I struggled last night to sleep. I was up till four o'clock. I couldn't sleep because I'm so
00:45:42.640 worried about my AP US history exam. Can you take me to school at lunchtime and let me sleep in? No,
00:45:48.940 I can't. I'm nice about it. It's okay. Listen, you're 15 years old. You can handle a night of
00:45:54.840 four hours sleep. It's no big deal. And you'll probably sleep great the next night. So we
00:46:00.320 acknowledge it. We don't minimize it, but we don't maximize it either. And we keep the schedule,
00:46:05.880 just like that drill sergeant. We're nice about it though. But this idea that because you were up till
00:46:11.100 four o'clock worried about an exam is going to give you some sort of Starbucks gift card,
00:46:15.440 allow you to sleep until noon and miss half your school day, it's not going to happen. It's not
00:46:19.380 going to happen on the weekend either. And so now he's going to go to bed the next night at nine or
00:46:24.540 10 o'clock. Having only slept a few hours a night before, suddenly that problem becomes a one night
00:46:30.440 situation versus, oh, we let him sleep until noon. We took him to school at one o'clock. Now it's 11
00:46:37.460 o'clock. He's not that tired to go to sleep because he just woke up at noon and the situation
00:46:42.140 perpetuates itself. My biggest record in my clinic is 58 tardies. One child in a half a year had 58
00:46:50.580 tardies because his parents were so concerned about his sleep, they'd let him sleep until he woke up in
00:46:56.160 the morning. Sometimes that was two in the afternoon. So that napping can really make a
00:47:04.200 little temporary hiccup in your sleep into a much bigger problem if you're not careful with that.
00:47:11.260 So if you're doing all this stuff, the sleep hygiene, you've taken care of the cognitive
00:47:15.220 aspect of sleeping and the insomnia, but you're still having trouble sleeping, that's when you'd
00:47:19.380 probably go visit someone like you, a sleep doctor, to see if there's some other issue like maybe sleep
00:47:23.840 apnea, restless leg syndrome, et cetera. And in those cases, those are medical conditions where
00:47:28.800 you might treat with some sort of drug or CPAP, right? Absolutely. Yeah. So if you're really
00:47:34.120 struggling with your sleep, the first visit to a sleep doctor is we're just going to talk. In fact,
00:47:41.260 if you're coming to my clinic, we're going to talk over your computer because we're completely
00:47:45.480 virtual right now. So nobody's going to hook up any wires to you. Nobody's going to probe you during
00:47:50.260 your sleep. It's just a conversation. That's how we really diagnose sleep disturbances. What time do
00:47:55.740 you go to bed? I want to take you to fall asleep. How long has this been going on? What medications
00:47:59.480 do you take? What does your partner notice about your sleep? How do you feel during the day? What
00:48:03.720 other medications do you take? To me, there's a lot of information gathering that happens to start to
00:48:09.820 understand where this problem is coming from and what of the 88 diagnosable sleep disorders might you
00:48:15.840 have. So there's really no risk for that first evaluation. Could you need a sleep study? A lot
00:48:22.840 of patients who come to see us do, but we work really hard to keep people out of the sleep lab.
00:48:27.420 Or we have home sleep studies that we can do now where you take this little device home and hook it
00:48:33.240 up to you and you sleep in your own bed. And we can get a wealth of information that way. So
00:48:38.340 don't let this thing be a chronic problem. I mean, if you're somebody who's not happy with the
00:48:45.460 way you sleep, somebody out there can deal with it and fix it. I mean, it's pretty rare
00:48:54.760 to be given something as a sleep specialist who's been in the field for what, almost 30 years that
00:49:00.100 I'm like, oh my gosh, I've never heard of that before. It just doesn't happen. And the nice thing
00:49:06.480 about sleep too is a lot of people kind of feel embarrassed about sleep and talking about what
00:49:10.340 they do. And I get up, I'm naked and I run around the house and scream things that embarrass me or
00:49:15.280 whatever. But like I said, we've heard it a million times before. We've heard about the adult wetting
00:49:21.040 the bed. We've heard about the weird sexual encounter you had with your partner that you
00:49:25.340 don't remember and the weird things you said during that time. I mean, it's okay. We are not here to
00:49:31.920 judge. We're here to fix. And we generally do a pretty good job of it. Sleep disorders are usually
00:49:36.980 pretty easy to fix if you're coming with a pretty educated, open mind. And that's really why I wrote
00:49:41.540 the book. So I feel like if you educated yourself about sleep, you could fix a lot of your own sleep
00:49:47.640 problems. It's the fear and the not understanding what's going on that usually lends itself to more
00:49:54.220 anxiety, which more anxiety never helps with sleep problems, which is why in this current political
00:49:59.780 landscape we're in right now, we're just exploding because anxiety amongst COVID and elections and all
00:50:05.440 this stuff is pretty prevalent. Well, Chris, this has been a great conversation. Where can people
00:50:09.120 go to learn more about the book and your work? Sure. I mean, if you can follow me on
00:50:13.020 at sportsleepdoc, S-B-O-R-T-S-L-E-E-P-D-O-C on Twitter. I work with a lot of professional sports
00:50:19.260 teams. That's why I picked that handle, even though the majority of what I do is to see average
00:50:23.700 patients. I'm not even that huge of a sports fan. I just think it's interesting when you fix an
00:50:28.680 athlete's sleep problem, we can measure their performance a lot easier than we can a lawyer,
00:50:33.500 for instance. So I find them to be a wonderful laboratory for does better sleep actually make
00:50:39.420 us perform better? So I'm at sportsleepdoc on Twitter. You can go on Amazon, Kindle, Audible,
00:50:45.160 and find my book. It's called The Sleep Solution, Why Your Sleep is Broken and How to Fix It.
00:50:50.140 I've got an upcoming book coming up about kids' sleeps called The Rested Child. So I'd be looking
00:50:55.280 for information about that. We've got a webpage that kind of some links to various things. But
00:51:00.500 I would just say, talk to your primary care doctor and say, look, I heard some sleep doctor
00:51:04.680 talk on a podcast. And I think that that's something that I could use. And if we can help
00:51:09.080 you, that's great. If not, I can almost guarantee you there's a smarter, more professional sleep
00:51:14.960 doctor in your vicinity that's ready to help you out and really change your life.
00:51:21.220 Fantastic. Well, Chris Winter, thanks for your time. It's been a pleasure.
00:51:23.520 Hey, my pleasure, Brett. Thanks for having me.
00:51:25.000 My guest today was Dr. Chris Winter. He is a sleep specialist and the author of the book,
00:51:29.680 The Sleep Solution. It's available on amazon.com and bookstores everywhere. You can check out our
00:51:33.180 show notes at aom.is slash sleep, where you can find links to resources where you can delve deeper
00:51:36.980 into this topic. Well, that wraps up another edition of the AOM Podcast. Check out our website
00:51:48.240 at artofmanliness.com, where you find our podcast archives, as well as thousands of articles written over
00:51:52.220 the years. And if you'd like to enjoy ad-free episodes of the AOM Podcast, you can do so on
00:51:55.440 Stitcher Premium. Head over to stitcherpremium.com, sign up, use code manliness at checkout for a
00:51:59.680 free month trial. Once you're signed up, download the Stitcher app on Android or iOS, and you can start
00:52:03.620 enjoying ad-free episodes of the AOM Podcast. And if you haven't done so already, I'd appreciate if you
00:52:07.280 take one minute to just review an Apple Podcast or Stitcher. It'll help out a lot. If you've done that
00:52:11.020 already, thank you. Please consider sharing the show with a friend or family member who would think we
00:52:15.080 get something out of it. As always, thank you for the continued support. And until next time, this is Brett McKay
00:52:18.900 reminding you not only to listen to the AOM Podcast, but put what you've heard into action.