The Peter Attia Drive - #58 – AMA with sleep expert, Matthew Walker, Ph.D.： Strategies for sleeping more, sleeping better, and avoiding things that are disrupting sleep

00:00:00.000 Hey everyone, welcome to the Peter Atiyah Drive. I'm your host, Peter Atiyah.

00:00:10.140 The Drive is a result of my hunger for optimizing performance, health, longevity, critical thinking,

00:00:15.600 along with a few other obsessions along the way. I've spent the last several years working with

00:00:19.840 some of the most successful, top-performing individuals in the world, and this podcast

00:00:23.620 is my attempt to synthesize what I've learned along the way to help you live a higher quality,

00:00:28.360 more fulfilling life. If you enjoy this podcast, you can find more information on today's episode

00:00:33.000 and other topics at peteratiyahmd.com.

00:00:41.440 Hey everybody, welcome to this week's episode of The Drive. I'd like to take a couple of minutes

00:00:46.000 to talk about why we don't run ads on this podcast and why instead we've chosen to rely entirely on

00:00:51.660 listener support. If you're listening to this, you probably already know, but the two things I care

00:00:56.460 most about professionally are how to live longer and how to live better. I have a complete fascination

00:01:02.780 and obsession with this topic. I practice it professionally, and I've seen firsthand how

00:01:07.480 access to information is basically all people need to make better decisions and improve the quality of

00:01:12.560 their lives. Curating and sharing this knowledge is not easy, and even before starting the podcast,

00:01:18.200 that became clear to me. The sheer volume of material published in this space is overwhelming.

00:01:22.840 I'm fortunate to have a great team that helps me continue learning and sharing this information

00:01:27.880 with you. To take one example, our show notes are in a league of their own. In fact, we now have a

00:01:33.840 full-time person that is dedicated to producing those, and the feedback has mirrored this. So all of

00:01:39.580 this raises a natural question. How will we continue to fund the work necessary to support this? As you

00:01:45.980 probably know, the tried and true way to do this is to sell ads. But after a lot of contemplation,

00:01:51.100 that model just doesn't feel right to me for a few reasons. Now the first and most important of

00:01:56.300 these is trust. I'm not sure how you could trust me if I'm telling you about something when you know

00:02:02.100 I'm being paid by the company that makes it to tell you about it. Another reason selling ads doesn't

00:02:07.580 feel right to me is because I just know myself. I have a really hard time advocating for something

00:02:12.840 that I'm not absolutely nuts for. So if I don't feel that way about something, I don't know how I can

00:02:18.520 talk about it enthusiastically. So instead of selling ads, I've chosen to do what a handful

00:02:23.280 of others have proved can work over time. And that is to create a subscriber support model for my

00:02:29.320 audience. This keeps my relationship with you both simple and honest. If you value what I'm doing,

00:02:36.260 you can become a member and support us at whatever level works for you. In exchange, you'll get the

00:02:41.840 benefits above and beyond what's available for free. It's that simple. It's my goal to ensure that no

00:02:47.860 matter what level you choose to support us at, you will get back more than you give.

00:02:52.860 So for example, members will receive full access to the exclusive show notes, including other things

00:03:00.380 that we plan to build upon, such as the downloadable transcripts for each episode. These are useful

00:03:06.760 beyond just the podcast, especially given the technical nature of many of our shows. Members also get

00:03:12.900 exclusive access to listen to and participate in the regular ask me anything episodes. That means

00:03:19.860 asking questions directly into the AMA portal and also getting to hear these podcasts when they come

00:03:25.800 out. Lastly, and this is something I'm really excited about. I want my supporters to get the best deals

00:03:31.140 possible on the products that I love. And as I said, we're not taking ad dollars from anyone, but instead

00:03:36.280 what I'd like to do is work with companies who make the products that I already love and would already

00:03:40.900 talk about for free and have them pass savings on to you. Again, the podcast will remain free to all,

00:03:48.700 but my hope is that many of you will find enough value in one, the podcast itself and two, the

00:03:56.440 additional content exclusive for members to support us at a level that makes sense for you. I want to

00:04:01.960 thank you for taking a moment to listen to this. If you learn from and find value in the content I

00:04:06.840 produce, please consider supporting us directly by signing up for a monthly subscription. My guest

00:04:12.360 this week is Matthew Walker. Many of you are familiar with Matthew because in April of this year,

00:04:17.480 we released a three-part series with him. The response to this was overwhelming. In fact,

00:04:23.040 it was among our most popular podcasts to date. And as a result, we decided to do a special AMA

00:04:31.100 with Matthew hosting and me asking the questions on behalf of our subscribers. So what you have here

00:04:37.920 today is what I would describe as three hours of the best Q and a I've ever heard on sleep imaginable.

00:04:47.180 I was super impressed with the questions that came in from people. I couldn't resist, but sprinkling in

00:04:53.360 a few of my own questions and many of my team did the same thing. And we had a hard stop imposed by his

00:04:59.780 flight departure. And that forced us to just be ruthlessly efficient and accomplish a lot. We

00:05:05.720 actually got through about 80% of what I thought would take probably six hours. So as a quick

00:05:13.280 refresher, Matthew is a professor of neuroscience and psychology at Cal Berkeley. He's the founder and

00:05:19.080 director of the Center of Human Sleep Science. He's earned his degree in neuroscience from Nottingham

00:05:24.360 University in the UK, his PhD in London before becoming a professor at Harvard and ultimately moving to

00:05:29.580 Berkeley. You may know him more from being the international bestselling author of the book,

00:05:35.320 Why We Sleep. He has also very recently given a TED talk that was incredibly well received this year at

00:05:41.560 the conference. And we will link to that, of course. As a reminder, of course, AMAs are for subscribers

00:05:46.100 only. So if you're not a subscriber, you'll only be able to listen to a little bit of this episode,

00:05:51.140 but hopefully episodes like this and all of the other AMAs and benefits will at least convince you of the

00:05:56.860 benefits of supporting our work here in an ad-free environment. And you can do that at

00:06:02.260 peteratiamd.com forward slash subscribe. In this episode, we talk about a ton of stuff. So the questions

00:06:10.060 dive in with how do we get the best amount of sleep? How do we specifically go about targeting

00:06:16.800 different stages of sleep? We talk a lot about what it means to create the perfect sleep environment.

00:06:23.060 So if the first episodes that we did with Matt focused a lot on why you want to sleep, we focused

00:06:28.860 much more today on how you want to sleep. Timing of sleep with respect to food, exercise, what does a

00:06:34.680 wind down routine look like, sound, temperature, light, all of these things. We got really deep on

00:06:40.160 supplements, melatonin, CBD. We talked about GHB, THC, all of these things. We went into strategies for

00:06:48.120 what to do when you blow it. We all do. We have a horrible night of sleep. What can you do about that?

00:06:53.480 This was something that actually I found very helpful personally. What can you do to help your

00:06:57.660 kids? Unfortunately, kids are often in an environment educationally that is actually not

00:07:02.880 in the best interest of their school. So one of the best takeaways from this entire episode was

00:07:08.640 what can you do as a parent to make it better for your kid if you don't have the luxury of simply

00:07:14.100 moving them to a school that has a better sleep strategy. It would take me another 10 minutes

00:07:18.300 to go into even at the topic level, what we talked about. So you'll have to take my word for it.

00:07:23.220 This was a great episode, totally worth your while. And without further delay, I'd love to

00:07:28.460 welcome you to my discussion as a follow-up with Professor Matthew Walker.

00:07:35.040 Hey Matt, thank you so much for coming all the way down to San Diego

00:07:38.160 to answer everybody's questions on sleep.

00:07:41.180 It's a pleasure.

00:07:41.880 Yeah. For the sake of time, because we're going to try to do this in under three hours. I won't

00:07:48.700 get to ask you how much fun you had last night in the simulator, but I think in a word, it looked

00:07:52.920 like it was pretty fun. Extra ordinary. Maybe we can convince you to do monthly AMAs if we throw in

00:08:00.320 the simulator. I mean, either or I'll come down for simulator or AMA or both, but it's a pleasure to

00:08:06.360 be back and thank you again for having me and hosting me here at your home. Yeah. Well, this is kind

00:08:10.140 of a first. I know we have never done it where we've taken someone who's been on before as a

00:08:13.820 guest and then brought them back specifically to do an AMA. I know Tim has done stuff like this in

00:08:17.400 the past. It's been quite popular. I think it's safe to say that your three episodes probably

00:08:23.360 generated more questions than any other topic we've covered. And I think that's why we realized

00:08:29.920 this was an important thing to do. And I know how passionate you are about this. In fact, in the

00:08:33.440 interim, since we did our first interview and this one, you've given a Ted talk and I think it just

00:08:38.240 came out, right? Yeah. It just came out. Yeah. We'll be sure to link to that. That's a tough talk

00:08:42.500 to give, huh? That's pretty intimidating. It was a lot of fun, but it was work to being a professor.

00:08:48.240 You know, I lecture most weeks. So you think that you know what you're doing. Ted is different. It has

00:08:53.700 a special aura around it. And then they have a particular sort of style that they would like.

00:09:00.440 So it was something different, but I like that because it stretches you. Just when you think you're

00:09:05.380 starting to perfect a craft, you realize that there's something else left. And to me, it's the

00:09:11.100 difference between being an exceptional public speaker and then being a speaker who has wonderment.

00:09:17.540 And I would rank people like Carl Sagan, Richard Feynman, and then probably Sir Ken Robinson, who's

00:09:24.820 done some fantastic Ted talks. They transcend being an exquisite public speaker into being someone who is

00:09:32.240 just so compelling because they add this sprinkle layer on top called wonderment. And I've yet to

00:09:38.800 ascend that pinnacle of wonderment in my public speaking capacity. I'm getting a little better,

00:09:44.720 but I'll never hit their perfection. Yeah. That's an interesting way to put it. I've heard all of them

00:09:48.560 speak, of course. In fact, Robinson's talk on education is probably the second or third, at least

00:09:54.540 at the last time I ever looked, was probably one of the five most viewed Ted talks. That's right.

00:09:58.480 And we're both from Liverpool. Yeah. Yeah. I got to watch it over and over again. I think you guys

00:10:01.920 have the accent advantage, by the way. I just think like I can listen to the accent all day long.

00:10:06.580 So we've got questions, some of them that are kind of high level, some of them that are super nerdy,

00:10:12.580 and we're going to get through, I think all of these. And you've, I know we have an imposed hard

00:10:17.020 stop so you can get a flight back home. Otherwise I realized this would take easily six hours. So we'll get

00:10:23.480 through what we can and whatever we can't get through. Maybe, you know, you offered to graciously just

00:10:27.080 take a microphone and start recording stuff, which I think people will lap up.

00:10:31.220 I will keep being a repeat offender on the show for as long as you and the listeners have me.

00:10:36.080 Yeah. So let's start with some of the sort of high level questions, right? So this was posed by a

00:10:40.520 reader. So for a healthy adult who wants to optimize their sleep and is willing to do everything they

00:10:45.060 can to get the A plus effort, gun to the head, pick a flawless sleep setup for an unknown healthy adult

00:10:51.740 using the intuition you have built. And so we've talked about some of these things, but how much time

00:10:56.560 should they be sleeping? How consistently do you want to see them hitting deep sleep or asleep?

00:11:00.860 And, you know, now that I think about it, before we ask this question, many of these questions come

00:11:05.100 through the lens of people using devices like Aura, Whoop, Fitbit, probably the Apple watch has

00:11:11.040 something comparable. What I heard you say in our last discussion was those devices are probably

00:11:16.600 pretty good at estimating duration of sleep, probably less good at estimating stage of sleep. Is that a

00:11:22.940 fair assessment? Yeah, I think it is right now. And especially the segregation between sort of rapid

00:11:27.260 eye movement and non-rapid eye movement. You can think of it as a sort of like a three-step level,

00:11:32.240 total sleep time. Are you awake? Are you asleep? Essentially that's kind of like a two-class

00:11:36.840 algorithm, wake sleep. And they're pretty good at that. Step down, then you can do a three-class

00:11:42.460 algorithm. Are you awake? Are you in non-REM sleep? Or are you in REM sleep? And they're pretty good

00:11:48.140 at that. Four-class model is, are you awake? Are you on light non-REM sleep? Are you in deep non-REM

00:11:54.960 sleep? Or are you in REM sleep? That's where they sort of fail. And that's where something like my

00:12:00.080 sleep laboratory continues to be the gold standard. So somewhere between sort of a two-class model and

00:12:06.260 a three-class model, that's where those devices right now are sort of rate limited. So I wouldn't get

00:12:13.160 too nervous about some of your sort of deep sleep versus light sleep numbers. Some of them could be

00:12:19.160 accurate within an individual, but for others, it can be more tricky because of the physiology that's

00:12:23.680 not giving the right signals for class accuracy. Yeah. And what about the relative changes? I mean,

00:12:28.680 this is sort of the way I explain things to my patients, which is probably there's no question I

00:12:32.820 get asked more than, Peter, why is my deep sleep only 17 minutes a night? It should be an hour and a

00:12:39.260 half to which I don't have a great answer other than let's not assume that that's necessarily the

00:12:44.400 case. It may be, it might not be. And unless we did a polysom, I don't think we can know,

00:12:48.480 but what about relative changes? So the most obvious example is alcohol, which we've talked about.

00:12:53.840 There is no doubt that alcohol impacts the model. That's right. In the wrong direction,

00:12:59.020 which gives you some confidence that the model is at least picking up a signal that makes sense.

00:13:03.120 This is a great point, which is overall from one individual to the next, it may be somewhat inaccurate

00:13:08.620 for that real deep classification of varied stages of sleep. But within an individual from one night

00:13:14.740 to the next, it may be routinely inaccurate. Meaning that once you establish some kind of baseline and you

00:13:22.160 see a deviation from that baseline, it's more than likely that that deviation is a real deviation rather

00:13:28.120 than a problem of the technology. Because the technology, even though it's errorful, is consistently

00:13:33.580 errorful night after night after night. And so any variance from that, you're absolutely right.

00:13:39.260 That's probably where you want to focus more of your attention.

00:13:41.920 Yeah. So what I try, and again, please tell me if you disagree, what I try to get people to think

00:13:45.920 about is once you've had these rings or whatever for a few months, you pretty much have a sense of

00:13:51.500 what your baseline is on deep sleep, light sleep, REM, time in bed, et cetera. Don't judge those numbers.

00:13:58.220 Now judge yourself against relative changes from those numbers.

00:14:00.960 Absolutely. So the way I think about this is don't follow headlines, follow weekly trend lines.

00:14:09.540 That's the way that you should really sort of think about this type of data set. Now I can follow

00:14:14.380 headlines in my sleep laboratory because we have that degree of precision and accuracy. But when it

00:14:19.080 comes to these trackers, and I wear them too, and I love the APIs, I just data hungry download it,

00:14:24.820 I will plot all sorts of those trends, but it's the trends to follow, not those sort of daily

00:14:30.480 headlines. Try not to be too worried, except when you see a marked deviation away from the trend line

00:14:36.600 and you think that you can pinpoint the cause, alcohol, great demonstration, jet lag, perfect

00:14:42.680 demonstration, et cetera, et cetera. So that's how you can see it. Yeah.

00:14:45.820 Yeah. I also tell patients they're much better at measuring the raw inputs because at least for

00:14:52.080 Aura, which is the one that I can speak to, because I know the most about it. I mean, they're very

00:14:55.100 good at measuring heart rate, heart rate variability, temperature movement. And those

00:15:00.100 things matter when you're resting heart rate is up seven beats per minute and your heart rate

00:15:04.040 variability is down 20%. Yeah. That's going to impact the algorithm negatively and whether or not

00:15:09.600 the fidelity with which its prediction is perfect, we don't know, but those are bad things. Your heart

00:15:14.600 rate shouldn't be up 10 beats. Your heart rate variability shouldn't get crushed. And as you said,

00:15:18.820 I don't think I've ever seen those things where I couldn't point to the Y. The room was boiling hot.

00:15:24.020 Ate a monster meal 10 minutes before bed. I had two drinks or more. Those are the things that sort

00:15:30.340 of consistently do it, which actually now brings us back to our questions. What is the optimal time

00:15:34.720 to stop eating before bed? So I would say probably about three hours before bed is where I would really

00:15:40.980 cut it off. And the principal reason is just because when you lie down, more likely to get acid reflux,

00:15:47.000 more likely to have digestive issues. That's the first principal reason a lot of people will just get

00:15:52.580 reflux if they eat too much closer to bedtime. The other reason, however, is to be mindful of core

00:15:58.620 body temperature. So the advice generally is don't go to bed too full. Don't go to bed too hungry.

00:16:04.420 And if you do feel as though you ate earlier in the evening and you just need something to take the

00:16:09.900 edge off, try to stay away from sort of simple carbs. The reason being is that those will actually

00:16:16.180 just get translated more quickly into a sort of an energy and ultimately a heat index. And when you

00:16:23.560 need to fall asleep, you need to drop your core body temperature. So if you're fueling yourself

00:16:28.240 with simple carbs right before bed, let's say that you just have a nice big bowl of cereal, sugary sort

00:16:34.140 of nonsense, you will actually see a slight increase in core body temperature because of that sort of

00:16:40.440 sugar caloric burning. That raises core body temperature. That makes it harder for you to

00:16:44.900 fall asleep. Why? Because you need to drop your core body temperature by about two to three degrees

00:16:49.700 Fahrenheit to initiate sleep and then to stay asleep. And that's the reason you'll always find it easier

00:16:55.300 to fall asleep in that room that's too cold than too hot. So that's the second reason that I would

00:17:00.060 say try to back away from food. If you do need to eat, try to maybe lean more towards protein if you can

00:17:05.920 and away from simple sugars just before bed. But for the most part, cut off about three hours.

00:17:10.840 Okay. And I want to come back to temperature in a moment with sleep environment, but let's go to

00:17:15.520 another question, which is the same question, but with respect to exercise. We certainly learned in

00:17:20.660 our first discussion that exercise has many benefits, but vis-a-vis sleep, it generates more

00:17:25.740 adenosine. And adenosine is one of these three pillars that creates this drive for sleep. But can it

00:17:32.240 backfire if you exercise too close to bed? We think it can. I mean, the evidence I would say is

00:17:37.560 moderate to strong and the following reasons. Firstly, you actually get an increase in core

00:17:43.100 body temperature, of course, and then you get this nice sort of down shoot sort of later on and that's

00:17:47.940 good. But if you're exercising, let's say in the last two hours before bed, your core body temperature,

00:17:53.960 depending on what you've done, may still be too high and working against what it would normally like to do

00:17:59.720 from a circadian perspective, which is start to drop down and lull you into sleep by sort of

00:18:06.100 evacuating the core temperature from your body. So be a little bit careful with exercise. Too close

00:18:12.520 to bed, I would say a cutoff of about two hours. The other reason is not just temperature though,

00:18:17.240 but also a whole cascade of hormones. You can typically get epinephrine, norepinephrine, or

00:18:22.880 adrenaline, noradrenaline. They're the same things.

00:18:24.580 Cortisol as well, I'm sure.

00:18:25.960 Cortisol usually has a time decay of exercise. And again, it depends on what you're doing,

00:18:30.100 of course, but sort of somewhere between 90 to 120 minutes. So those things can actually work

00:18:36.560 against you in terms of sleep. But for the most part, exercise, anything that is before two hours

00:18:43.240 of sleep is a fantastic tool in terms of sleep promotion. What I would say though, is that the data

00:18:50.060 in the opposite direction is even more powerful. And I think we chatted a little bit about this.

00:18:55.020 It's not just that exercise helps sleep. Sleep profoundly helps exercise. And in fact,

00:19:00.800 that is a two-way street. But if the traffic is flowing more dominantly, I would argue the evidence

00:19:05.300 is that sleep is better for exercise and they're both reciprocally beneficial. And what we know is that

00:19:11.580 when you're sleeping well, firstly, just your motivation to do anything, and especially exercise,

00:19:17.920 is increased dramatically. So forget anything thereafter, the likelihood that you're going

00:19:22.660 to get into the gym, get out on the bike, get out on the road and start pounding the pavement

00:19:26.800 far higher when you've slept well. Thereafter, it's great. Peak muscle strength increases.

00:19:32.540 Your ability to respire and expel carbon dioxide is improved the more sleep that you're getting.

00:19:38.180 Likelihood of injury risk, markedly decreased. Your ability to even sweat and perspire is determined

00:19:45.860 by how much sleep that you get. And we sometimes forget how critical perspiration is for optimal

00:19:52.000 exercise. So it's just a peak muscle strength, all of those things. It's just this cascade of benefit

00:19:58.560 that you get from sleep from the point of getting out of bed, getting started. And then once you get

00:20:03.680 started, exactly what your performance will be, including time to physical exhaustion, which we

00:20:08.280 mentioned last time too. Beautiful relationship there between those two.

00:20:11.900 Yeah. Two nights ago, I flew back from New York and I almost always take the morning flight back

00:20:17.580 because one, you're more productive on the airplane. It's just the morning. There's a far

00:20:21.980 less chance of delay on the first flight out of New York than the last flight out. But occasionally you

00:20:26.500 just, whatever the schedule on. So I had to do what I hate doing, which is take the 8 PM flight

00:20:30.800 from JFK back. And as is the case, at least 50% of the time crew shows up late. By the time the crew

00:20:38.280 gets there an hour and a half later, you're number 317 on the runway. I mean, we didn't get back until

00:20:44.020 like two and a half hours later than planned. So, and I have a pretty fixed wake up time just both

00:20:50.040 because of the jet lag coming back, but also the kids. So I woke up yesterday morning only having

00:20:55.760 five hours of sleep, which was I think good, all things considered, but it's less than what I've now

00:21:00.100 become accustomed to. And it's interesting you say this because I worked out in the morning and my wife

00:21:05.600 asked me later in the day, she was like, how was your workout? And I was like, I got to tell you,

00:21:08.780 it was miserable. Not for any other reason than I didn't want to even be in the gym.

00:21:12.580 It was like two hours of how quickly can I be done with this? I just don't want to be here.

00:21:18.740 For what it's worth, I didn't perform well either. But what caught my attention was how

00:21:22.960 little I wanted to be in the gym. If that's not bad enough, what you also do is get a compounding

00:21:28.500 set of problems atop of that, which is your appetite. And I think there was a question that

00:21:33.660 maybe I can try to weave in here, which is when you are sleep deprived, essentially what the brain

00:21:39.380 receives is a signal that is not dissimilar to starvation. And it releases a cascade of hormones

00:21:47.640 that change your appetite profile. You want to eat more and you're less satisfied with your food.

00:21:53.340 Why is this? The reason is the following, and we've mentioned it before, I think briefly,

00:21:58.080 human beings seem to be the only species that will deliberately deprive themselves of sleep for no

00:22:02.780 apparent reason. Only other time that we see this in the wild where it does seem to have an impact

00:22:09.520 is when animals are under conditions of starvation. When you get a starvation signal, it usually is

00:22:16.500 sort of the cause of saying you need to forage in a larger perimeter area for you to survive. And the

00:22:23.420 way that you're going to do that is probably to stay awake for longer hours so you can forage further.

00:22:28.180 So what happens when the body undergoes sleep deprivation is that the brain thinks,

00:22:34.720 oh, I must be under conditions of starvation. From an evolutionary perspective, the only time

00:22:39.140 I'm ever sleep deprived is when I'm starving, when I'm under conditions of starvation. Now,

00:22:44.860 human beings, when they sleep deprive themselves, they're not under conditions of starvation. So it's

00:22:49.560 a fake starvation signal. So when you're deprived, your brain thinks, oh my goodness, I must be under

00:22:56.500 starvation. It increases a hormone called ghrelin, which makes you want to eat more. It suppresses a

00:23:03.200 hormone called leptin, which says you're satisfied with your food, don't eat more. So overall hunger

00:23:08.620 levels go up, you start to eat more. Now we combine that with this lack of motivation of exercise in all

00:23:15.540 sorts of obesogenic directive territory, eating more, wanting to exercise less, you're burning fewer

00:23:21.880 calories. That usually is why we're starting to understand part of the sleep dependent obesogenic

00:23:27.500 equation. And the other hormone that plays, I think, at least for me, an increasingly greater and

00:23:32.780 greater role in that cascade is cortisol. Because of its role directly on the adipocyte, it is a very

00:23:40.560 anabolic hormone to adipose tissue and a very catabolic hormone to muscle tissue, but also its

00:23:46.020 effect on the liver and glycogen stores via hepatic glucose output. So it's raising glucose,

00:23:50.500 which in turn is raising insulin, which is now acting alongside cortisol. I mean, it seems intuitive

00:23:56.920 to me, but I don't know what the evidence is that sleep deprivation would tend to also run with

00:24:02.900 hypercortisolemia. We can see why hypercortisolemia would drive sleep deprivation. Do we think that there's

00:24:08.600 a feedback loop that is in the wrong direction, i.e. the more sleep deprivation you have, the more

00:24:14.760 cortisol that the animal or human tends to produce? That's exactly what we see typically. Yeah. And if

00:24:20.100 you can go into that state chronically, which is what most of society is not pulling all-nighters,

00:24:24.940 most of society is chronically underslept. So what you end up doing is having this kind of chronic

00:24:30.760 mid to high level of hypercortisolemia. And that is leading to all of this cascade of biology that

00:24:39.140 is non-optimal, part of which is a collection of changes, not just in the brain, but also in the body

00:24:46.300 too. That cortisol spike can actually lead to things like anxiety. And what you should not have if you're

00:24:54.440 looking for good sleep is a high level of cortisol. And so it's bidirectional that the less that you're

00:25:00.660 sleeping, the higher that cortisol level. If that cortisol level stays high at night, it's very

00:25:05.720 difficult to get the good sleep that you need and so on and so forth. And that might also be

00:25:10.500 evolutionary, right? It might be that when the animal is sleep deprived, the evolutionary trigger is

00:25:15.620 there's a reason you're sleep deprived. You will need more cortisol. That's right. I had this discussion

00:25:20.140 with Robert Sapolsky where we went into great detail about the role of cortisol in the subacute

00:25:25.340 level of stress, which is actually for many people, not the stress we're under, but evolution doesn't

00:25:31.720 know the difference. Right. Yeah. We've imposed sort of the mental saber tooth tiger, which is called

00:25:37.500 societally triggered anxiety. I should put fangs on my phone. You know, it's nothing more than a

00:25:43.780 collection of electronics. And yet it induces in me the same feeling as a saber tooth tiger would

00:25:50.000 if it were just growling around me from a hundred yards away in perpetuity.

00:25:54.660 Yeah. And just like that, you have night shift on your iPhone. Those fangs during the day should

00:25:59.080 switch to a sign with a lots of Z's and then a big strike against them over there, because that's 0.50

00:26:04.760 essentially what it's going to do to your sleep as well.

00:26:06.920 Well, let's talk a little bit about the wind down routine then. That's a nice foray into that. So

00:26:10.680 I think anybody listening to this who is obviously so curious about sleep has thought about this idea of,

00:26:16.880 okay, you've made a very compelling case in our first discussion that if you want to sit there

00:26:22.680 on your phone, glued to your phone in bed until you put it down, that's just a recipe for disaster.

00:26:28.300 So we accept the fact that we've got to get the electronics out of the way because of two reasons,

00:26:34.380 at least, right? The blue light itself is damaging and it prevents the pineal gland from getting ready

00:26:38.660 to give us that surge of melatonin. But also there's kind of an emotional piece of that as well.

00:26:43.560 So if you were giving somebody advice on the perfect wind down routine, and this is a real

00:26:48.760 person. So this isn't someone who has the luxury of being on a meditation retreat their whole life.

00:26:53.400 This is someone who has a job. This is someone who has a boss. This is someone who is still

00:26:58.560 accountable and lives in a world that unfortunately demands paying attention to their phone, but they're

00:27:04.280 committed to getting the best sleep they can. How would you counsel them at 6 PM? They just finished

00:27:09.660 dinner or 6 30, whatever. What should they be doing between now and say 9 30?

00:27:14.860 Hey everyone. Hope you enjoyed a sneak peek of this AMA. AMAs along with extensive show notes and

00:27:19.980 member only discounts on products that I think are awesome are available to subscribers only.

00:27:24.220 So if you're interested in hearing the remainder of this AMA or want to access any other benefits that

00:27:27.940 come with being a subscriber, please head over to peteratiamd.com forward slash subscribe to learn

00:27:33.060 more and sign up. You can find all of this information and more at peteratiamd.com forward

00:27:40.100 slash podcast. There you'll find the show notes readings and links related to this episode. You can

00:27:45.900 also find my blog at peteratiamd.com. Maybe the simplest thing to do is to sign up for my subjectively

00:27:51.600 non lame once a week email where I'll update you on what I've been up to the most interesting papers

00:27:56.480 I've read and all things related to longevity, science, performance, sleep, etc. On social,

00:28:02.260 you can find me on Twitter, Instagram, and Facebook all with the ID peteratiamd.com. But

00:28:07.360 usually Twitter is the best way to reach me to share your questions and comments. Now for the

00:28:11.460 obligatory disclaimer, this podcast is for general informational purposes only and does not constitute

00:28:16.100 the practice of medicine, nursing, or other professional healthcare services, including the

00:28:21.000 giving of medical advice. And note, no doctor patient relationship is formed. The use of this

00:28:26.540 information and the materials linked to the podcast is at the user's own risk. The content of this

00:28:31.540 podcast is not intended to be a substitute for professional medical advice, diagnoses, or treatment.

00:28:37.000 Users should not disregard or delay in obtaining medical advice for any medical condition they have

00:28:41.580 and should seek the assistance of their healthcare professionals for any such conditions.

00:28:46.720 Lastly, and perhaps most importantly, I take conflicts of interest very seriously. For all of my

00:28:51.440 disclosures, the companies I invest in and or advise, please visit peteratiamd.com forward slash about.

00:29:01.540 Thank you.

00:29:03.540 Thank you.

00:29:04.540 Thank you.

00:29:05.540 Thank you.

The Peter Attia Drive - June 17, 2019

#58 – AMA with sleep expert, Matthew Walker, Ph.D.： Strategies for sleeping more, sleeping better, and avoiding things that are disrupting sleep

Episode Stats

Summary

Transcript